Richard A. Larson, MD, is a professor of drugs within the Part of Hematology/Oncology and director of the Hematologic Malignancies Scientific Analysis Program on the College of Chicago. He acquired his medical diploma from the Stanford College College of Drugs and accomplished his postdoctoral coaching in Inside Drugs, Hematology, and Medical Oncology on the College of Chicago. Dr. Larson can also be a member of the 2023 Cancer.Net Editorial Board. View Dr. Larson’s disclosures.
A blood transfusion is a medical process to present blood, or elements of the blood, to somebody who wants it. Some folks may have a blood transfusion if they’ve a medical situation, resembling most cancers, that impacts how the physique produces blood cells. They might additionally require a blood transfusion in the event that they lose blood after surgical procedure or are experiencing different causes of bleeding.
Right here, be taught extra about why you may obtain a blood transfusion throughout most cancers, what to anticipate throughout a blood transfusion, and what to know in regards to the unwanted effects it’s possible you’ll expertise after receiving a transfusion.
Why may somebody with most cancers want a blood transfusion?
Individuals with most cancers could require a blood transfusion for numerous causes, relying on their particular situation and therapy. These causes may embrace:
Chemotherapy-induced anemia. Chemotherapy can suppress the bone marrow’s capacity to supply pink blood cells, resulting in anemia. Anemia is when you’ve gotten a low stage of pink blood cells in your physique. Blood transfusions replenish the pink blood cell rely and may relieve signs resembling fatigueweak point, and shortness of breath.
Surgical procedure-related blood loss. Most cancers surgical procedure may cause bleeding, and if the affected person’s blood quantity drops too low, a blood transfusion could also be wanted to revive it to a protected stage.
Bone marrow failure and thrombocytopenia (low platelet rely). Sure cancers, resembling leukemia or myeloma, predominantly have an effect on the bone marrow and intrude with the manufacturing of regular blood cells. That is known as “pancytopenia.” These ailments, in addition to chemotherapy, can intrude with the traditional manufacturing and performance of platelets, which assist the blood to clot. Platelet transfusions may also help stop or management bleeding episodes in these sufferers.
Help throughout a bone marrow transplant. Earlier than a bone marrow transplant, an individual usually acquired high-dose chemotherapy and/or radiation remedy, which might harm the bone marrow and cut back its capacity to supply blood cells. Then, throughout a bone marrow transplant, the diseased bone marrow is changed by wholesome stem cells from the donor. Blood transfusions could also be needed throughout this era to help the affected person till the transplanted stem cells start to perform and produce new blood cells.
What are the various kinds of blood transfusions?
Blood is made up of various elements, or elements. These elements embrace the liquid plasma, pink blood cells, white blood cells, and platelets. Transfusion of complete blood is much less widespread than transfusion of one of many blood elements. For many varieties of blood transfusions, the blood used comes from a donor. Particular measures are used to make sure that blood donation is protected for each recipients and donors.
The various kinds of blood transfusion that your physician could suggest throughout most cancers and its therapy embrace:
Plasma is the liquid a part of blood that carries the blood cells. It incorporates proteins that assist the blood clot. It may be frozen and saved. A plasma transfusion could be given to individuals who have bleeding problems, sure varieties of most cancers, or liver illness. It might even be given after surgical procedure if the particular person had appreciable blood loss.
Crimson blood cell transfusion
Crimson blood cells are made within the bone marrow and carry oxygen to the tissues within the physique. Crimson blood cells include hemoglobin, which is a protein that carries oxygen and provides blood its pink colour. Bleeding that’s brought on by trauma, surgical procedure, or sure ailments could result in a low pink blood cell rely. If an individual has a low pink blood cell rely, a pink blood cell transfusion could also be wanted. A pink blood cell transfusion is often given when an individual’s pink blood cell rely or hemoglobin stage drops low sufficient to trigger signs resembling dizzinessfatigue, or shortness of breath.
A low platelet rely is named thrombocytopenia. A platelet transfusion could also be wanted if the bone marrow can’t make sufficient platelets, which can happen throughout most cancers or its therapy. There’s a danger of spontaneous bleeding if an individual’s platelet rely falls too low. Platelets could also be given upfront if there may be an elevated danger of bleeding from a surgical process. Typically, platelet transfusions will not be wanted regardless of a low platelet rely if there aren’t any indicators of bleeding.
White blood cell or granulocyte transfusion
White blood cells assist the physique combat an infection. Granulocyte transfusions are hardly ever given. They’re often reserved for individuals who have a really low white blood cell rely, known as leukopenia or neutropeniain addition to for individuals who have a extreme an infection that doesn’t reply to antibiotics. As an alternative of transfusing white blood cells, docs generally give injections of white blood cell development components that stimulate the physique to make its personal white blood cells.
Autologous blood donation
In some instances, an individual can function their very own blood donor. When somebody donates their blood for their very own use, it’s known as an “autologous blood donation” or “autotransfusion.” Individuals could donate their very own blood earlier than present process surgical procedure in case they want a blood transfusion throughout or after the process. Usually, blood could be saved for as much as 42 days.
How is the blood ready for transfusion?
Blood merchandise which are utilized in transfusions are handled in particular methods to make them protected and to stop reactions within the recipient. Blood merchandise could also be handled with radiation earlier than they’re transfused. Radiation doesn’t have an effect on pink blood cells or platelets, but it surely stops white blood cells from functioning. Particular blood filters might also be used that assist take away white blood cells. This course of is named “leukocyte discount,” and it’s used to assist stop a response in blood transfusion recipients.
What ought to I count on throughout a blood transfusion?
In case your physician has really useful that you just obtain a blood transfusion, you’ll have a blood take a look at to seek out out your blood kind and Rhesus (Rh) issue. There are 4 blood sorts: A, B, AB, or O. The Rh issue is an antigen that’s discovered on the floor of some pink blood cells, making the cells “Rh-positive.” This info is necessary to know so that you just obtain blood from a donor who matches your blood kind and Rh issue.
The blood financial institution takes necessary precautions to stop the recipient from having a response to the donated blood. They cross-match the donor’s blood to examine that it matches and is suitable with the recipient’s blood kind. The well being care staff additionally rigorously checks the donated blood to verify the appropriate kind of blood is given to the appropriate particular person. Earlier than a transfusion, it’s possible you’ll be given acetaminophen or antihistamines, resembling diphenhydramine, to assist stop gentle reactions.
Throughout a blood transfusion, an intravenous (IV) needle is inserted right into a vein in your hand or arm. A bag of specifically chosen and matched blood cells is held on a pole, and the blood flows from the bag by way of the IV and into your vein. More often than not, folks don’t really feel any discomfort when the blood goes in. Nonetheless, the blood is refrigerated, so it might really feel a bit chilly.
Throughout the transfusion, the nurse will monitor your temperature, blood stress, and coronary heart charge. The nurse may also look ahead to any rash or indicators of an allergic response. A pink blood cell transfusion often takes between 2 and three hours. Platelet transfusions are shorter.
What are the attainable unwanted effects of a blood transfusion?
A blood transfusion is usually a really protected process, and the advantages of receiving a transfusion usually outweigh the attainable dangers. Adults or kids who’ve acquired a number of blood transfusions could have the next danger of reacting to later blood transfusions.
The well being care staff will watch you intently throughout a blood transfusion to observe for attainable unwanted effects. Though unusual, some unwanted effects that will happen throughout or after a blood transfusion embrace:
Fever, chills, headacheor nausea. These signs could be brought on by a response between the recipient’s immune system and the cells or proteins from the donated blood. When this occurs, the nurse could cease the transfusion and provides a fever-reducing medication. When the particular person’s temperature is again to regular, the transfusion can often proceed.
Allergic response. An allergic response can happen if the recipient’s immune system reacts to proteins within the donated blood. These reactions could embrace hives or itching. In uncommon instances, a blood transfusion may cause anaphylaxis, which is a extreme and generally life-threatening allergic response. If an allergic response happens, the transfusion is stopped and allergy medicines resembling antihistamines and steroids are given. If the response is gentle, the transfusion can begin once more. If the response is extra critical, the transfusion is stopped.
Hemolytic response. This sort of response could be very uncommon however can happen when the donor’s and recipient’s blood sorts don’t match. Throughout a hemolytic response, the recipient’s antibodies assault the transfused pink blood cells, inflicting them to interrupt down, or hemolyze. The recipient develops fever, chills, or chest and decrease again ache. This response could be gentle or extra extreme. If extreme, a hemolytic response may end up in kidney harm and even dying.
Transfusion-related acute lung harm (TRALI). It is a response of the recipient’s immune system to substances within the transfused blood. TRALI damages lung tissue and causes fluid to build up within the lungs. TRALI could also be speedy or delayed and causes problem respiratory. Therapy for TRALI could embrace being given oxygen.
Circulatory overload. This happens when the recipient’s circulatory system has an excessive amount of blood quantity in it, which might trigger problem respiratory and coronary heart failure. Circulatory overload is extra prone to happen in older people and people with long-standing anemia or coronary heart issues. It’s handled by stopping the transfusion, giving oxygen, and utilizing a diuretic medication to extend urination and decrease the plasma quantity.
Iron overload. Iron is current in pink blood cells and may construct up after a number of blood transfusions are given. An excessive amount of iron can harm the center, liver, and different organs. Iron overload is often handled with a chelating agent that binds to extra iron, inflicting it to be eradicated by way of the urine.
Infectious illness. The blood you’ll obtain throughout a transfusion is extraordinarily protected as a result of the blood is examined for infectious organisms, and potential donors are rigorously screened. Nonetheless, there’s a very small likelihood that an infectious illness could also be transmitted by way of a blood transfusion. Hepatitis virus and cytomegalovirus (CMV) are 2 viruses that may be transmitted by way of blood transfusion. The human immunodeficiency virus (HIV), which causes acquired immune deficiency syndrome (AIDS), will also be transmitted by way of blood.
You’ll want to discuss along with your well being care staff you probably have any questions or considerations in regards to the blood you can be receiving throughout your transfusion, how the blood was examined and ready, and what unwanted effects could be attainable after receiving a transfusion.