BLOOD TRANSFUSSION

DEFINITION

A blood transfusion is the transfer of blood or blood products from one person (donor) into another person's bloodstream (recipient).

BLOOD TRANSFUSSION
A blood transfusion is a safe, common procedure in which blood is given to you through an intravenous (IV) line in one of your blood vessels. The procedure usually takes 1 to 4 hours, depending on how much blood you need.

 This is usually done as a life saving maneuver to replace blood cells or blood products lost through severe bleeding, during surgery when blood loss occurs or to increase the blood count in an anemic patient. Blood is transfused either as whole blood (with all its parts) or, more often, as individual parts. The blood used in a transfusion must matched with recipient blood type. If it doesn't, antibodies (proteins) in recipient blood attack the new blood.

 Type O blood is safe for almost everyone. Type O : universal donors. Type AB : universal recipients.

* If you have Rh-positive blood, you can get Rhpositive or Rh-negative blood. But if you have Rhnegative blood, you should only get Rh-negative blood. Rh-negative blood is used for emergencies when there's no time to test a person's Rh type *

COMPONENT OF BLOOD
An adult human has about 46 liters of blood circulating in the body. Among other things, blood transports oxygen to various parts of the body. Blood consists of several types of cells floating around in a fluid called plasma. The red blood cells contain hemoglobin, a protein that binds oxygen. Red blood cells transport oxygen to, and remove carbon dioxide from, the body tissues. The white blood cells fight infection. The platelets help the blood to clot, if you get a wound for example. The plasma contains salts and various kinds of proteins.

BLOOD GROUP AND CROSS MATCHING

ABO system Rhesus system

a) ABO system
The differences in human blood are due to the presence or absence of certain protein molecules called antigens and antibodies. The antigens are located on the surface of the red blood cells and the antibodies are in the blood plasma. Not all blood groups are compatible with each other. Mixing incompatible blood groups leads to blood clumping or agglutination, which is dangerous for individuals.

 Blood group A A antigens on the surface of red blood cells and B antibodies in blood plasma.

Blood group B B antigens on the surface of red blood cells and A antibodies in blood plasma.

Blood group AB Both A and B antigens on the surface of red blood cells and no A or B antibodies at all in blood plasma.

Blood group 0 Neither A or B antigens on the surface of red blood cells but both A and B antibodies in blood plasma.

b) Rhesus system
Rh factor on the red blood cell's surface. This is also an antigen and those who have it are called Rh+. Those who haven't are called Rh-. A person with Rh- blood does not have Rh antibodies naturally in the blood plasma. But a person with Rh- blood can develop Rh antibodies in the blood plasma if he or she receives blood from a person with Rh+ blood, whose Rh antigens can trigger the production of Rh antibodies. A person with Rh+ blood can receive blood from a person with Rh- blood without any problems.

What happens when blood clumps or agglutinates?

If they are not, the red blood cells from the donated blood will clump or agglutinate.

AB0 and Rh blood groups must be compatible between the donor blood and the patient blood.

The agglutinated red cells can clog blood vessels and stop the circulation of the blood to various parts of the body.

This can have fatal consequences for the patient.

The red blood cells contain hemoglobin which becomes toxic when outside the cell.

The agglutinated red blood cells also crack and its contents leak out in the body.

TYPES OF BLOOD TRANSFUSSION

Red Blood Cell Transfusions due to an injury, surgery or severe anemia. Platelets and Clotting Factor Transfusions Due to internal bleeding or illnesses (eg: hemophilia). Plasma Transfusions It's mainly water, but also contains proteins, clotting factors, hormones, vitamins, cholesterol, sugar, sodium, potassium, calcium, and more. badly burned, liver failure or a severe infection

a) Whole blood
it is an ineffective use of the limited resource. whole blood transfusion has significant advantages over packed cells as it is coagulation factor rich and, if fresh, more metabolically active than stored blood.

b) Packed red cells

Packed red blood cells are cells that are spun down and concentrated. Each unit is approximately 330 ml and has a haematocrit of 5070%.

c) Fresh-frozen plasma
Fresh-frozen plasma (FFP) is rich in coagulation factors. It is the first-line therapy in the treatment of coagulopathic haemorrhage. Rhesus D-positive FFP may be given to a Rhesus D-negative woman.

d) Cryoprecipitate
Cryoprecipitate is prepared from plasma and contains fibrinogen, von Willebrand factor, factor VIII, factor XIII and fibronectin. It is given in low-fibrinogen states or in cases of factor VIII deficiency.

e) Platelets
Platelet transfusions are given to patients with:
Thrombocytopenia Platelet dysfunction who are bleeding or undergoing surgery. Anti-platelet therapy such as aspirin or clopidogrel for reduction of cardiovascular risk. Patients on clopidogrel who are actively bleeding and undergoing major surgery may require almost continuous infusion of platelets during the course of the procedure.

f) Prothrombin complex concentrates

Prothrombin complex concentrates (PCCs) are highly purified concentrates prepared from pooled plasma. They contain factors II, IX and X; factor VII may be included or produced separately. PCCs are indicated for the emergency reversal of anti-coagulant (warfarin) therapy in uncontrolled haemorrhage.

g) Autologous blood
It is possible for patients undergoing elective surgery to predonate their own blood up to 3 weeks before surgery for retransfusion during the operation. Similarly, during surgery blood can be collected in a cell saver; this washes and collects

WHO NEED BLOOD TRANSFUSSION

People who have surgery because they lose blood during their operations. Some people who have serious injuries (eg:car crashes, war, or natural disasters) need blood transfusions to replace blood lost during the injury. Some people need blood or parts of blood because of illnesses.
A severe infection or liver disease that stops your body from properly making blood or some parts of blood. An illness that causes anemia, such as kidney disease or cancer. A bleeding disorder, such as hemophilia or thrombocytopenia.