TRANSFUSION

MEDICINE
 Indications for blood transfusion
 Criteria for donor selection
 Screening program
 Blood transfusion reactions
Indications for blood transfusion
can be divided as follows:
 Whole blood transfusion
 Packed red cell transfusion
 Granulocyte transfusion
 Platelet transfusion
 Irradiated blood transfusion
 Cryoprecipitate transfusion
Indications for whole blood transfusion:
 Actively bleeding patient with blood loss
greater than 25%
 Exchange transfusion ( blood <5 days old)

Indications for packed red cell transfusion:

 Thalassemia major
 Sickle cell anemia
 Aplastic anemia
 Severe anemia of any cause
 Hypovolemia of any cause
 Surgery
Indications for granulocyte transfusion:
 Bone marrow showing myeloid hypoplasia.
 Neutopenia <500PMN/ul.

Indications for platelet transfusion:

 Non bleeding patients with a failure of platelet
production (<20,000/ul)
 Bleeding patient like DIC (<50,000/ul).
 Active bleeding cases.
 Diffuse bleeding following cardiopulmonary
bypass.
 Platelet function defect, regardless of platelet
count.
Indications for irradiated blood transfusion:
 Patients with congenital immuno-deficiency
syndromes.
 Bone marrow transplant recipients.
 Premature new borns.
 Hematological malignancies.

Indications for cryoprecipitate transfusion:

 Hemophilia A
 Von-Willibrands Disease
 Congenital or acquired fibrinogen disease
 Donor selection
 Age: 18-60yrs
 Sex: healthy male in every three months
and female in every six months. Females
should not be bled during menstruation,
pregnancy and lactation.
 Hemoglobin: >12.5gm/dl.
 Weight: >50kg.
 Transmission diseases: Those with a history of
having suffered from or been in contact with or
are carriers of transmissible diseases like
hepatitis, syphilis, malaria and HIV are to be
rejected.
 Donor vaccinated against polio, yellow fever,
measles and small pox within 3 weeks are not
suitable.
 Donor with an animal bite or antirabies vaccine
or Hepatitis B immunoglobulin – deferred for
one year.
 CONDITIONS PERIOD OF DEFERMENT
Abortions 6 months
H/o blood transfusion 6 months
Alcoholism Till intoxicated
Minor surgery 3 months
Major surgery 6 months
Typhoid 6 months after recovery
Malaria 3 months
Tattoo 6 months
Acute Nephritis 6 months after recovery
 CONDITIONS PERIOD OF DEFERMENT

Breast feeding 6 months after delivery

Immunization(Cholera,Typhoid, 24 hours after symptoms
Diphtheria, Tetanus, Plague,
Gammaglobulin) free
Rabies vaccination 1 year after bite

H/o hepatitis or close 6 months

contact
immunoglobulin 12 months

H/o Jaundice Not accepted

 No person shall donate blood and no blood bank
shall receive blood from persons suffering from
any of the diseases mentioned below:
1. Cancer
2. Heart disease
3. Abnormal bleeding tendencies
4. Unexplained weight loss
5. Diabetes controlled on insulin and oral drugs
6. Hepatitis B infection
7. Chronic nephritis
8. Signs and symptoms suggestive of AIDS
9. Liver disease
 Blood Transfusion Reactions
 Blood transfusion has undoubted benefits
but some adverse effects do occur in
spite of all relevant tests and they are
commonly called blood transfusion
reactions.
Types of transfusion reactions:
 Hemolytic transfusion reaction
 Non-hemolytic transfusion reaction
 Signs and symptoms of hemolytic
transfusion reactions:
1. Burning sensation at the site of injection
2. Flushing and fever
3. Chills
4. Pain in the back
5. Shortness of breath
6. Hypotension/shock
7. Disseminated Intravascular Coagulation
(DIC)
8. Acute renal failure
Causes of hemolytic transfusion reactions:
 Inadequate or incorrect labeling of blood.
 Improper identification of the patient either
at the time of sample collection or
transfusion of blood.
 Errors in blood grouping.
 Incompatibility not detected in cross
matching.
 Failure to detect weak antibodies.
Non hemolytic transfusion reactions
can be classified as:
 Febrile non hemolytic transfusion reaction
 Utricarial (allergic) transfusion reaction
 Anaphylactic transfusion reaction
 Non cardiogenic pulmonary edema
 Circulatory overload
 Graft versus host disease (GVHD)
 Measures to be taken in any suspected
transfusion reactions:
 Stop transfusion.
 Keep I.V. line open with normal saline.
 Inform the attending physician and blood
bank.
 Check all the labels, forms and identity of
patient to determine that the patient
received correct unit of blood sent from
blood bank.