Blood Transfusion, This You Need to Know

Blood transfusion is a procedure for delivering blood collected in blood bags to people who need blood, through veins (intravenously). Blood supplied comes from donors. Blood transfusion is part of the treatment of doctors to save the lives of patients who lack blood or are suffering from certain diseases. Transfused blood can be in the form of a whole blood component (whole blood), or just one component of the blood, including:

• Red blood cells (packed red cell / PRC). It is the component of blood that is most often transfused. Red blood cells function to carry oxygen from the heart throughout the body and remove carbon dioxide and body wastes.
• Platelets (thrombocyte concentrates / TC). Play a role in stopping bleeding.
• Clotting factor (cryoprecipitate). Like platelets, they play a role in stopping bleeding.
• Blood plasma (fresh frozen plasma / FFP). Blood plasma is a blood component that is liquid, which contains clotting factors, protein, vitamins, calcium, sodium, potassium, and hormones.

Indications for Blood Transfusion

Blood transfusion will be given if the patient has deficiency of one or all components of the blood. The type of blood given will be adjusted to the needs of the patient in reference to the situation or condition experienced, including:

• Transfusion of PRC.

Anemia or low Hb is a condition that underlies a person given PRC. Anemia can occur in children as well as adults. Some diseases that can cause anemia and require transfusion of red blood cells, namely thalassemia, aplastic anemia, or anemia due to bleeding.

• TC or cryoprecipitate transfusion.

Thrombocytes or cryoprecipitate will be given to a patient if the patient has bleeding or is suspected of having bleeding due to blood clotting disorders, such as hemophilia or thrombocytopenia.

• FFP transfusion.

Needed when experiencing severe infections, liver disease or severe burns. FFP also contains clotting factors, so that in some cases bleeding, FFP can be given.

Before Blood Transfusion

Patients will be taken blood samples to check blood type, based on blood type ABO (A, B, AB, or O) and based on rhesus (Rh) divided rhesus positive and negative. After the blood type is appropriate, a re-examination will be carried out by matching the blood type taken from the donor with the recipient's blood type (recipient), called a crossmatch. At the time of crossmatch, not only match the donor's blood group with the recipient, but also the appearance of antibodies that might attack the donor's blood cells and endanger the recipient's body.

Blood Transfusion Procedure

Blood transfusion can generally take up to 4 hours or faster depending on the type of blood and the amount of blood given. The patient can be asked to lean back in a chair or lie on the bed. After that, the doctor will stick a needle into a vein around the arm. The needle that enters the blood vessel is then connected by a catheter or thin tube that connects to the blood bag. At this stage, blood will be flowed using a thin tube, from the blood bag to the blood vessels. In the first 15 minutes of a blood transfusion, the patient's condition will continue to be monitored to ensure the patient does not experience an allergic reaction. If symptoms of an allergic reaction occur, the procedure can be stopped immediately. After an hour of running tests and no allergic reactions, doctors or nurses can speed up the blood transfusion process.

After Blood Transfusion

The doctor or nurse will remove the tube that was previously inserted into a vein. The patient's vital condition will be monitored, ranging from heart rate, blood pressure, to body temperature.

Risk of Blood Transfusion

Risks that can arise, though rarely, at the time of blood transfusion or some time after, include:

• Fever.

Can occur suddenly when blood transfusion. However, fever is a form of the body's response to donor white blood cells that enter the recipient's body. This condition can be treated by administering a fever-reducing drug or prevented by giving a type of blood that has been discharged white blood cells (leukodepleted).

• Allergic reaction.

Cause discomfort, chest or back pain, difficulty breathing, fever, chills, reddened skin, rapid heartbeat, drop in blood pressure, and nausea.

• Iron overload.

Too much amount of blood transfused can cause excess iron. This condition is commonly experienced by people with thalassemia, who often need blood transfusions. Excess iron can cause damage to the heart, liver and other organs.

• Lung injury.

Although rare, blood transfusions can damage the lungs. This condition generally occurs 6 hours after the procedure is done. In some cases, patients can recover from this condition. However, as many as 5-25 percent of patients suffering from lung injuries can lose their lives. Not yet known why blood transfusions can damage the lungs,

• Infection.

Infectious diseases, such as HIV, hepatitis B, or hepatitis C, can be transmitted through the blood of donors. But this is very rare in the present, because the blood to be donated has been checked in advance for the presence or absence of infection that can be transmitted through blood.

• Graft versus host disease

Transfused white blood cells will invade recipient tissue. This disease is classified as fatal and the risk of attacking people who have low immunity, such as people with autoimmune diseases, leukemia or lymphoma.

• Acute immune hemolytic reaction.

The immune system will attack the transfused blood cells, which is caused by a mismatch of blood received by the patient. In this condition, blood cells that have been attacked will release compounds that harm the kidneys. Delayed hemolytic reaction. Similar to acute immune hemolytic reaction, only the reaction runs slower (within 1-4 weeks). This reaction can reduce the number of red blood cells slowly to a very low level, even the sufferer can become unconscious. Hemolytic reactions, both acute and delayed, usually occur in patients who have received blood transfusions before.