Blood Transfusions

Important information for all patients who may need a blood transfusion -

Like all medical treatments, a blood transfusion should only be given if it is essential. Your doctor will balance the risk of you having a blood transfusion against the risk of not having one.

Why might I need a blood transfusion?

Blood contains many different cells. The red blood cells are essential for carrying oxygen around the body. A lack of these red blood cells is called anaemia.

A blood transfusion may be given because of a shortage of these red blood cells in the blood as a result of the body not producing enough of them or as a result of blood loss.

Sometimes the bone marrow, which produces blood cells cannot make enough of them. This may be due to a disease or a failure of the bone marrow to work properly. It may be temporary or a longer term problem. Some treatments, such as chemotherapy, can also affect the bone marrow in this way. In some cases the anaemia can be treated with medicines; in other cases, a blood transfusion may be the best treatment.

Most people can cope with losing a moderate amount of blood without needing a blood transfusion, as this loss can be replaced with other fluids. However, if larger amount of blood are lost, a blood transfusion may be best way of replacing blood rapidly. A blood transfusion may be needed to treat severe bleeding, for example during or after an operation, childbirth or after a serious accident.

Ask your doctor, nurse or midwife to explain why you might need a blood transfusion.

Is a blood transfusion my only option?

Certain medical conditions causing anaemia may be managed by treating the cause rather than giving a blood transfusion. If you are told that you may need a blood transfusion, you should ask why it is necessary and whether there are any alternative treatments. You do have the right to refuse a blood transfusion, but you need to fully understand the consequences of this before doing so. Some medical treatments or operations cannot be carried out safely without a blood transfusion being given.

Blood transfusions are on needed for a small number of patients having an operation. Sometimes it is possible to recycle your own blood during or after an operation. Ask if this is appropriate for you.

What can I do to reduce the risk the need for a blood transfusion before an operation?

If you do not eat enough foods containing iron, you may have low iron levels. A varied and balanced diet should normally provide adequate iron intake. A leaflet called "Iron in your diet" is available from the Welsh Blood Service, which gives further advice on this. Depending upon the types of operation you are having, you should have a blood sample taken 6-8 weeks before your operation to see if you are anaemic.

Ask your doctor or nurse about this. A shortage of iron can cause anaemia and correcting this in good time, before your operation, may reduce the need for a blood transfusion.

Some medications, such as Warfarin, Aspirin and some anti-inflammatory drugs during your operation.

Always check with your doctor to find if you should stop taking these before your operation and if so, when you should restart them. Do not stop taking any medications without consulting your doctor.

Are blood transfusions safe?

Yes, the risk that blood transfusion will make you ill is very low. One of the most important ways of achieving a safe transfusion is making you get the right blood. You can help reduce the small risk of being given the wrong blood by asking your nurse or doctor to check that it is the right blood for you.

You must be correctly identified at each stage of the transfusion to make sure you get the right blood, including when blood samples are taken before the transfusion. Wearing an identification band with your correct details is essential. You will to state your full name and date of birth, and the identification band will be checked before each sample is taken and before each bag is given. It is alright to remind your nurse or doctor to ask you this.

If you have previously been given a card which states that you need to have blood of a specific type, please show it as soon as possible to your doctor,nurse or midwife and ask them to tell the hospital transfusion laboratory.

Compared to other everyday risks the likelihood of getting an infection from a blood transfusion is very low. All blood donors are unpaid volunteers. They are very carefully selected and tested to make sure that the blood they donate is as safe as possible. The risk of getting hepatitis from a blood transfusion in the UK in 2011 was about 1 in 670,000 for hepatitis B and 1 in 83 million for hepatitis C.

The chance of getting HIV (Human Immunodeficiency Virus) infection was about 1 in 5 million or HTLV ( Human T-Lymphotropic Virus) infection is about 1 in 18 million. Although the risk of getting varient Creutzfeldt-Jakob Disease (vCJD) from a blood transfusion is probably low with a single blood transfusion, the risk of any infection will increase with additional blood transfusions.

Each year, approximately 2.5 million units of blood are transfused in the United Kingdom and there have been just a handful of cases where patients are known to have been infected with vCJD from a blood transfusion.

How will my blood transfusion be given?

A blood transfusion is usually given through a tiny tube directly into a vein in the arm. It may take up to four hours to give each bag, but it can be safely given more quickly if needed. You may be given more than one bag of blood as part of your treatment.

How will I feel during my blood transfusion?

Most people don't feel anything whilst receiving a transfusion. You will be observed before,during and after your blood transfusion; if you feel unwell during or after it, you should inform your doctor or nurse immediately. Some people develop a temperature, chills or a rash. These reactions are usually mild and are easily treated with medicines such as paracetamol or antihistamines, or by slowing down or stopping the blood transfusion. Severe reactions to blood is extremely rare. If they do occur, staff are trained to recognise and treat them.

What if I have any worries about receiving a blood transfusion?

If you have any concerns you should discuss these with your doctor, nurse or midwife. Many hospitals have a dedicated Hospital Transfusion Team, and if appropriate they may be able to come and discuss your concerns with you.

***NOTE*** As a precautionary measure anyone who has received a blood transfusion since 1980 are not currently able to donate blood.

Additional sources of Information

If you are interested in finding out more about blood transfusions you may find the following websites useful:

- NHS choices

www.nhs.uk/Conditions/Blood-transfusion/Pages/Introduction.aspx

- Uk Transfusion Services

www.transfusionguidelines.org.uk/index.aspx

- Welsh Blood Service

www.welshblood.org.uk

Thank you guys for reading and remember blood donors save lives!!!!