Blood Transfusions: Everything You Need to Know

What is a blood transfusion?

A blood transfusion is a way of adding blood to your body after an illness or injury. If your body is missing one or more of the components that make up healthy blood, a transfusion can help supply what your body is missing.

Depending on how much blood you need, a transfusion can take between 1 and 4 hours. About 5 million Americans need a blood transfusion every year, and the procedure is usually safe.

A blood transfusion is a common procedure in which donated blood or blood components are given to you through an intravenous line (IV). A blood transfusion is given to replace blood and blood components that may be too low.

Why might I need to get a blood transfusion?

A blood transfusion can save your life. You may need a blood transfusion if you’ve lost blood from an injury or during surgery, or if you have certain medical conditions including:

• Anemia.
• Certain cancers.
• Hemophilia.
• Sickle cell disease.

What are blood components?

In addition to whole blood, a transfusion can provide certain blood components, or parts. These components include:

• Cryoprecipitate: Helps your blood clot.
• Plasma: Carries nutrients your body needs.
• Platelets: Help your blood clot.
• Red blood cells: Carry oxygen throughout your body.

Procedure Details

Where does blood for a blood transfusion come from?

Typically, the blood comes from an anonymous person who has donated it for use as hospitals see fit. A blood bank holds the blood until needed for a transfusion.

In some cases, though, people donate blood to directly benefit a friend or loved one. You may also have the chance to bank your own blood for a scheduled surgery.

How does a blood transfusion work?

The donated blood or blood components are stored in special medical bags until they are needed. Your healthcare provider connects the needed bag of blood to an intravenous line made of tubing. A needle at the end of the tubing is inserted into one of your veins and the blood or blood components begins to be delivered into your circulatory system.

What can I expect during the transfusion?

Before your transfusion, your nurse will:

• Check your blood pressure, pulse and temperature.
• Make sure the donor blood type is a match for your blood type.
• Make sure that the supplied blood is the product ordered by your doctor and is labeled with your name.

During your transfusion, your nurse will:

• Recheck your blood pressure and pulse after 15 minutes.
• Recheck your blood pressure and pulse at the end of the transfusion.

How long does a blood transfusion take?

How long a blood transfusion takes depends on many factors, including how much blood and/or blood component you need. Most transfusions take between one and three hours. Talk to your healthcare provider for more specifics about your needs.

Risks / Benefits

What are blood transfusion risks?

The healthcare industry work hard to ensure the safety of blood used in transfusions. Blood banks ask potential donors questions about their health, behavior and travel history. Only the people who pass the blood donor requirements can donate blood. Donated blood is tested according to national guidelines. If there is any question that the blood is not safe, it is thrown away.

Even with these precautions, there’s a small chance something will go undetected in the screening process. However, the odds of this happening are very small. For example, your chances of getting certain diseases from a transfusion are:

• HIV: 1 in 1.5 million donations.
• Hepatitis C: 1 in 1.2 million donations.
• Hepatitis B: 1 in 293,000 donations.
• Bacterial contamination: 1 in 100,000 transfusions.

You’re more likely to get struck by lightning than to get a disease from a transfusion. The precautions healthcare workers take have helped make transfusions very safe.

What kind of reactions can happen from a blood transfusion?

People can react in various ways to blood transfusions. Reactions people experience may include:

• Breathing troubles.
• Fevers, chills or rashes.
• Hemolytic transfusion reaction (your immune system tries to destroy transfused red blood cells).

Most people don’t have any of these reactions. When they do happen, they often feel like allergies. If you experience unusual symptoms during a transfusion, tell your healthcare provider. Stopping the transfusion or getting certain medications can provide relief.

What are the benefits of a blood transfusion?

Blood is important. If you don’t have enough blood or one of the components of blood, you could face a life-threatening situation. Blood and the components of blood benefit the body in these ways:

• Red blood cells carry oxygen through your body to your heart and brain. Adequate oxygen is very important to maintain life.
• Platelets help to prevent or control bleeding due to low platelet count.
• Plasma and cryoprecipitate also help to prevent or control bleeding.

Recovery and Outlook

How long does it take to recover from a blood transfusion?

After your transfusion, your healthcare provider will recommend that you rest for 24 to 48 hours. You’ll also need to call and schedule a follow-up visit with your healthcare provider.

When to Call the Doctor

When should I call my doctor after a blood transfusion?

Reactions to a blood transfusion can happen at unexpected times. You can have a reaction during the transfusion, a day afterward or up to several months later. Call your healthcare provider right away (or your nurse if you are still in the hospital) if you experience:

• Bleeding, pain or new bruising at the IV site.
• Cold and clammy skin, fever or chills.
• Dark or reddish urine.
• Fast heartbeat, chest pain, trouble breathing or wheezing.
• Headache, dizziness, nausea or vomiting.
• Rash, hives or itching.
• Severe back pain.

Additional Details

Are there alternatives to blood transfusions?

Alternatives to blood transfusions exist but may not work in all situations. Medications can help your body produce blood. But if you’ve lost too much blood or your life is in danger, you’ll likely need a transfusion. The alternatives won’t help quickly enough.

Can I refuse to receive a blood transfusion?

You can refuse a transfusion, but you should know the risks and consequences. You’ll need to discuss this option with your healthcare provider. If you choose to refuse the transfusion, you could face permanent disability or loss of life.

What Happens During a Blood Transfusion?

Your blood is made up of several different parts including red and white cells, plasma, and platelets. “Whole blood” refers to blood that has all of them. In some cases, you may need to have a transfusion that uses whole blood, but it’s more likely that you’ll need a specific component.

Why Would You Need a Blood Transfusion?

There are many reasons you might need to receive a blood transfusion. These are just a few of them:

• You’ve had major surgery or a serious injury and you need to replace lost blood
• You’ve experienced bleeding in your digestive tract from an ulcer or other condition
• You have an illness like leukemia or kidney disease that causes anemia (not enough healthy red blood cells)
• You’ve received cancer treatments like radiation or chemotherapy
• You have a blood disorder or severe liver problems

Types of Blood Transfusions

There are several common kinds of blood cell transfusions:

• A red blood cell transfusion may be used if you have anemia or an iron deficiency.
• Platelets are tiny cells in the blood that help you stop bleeding. A platelet transfusion is used if your body doesn’t have enough of them, possibly because of cancer or cancer treatments.
• A plasma transfusion helps replace the proteins in your blood that help it clot. It may be needed after severe bleeding or if you have liver disease.

During the Transfusion

You’ll likely go to your doctor’s office or a hospital to receive your blood transfusion. The new blood will be given to you through a needle and an IV line. You’ll be monitored in case there are any problems.

Risks and Complications

In general, blood transfusions are considered safe, but there are risks. Sometimes complications show up immediately, others take some time.

Fever: It’s usually not considered serious if you get a fever 1 to 6 hours after your transfusion. But if you also feel nauseated or have chest pain, it could be something more serious. See your doctor right away.

Allergic reactions: It’s possible to experience an allergic reaction to the blood you receive, even if it’s the correct blood type. If this happens, you’ll likely feel itchy and develop hives. If you have an allergic reaction, it’s likely to happen during the transfusion or very shortly after.

Acute immune hemolytic reaction: This complication is rare, but is a medical emergency. It happens if your body attacks the red blood cells in the blood you’ve received. This normally takes place during or right after your transfusion, and you’ll experience symptoms like fever, chills, nausea, or pain in your chest or lower back. Your urine might also come out dark.

Delayed hemolytic reaction: This is similar to an acute immune hemolytic reaction, but it happens more gradually.

Anaphylactic reaction: This happens within minutes of starting a transfusion and may be life-threatening. You may experience swelling of the face and throat, shortness of breath, and low blood pressure.

Transfusion-related acute lung injury (TRALI): This is a rare, but potentially fatal reaction. It shows up within hours of the start of the transfusion in the form of a fever and low blood pressure. TRALI damages your lungs. It may be caused by antibodies or other substances in the new blood. Even though it’s rare, it’s still the leading cause of transfusion-related death in the United States.

Bloodborne Infections: Blood banks thoroughly screen donors and test donated blood for viruses, bacteria, and parasites, but infections are still a rare possibility.

• HIV: Your chance of contracting HIV through donated blood is 1 in 2 million (a lower risk than being struck by lightning).
• Hepatitis B and C: Your chance of contracting hepatitis B is about 1 in 300,000 and your risk of contracting hepatitis C is about 1 in 1.5 million.
• West Nile virus: Your chance of contracting West Nile virus is about 1 in 350,000.
• Zika virus: In 2016, the FDA began recommending that blood centers screen for Zika. Most people who have it don’t show any symptoms.

Hemochromatosis (iron overload): You can get too much iron in your blood if you have multiple blood transfusions. This can damage your heart and liver.

Graft-versus-host disease: This complication is extremely rare, but is usually fatal. It happens when the white blood cells in the new blood attack your bone marrow. You may be more likely to experience this complication if you have a weakened immune system.