Blood transfusions

Why are blood transfusions performed?

There are several different components of the blood that can be transfused into a child. Red blood cells are the most common type of blood product transfusion. If your child's physician has decided your child might need a transfusion of blood, or blood products, he or she will explain the reasons for the transfusion. There are several reasons why your child may require a blood transfusion, including the following:

• A sudden loss of blood (sometimes as high as a quarter of the normal blood volume).
• A low hemoglobin before, during or after surgery.
• Severe heart or lung disease.
• Bone marrow failure.
• Moderate to severe anemia.

What is blood made of?

Human blood is made of a fluid called plasma that carries red and white blood cells and platelets. Each part of blood has special functions and can be separated from each other. The bone marrow is the spongy material in the center of the bones that produces about 95 percent of the body's blood cells.

What are red blood cells?

Red blood cells carry oxygen from the lungs to other body organs and carry carbon dioxide back to the lungs. A certain number of these cells are needed for the body to function. Bleeding due to trauma, surgery or disease may cause a low red blood cell count.

What are white blood cells?

White blood cells fight infections by destroying bacteria, viruses and other germs. White blood cell transfusions are rarely given. They are usually reserved for children who have a low white cell count and severe infection that is not responsive to antibiotic therapy.

What are platelets?

Platelets help control bleeding by covering blood vessels opened by injury or surgery. The body may not be able to make enough platelets because of bone marrow disorders, increased destruction of platelets or medications such as chemotherapy. Platelets may be transfused before an invasive procedure that may cause a child with a low platelet count to bleed.

What is plasma?

Plasma carries the blood cells throughout the body and contains proteins, vitamins, and minerals. Some of the proteins help the blood to clot. Plasma or fresh frozen plasma can be transfused in children who have a severe deficiency of certain clotting components of the blood.

Are blood transfusions safe?

The blood used at most hospitals is from volunteer donors. Donors are not paid for giving blood or blood products. Each blood donor must answer medical history questions and be given a limited physical examination before being accepted as a donor. The donated blood is carefully tested for hepatitis, syphilis and antibodies to two immunodeficiency viruses, including the AIDS virus. These tests decrease the chances of transfusion-related infections.

How is blood transfused?

Blood is collected and stored in sterile bags. The bags are used once and then thrown away. Before blood is given to your child, it is crossmatched with their own blood to make sure it is compatible. The blood will be given through a needle or catheter placed in the vein. Your child's temperature, blood pressure and heart rate will be checked many times while the blood is being given. It may take a few hours to complete the process.

What is directed donation?

A directed (or designated) blood donation is one in which a person donates blood that is reserved (at the time of donation) for the transfusion of a specific patient at a later date. The donor is usually a family member or a close friend that has been chosen by the patient's family. Consult your child's physician if you are interested in learning more about directed donation. It is recommended that families donate in the child's name versus directed donation, because if directed blood is not needed, it is wasted.

Are directed donors safer than volunteer donors?

There is no proof that directed donors are safer than volunteer donors. Many directed donors have never donated blood before, and so, have not been proven (by repeated donations) to be free of infectious agents. Not all directed donor blood will be compatible with the patient's blood.

Are there risks in receiving a blood transfusion?

Most transfusions are performed without any problems. Mild side effects may include symptoms of an allergic reaction such as headache, fever, itching, increased breathing effort, or rash. This type of reaction can usually be treated with medication, should your child require additional transfusions. Serious reactions are rare. The most common serious side effect is serum hepatitis, an infection of the liver. Transfusion with blood of the wrong type can be fatal, but this is highly unlikely to occur.