WOLLEGA UNIVERSITY

SCHOOL OF MEDICINE& ANESTHESIA

Seminar presentation on: Pre-Operation Blood
Transfusion
By: kalkidan Muliye
Instructor : Mr. Nega (ass.prof)
 outline
 History of blood transfusion
 Definition of blood transfusion
 Function and components of blood
 Types of blood transfusion
 Indication of blood transfusion
 Pre-operative blood transfusion
 Risk, complication and procedure done for
blood transfusion
 History of blood transfusion
“In 1492, sick Pope
Innocent VIII is said to
have received blood
prescribed by Jewish
physician, a transfusion of
the blood of three ten year
old boys, each of whom
was paid a Gold coin and
all of whom died.
 Probably the blood was
drawn, but was intended
to be taken orally.’’
 …
• In 1628 British
physician William
Harvey discovers the
circulation of blood.
The first known blood
transfusion is
attempted soon
afterward.
 …
• In 1665 The first recorded successful blood
transfusion occurs in England: Physician
Richard Lower keeps dog alive by transfusing
blood from other dogs.
 …
• In 1901 Karl
Landsteiner, an
Austrian physician,
discovers the first three
human blood groups.
• The Nobel Prize in
Physiology or Medicine
1930 was awarded to
Karl Landsteiner"for
his discovery of human
blood groups".
 …
• In 1947 ABO blood-typing and syphilis testing
is performed on each unit of blood.
WHAT IS BLOOD ?

• Blood is essential to life. Blood circulates

through our body and delivers essential
substances like oxygen and nutrients to the
body's cells.
 DEFINITION
• Blood transfusion is the
process of transferring
blood products into one's
circulation intravenously.
OR
• Is the procedure of
introducing the blood of a
donor, or pre donated
blood by a recipient into
the recipient’s bloodstream
 What is the function of blood?
Blood carries the following to the body tissues:
• Nourishment
• Electrolytes
• Hormones
• Vitamins
• Antibodies
• Heat
• Oxygen
• Immune cells (cells that fight infection)
 …
Blood carries the following away from the
body tissues:
• Waste matter
• Carbon dioxide
 What are the components of blood?
The components of human blood are:
• Plasma. Is the liquid component of the blood in which it holds : amino acids, nutrients,
nitrogenous waste, electrolytes and portions.
the protein also contain - Albumin,
- Fibrinogen
- Globulin
 Formed cells or cellular elements contain:
• Red blood cells (erythrocytes). These carry oxygen from the lungs to the rest of the body
• White blood cells (leukocytes). These help fight infections and aid in the immune process. Types
of white blood cells include:
• Lymphocytes
• Monocytes
• Eosinophils
• Basophils
• Neutrophils
• Platelets (thrombocytes). These help in blood clotting
…
What are the type of blood transfusion

These include 
• red cells,
• platelets,
• plasma,
• cryodepleted plasma and
• cryoprecipitate. 
…
 Indications for blood transfusion
 Indications for transfusion include:
• Red blood cell transfusions: are used to treat
hemorrhage and to improve oxygen delivery to
tissues
• symptomatic anemia (causing shortness of breath,
dizziness, congestive heart failure, and decreased
exercise tolerance), acute sickle cell crisis, and
acute blood loss of more than 30 percent of blood
volume.
 …
• Fresh frozen plasma (FFP)infusion: can be used
for reversal of anticoagulant effects.
• Platelet transfusion is indicated: to prevent
hemorrhage in patients with thrombocytopenia
or platelet function defects.
• Cryoprecipitate is used: in cases of
hypofibrinogenemia, which most often occurs in
the setting of massive hemorrhage or
consumptive coagulopathy. 
 o n
fu si
a ns
Tr
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B l
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 Perioperative Blood Transfusion
• Perioperative blood transfusion addresses the
- preoperative,
- intraoperative, and
- postoperative administration of blood and
blood components. (e.g., allogeneic or
autologous blood, red blood cells, platelets,
cryoprecipitate, and plasma products, fresh-
frozen plasma [FFP].
 Preoperative Blood Transfusion
• Preoperative blood transfusion is the process of
receiving blood transfusion before a scheduled
surgical procedure.
• The purpose of preoperative blood transfusion
is to increase the patient's hemoglobin level and
restore their blood volume before surgery,
which can help reduce the risk of blood loss
during the procedure and decrease the need
for post-operative transfusion.
 …
• Preoperative blood transfusion may be
recommended for patients who have anemia or
low hemoglobin levels, which can be caused
by various conditions such as chronic kidney
disease, cancer, or gastrointestinal bleeding.
Depending on the severity of the anemia, the
patient may need one or more units of blood to
restore their hemoglobin levels.
 …
• However, preoperative blood transfusion is not
without risks. Potential complications of blood
transfusion include transfusion reactions,
infections, and transfusion-related acute lung
injury (TRALI). Therefore, the decision to
perform preoperative blood transfusion should be
based on a careful evaluation of the patient's
individual risks and benefits, and should be made
in consultation with their healthcare provider.
 Indications of blood transfusion can be summed up as:

• Anemia
• Major Surgical Operation.
• Accidents resulting in considerable blood loss.
• Cancer patients requiring therapy.
• Women in childbirth and newborn babies in certain
cases.
• Patients of hereditary disorders like Hemophilia and
Thalassemia.
• Severe burn victims.
WHO GUIDELINES FOR BLOOD TRANSFUSION

• Trigger's for blood transfusion(in adults)

• Preoperative transfusion:
- Hgb<8gm/dl for pts undergoing
cardiovascular sx
- orthopedic sx & acute GI bleeding.
• For chronic anaemia (Hgb<7gm/dl in adults
• Acute blood loss: >30% of blood volume
 Risks & Complications
Blood Transfusions:
• Often patients who have
received a blood
transfusion experience
no complications or
problems. However,
minor to severe
problems do
occasionally occur.
• Some of the most
common complications
in blood transfusions
are listed below:
 …
• Allergic Reactions: Some people have allergic
reactions to blood received during a transfusion, even
when given the right blood type. In these cases
symptoms include hives and itching. Like most
allergic reactions, this can be treated with
antihistamines.

• Fever: Developing a fever after a transfusion is not

serious. A fever is your body’s response to the white
blood cells in the transfused blood. However, it can be
a sign of a serious reaction if the patient is also
experiencing nausea or chest pain.
 …
• Blood borne infections: Blood banks screen
donors and test donated blood to reduce the risk of
transfusion-related infections, so infections, such as
HIV or hepatitis B or C, are extremely rare.
 Other serious reactions: Also rare, these
include:
• Acute immune hemolytic reaction: Your immune
system attacks the transfused red blood cells
because the donor blood type is not a good match.
The attacked cells release a substance into your
blood that harms your kidneys.
 …
• Delayed hemolytic reaction. Similar to an acute
immune hemolytic reaction, this reaction occurs more
slowly. It can take one to four weeks to notice a
decrease in red blood cell levels.

• Graft-versus-host disease. In this condition,

transfused white blood cells attack your bone
marrow. Usually fatal, it's more likely to affect people
with severely weakened immune systems, such as
those being treated for leukemia or lymphoma.
How to prepare and the procedur for blood transfusion

Blood will be tested

before a transfusion to
determine whether the
blood type is A, B, AB or
O and whether the blood
is Rh positive or Rh
negative. The donated
blood used for the
transfusion must be
compatible with the blood
type.
The procedure for blood transfusion typically
involves several steps
Step 1. Patient evaluation: The healthcare provider will
evaluate the patient's medical history, current condition,
and blood type to determine if a blood transfusion is
necessary and what type of blood product is required. 

Step 2. Informed consent: The healthcare provider will

explain the risks and benefits of the transfusion to the
patient and obtain their informed consent.
 
 …
Step 3. Blood typing and crosshatching: Blood
samples from the patient and the donor blood are
tested to determine compatibility and prevent
transfusion reactions. 

Step 4. Preparation of blood product: The blood

product is prepared by a blood bank technician and
may be modified to meet specific patient needs,
such as removing certain components or adding
medications.
 …
Step 5. Verification: The healthcare provider will verify the
patient's identity and the blood product to ensure that they
match.

Step 6. Administration: The blood product is administered

through an intravenous (IV) line, typically in the arm. The
healthcare provider will monitor the patient closely for signs of
transfusion reactions, such as fever, chills, itching, or shortness
of breath.

Step 7. Post-transfusion monitoring: After the transfusion,

the healthcare provider will continue to monitor the patient for
several hours to ensure that there are no adverse reactions.
GALATOOMA!!!