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What is blood?
Blood is a living tissue composed of two parts: liquid
and solid. The liquid part, called plasma, is made of water, salts, and proteins. Your blood is about 55 percent plasma. The rest of your blood contains cells such as red blood cells, white blood cells, and platelets. Hemoglobin Hemoglobin makes blood look red. It is a protein in red blood cells that carries oxygen from the lungs to the body, and brings the waste product, carbon dioxide, back to the lungs to be exhaled.
Red blood cells may also be needed during and after surgery. aplastic anemia. thalassemia. or cancer. .Components of Blood y Red blood cells Red blood cells carry oxygen to and from tissues and organs. Transfusions of red blood cells help patients with sickle cell disease. leukemia.
Platelet transfusions control bleeding in patients with leukemia and cancer.y Platelets Platelets help blood clot. They also help patients after surgery. .
or leukocytes (also spelled "leucocytes.White blood cell y White blood cells. . are cells of the immune system involved in defending the body against both infectious disease and foreign materials." "leuco-" being Greek for white).
.y Plasma Plasma helps blood clot in patients having surgery. and in those with cancer or immune disorders.
common procedure in which blood is given to you throughan intravenous (IV) line in one of your blood vessels. A transfusion also may be done if your body can't make blood properly because of an illness .Blood transfusions are done to replace blood lost during surgery or due to a seriousinjury.What Is a Blood Transfusion? y A blood transfusion is a safe.
and AB. A. The four major blood groups are O. y Blood group y Red blood cells are covered by proteins that make up a person s blood group. A low hematocrit may mean that you have anemia.y Hematocrit y Your hematocrit is the percentage of red blood cells in relation to how much blood you have. B. .
almost 5 million Americans need ablood transfusion. Most blood transfusions go well. The procedure usually takes1 to 4 hours. Through this line. Mild complications can occur. depending on how much blood you need. Veryrarely. serious problems develop . Each year.y During a blood transfusion. you receive healthy blood. a small needle is used to insert an IV line into one of your blood vessels.Blood transfusions are very common.
platelets (PLATE-lets). Having a healthy supply of blood is important to your overall health. and plasma. Blood has many vital jobs. It carries oxygen and other nutrients to your body's organs and tissues. Blood is transfused either as whole blood (with all its parts) or. more often. white blood cells. including red blood cells.Important Information About Blood The heart pumps blood through a network of arteries and veins throughout the body. Blood is made up of various parts. . as individual parts.
if you have type A blood. every person's blood is either Rh-positive or Rh-negative. So. antibodies (proteins) in your blood attack the new blood and make you sick. Type O blood is safe for almost everyone. The blood used in a transfusion must work with your blood type. B. If it doesn't. Type O blood is used for emergencies when there's no time to test a person's blood type. . AB. or O. it's either A positive or A negative. People who have this blood type are called universal donors. Also.Blood Types Every person has one of the following blood types: A. About 40 percent of the population has type O blood.
y If you have Rh-positive blood. you should only get Rh-negative blood. you can get Rh-positive or Rh-negative blood. But if you have Rh-negative blood. .y People who have type AB blood are called universal recipients. Rhnegative blood is used for emergencies when there's no time to test a person's Rh type. This means they can get any type of blood.
B. that could make you sick. such as viruses. Blood bank staff also screen each blood donation to find out whether it's type A. . and store blood. Getting a blood type that doesn't work with your own blood type will make you very sick.Blood Banks Blood banks collect. test. They carefully screen all donated blood for possible infectious agents. AB. That's why blood banks are very careful when they test the blood. or O and whether it's Rh-positive or Rh-negative.
If it's surgery that you're able to schedule months in advance. your doctor may ask whether you would like to use your own blood. This process is called white cell or leukocyte (LU-ko-site) reduction. rather than donated blood. To prepare blood for a transfusion. Removing these cells makes allergic reactions less likely. If you're going to have surgery. some people are allergic to white blood cells in donated blood. . you may need a blood transfusion because of blood loss during the operation. Although rare. Not all transfusions use blood donated from a stranger. some blood banks remove white blood cells.
. There's currently no man-made alternative to human blood.y If you choose to use your own blood. A blood bank will store your blood for your use. researchers have developed medicines that may help do the job of some blood parts. However. y Alternatives to Blood Transfusions y Researchers are trying to find ways to make blood. you will need to have blood drawn one or more times prior to the surgery.
some people who have kidney problems can now take a medicine called erythropoietin that helps their bodies make more red blood cells. y Surgeons try to reduce the amount of blood lost during surgery so that fewer patients need blood transfusions.y For example. . This means they may need fewer blood transfusions. Sometimes they can collect and reuse the blood for the patient.
Transfusions are needed for patients having surgery. and leukemia. or for those being treated for blood disorders. cancer. Clinical Center patients need about 5.000 transfusions of platelets every year.PREPARING FOR BLOOD TRANSFUSION y Each year.000 units of red blood cells and 3. . over 4 million Americans get blood transfusions.
Complications of transfusions Transfusions of blood products is associated with several complications. lung injury. Nonimmunologic complications include infections. or non-immunologic complications. delayed hemolytic reactions. and transfusion purpura. febrile nonhemolytic reactions. volume overload. hypothermia. which can be broadly categorized as immunologic transfusion reactions. Immunologic reactions include acute hemolytic reactions. The risks of complications usually increase with increasing frequency and volume of transfusion. and coagulopathy. . allergic reactions.
Delayed hemolytic reactions occur more frequently (about 0.Immunologic reactions Acute hemolytic reactions occur with transfusion of red blood cells. Treatment is supportive. When suspected. and blood sent for tests to evaluate for presence of hemolysis. increased heart rate. evidence of hemolysis and falling hemoglobin levels may still occur. and rapid drop in blood pressure. but due to the presence of recipient antibodies. shortness of breath. with about 0. and occurs in about 0. Kidney injury may occur due to the effects of the hemolytic reaction (pigment nephropathy). the consequences are generally mild and a great proportion of patients may not have symptoms. hemorrhage. Treatment is generally not needed. transfusion should be stopped immediately.025 percent of transfusions) and are due to the same mechanism as in acute hemolytic reactions.003 percent being fatal.016 percent of transfusions. chills. However. Most often this occurs due to clerical errors or improper typing and crossmatching. future compatibility may be affected. . Symptoms include fever. chest pain. This is due to destruction of donor erythrocytes by preformed recipient antibodies. back pain. However.
may develop an anaphylactic reaction. Febrile nonhemolytic reactions are due to recipient antibodies to donor white blood cells. and does not require prior exposure to transfusions. . and may proceed to anaphylactic shock. pruritus. Symptoms include urticaria. and upon exposure to IgA-containing blood. Treatment is the same as for any other type 1 hypersensitivity reactions. and transfusions may be finished as long as an acute hemolytic reaction is excluded. Fever is generally short lived and is treated with antipyretics. This may occur after exposure from previous transfusions. Allergic reactions may occur when the recipient has preformed antibodies to certain chemicals in the donor blood. A small population (0. and occurs in about 7% of transfusions.13%) of patients are deficient in the immunoglobin IgA.
and recipients should only receive future transfusions with washed cells or HPA-1a negative cells. Transfusion-associated acute lung injury (TRALI) is an increasingly recognized adverse event associated with blood transfusion. and the mortality rate from this condition is less than 10%. Because these types of antibodies are commonly formed during pregnancy. Treatment is with intravenous immunoglobulin. TRALI is typically associated with plasma components rather than packed red blood cells (RBCs). it has been consistently associated with anti-HLA antibodies. Although the cause of TRALI is not clear. Posttransfusion purpura is a rare complication that occurs after transfusion containing platelets that express a surface protein HPA-1a. TRALI is a syndrome of acute respiratory distress. but most patients recover fully within 96 hours. which may occur as often as 1 in 2000 transfusions. and hypotension. . though there is some residual plasma in RBC units. and develop thrombocytopenia about 7 10 days after subsequent transfusions. often associated with fever. Symptoms can range from mild to life-threatening. Recipients who lack this protein develop sensitization to this protein from prior transfusions. several transfusion organisations have decided to use only plasma from men for transfusion. non-cardiogenic pulmonary edema.
Hypothermia can occur with transfusions with large quantities of blood products which normally are stored at cold temperatures.Nonimmunologic complications Transfusion-associated volume overload is a common complication simply due to the fact that blood products have a certain amount of volume. . Plasma transfusion is especially prone to causing volume overload due to its hypertonicity. Prevention should be done with warming the blood to ambient temperature prior to transfusions. Core body temperature can go down as low as 32 °C and can produce physiologic disturbances. This is especially the case in recipients with underlying cardiac or kidney disease.
Close monitoring and transfusions with platelets and plasma is indicated when necessary. The mechanism is thought to be due to disseminated intravascular coagulation. Transfusions with large amounts of red blood cells can lead to an inclination for bleeding. Metabolic alkalosis can occur with massive blood transfusions due to the breakdown of citrate stored in blood into bicarbonate Hypocalcemia can also occur with massive blood transfusions due to the complex of citrate with serum calcium . along with dilution of recipient platelets and coagulation factors.
Despite this. many cases of HIV seropositive blood were missed. the transmission of HIV during transfusion has dropped dramatically. HIV transmission can still occur but with a rate of even less than this. cytomegalovirus infections (in immunocompromised recipients).Infectious complications Ever since the advent of HIV testing of donor blood starting in the 1980s. The development of a nucleic acid test for the HIV-1 RNA has dramatically lowered the rate of donor blood seropositivity to about 1 in 3 million units. syphilis. Such low rates has mostly been attributed to the ability to screen for both antibody as well as nucleic acid testing for viral RNA in donor blood. due to the existence of a window period (a period of time a person is infectious but has not had time to develop antibodies). The transmission of hepatitis C via transfusion currently stands at about a rate of 1 in 2 million units. Prior testing of donor blood only included testing for antibodies to the HIV virus. . Other rare transmissible infections include hepatitis B. and HTLV. However. Chagas disease.