Blood Transfusions: Classification, Function, Process, and Healing
Blood transfusions are a vital medical procedure that can save lives in cases of severe injury, surgery, or blood loss. However, like any medical intervention, blood transfusions come with their own set of risks and complications.
These risks can be categorised into immediate and long-term categories, encompassing various immunological, infectious, and physiological responses.
Immediate risks include hemolytic transfusion reactions, which occur when a patient's antibodies react against donor red cells, particularly in patients with previous transfusions or multiparous women. Allergic and anaphylactic reactions, more common in patients with IgA deficiency, also pose a threat. Febrile non-hemolytic transfusion reactions (FNHTR) are more frequent in patients with multiple prior transfusions, while transfusion-related acute lung injury (TRALI) and transfusion-associated circulatory overload (TACO) carry the risk of fluid overload leading to heart failure. Infections, though minimised by screening, can potentially transmit bacterial contamination, especially with platelet transfusions stored at warmer temperatures. Immunomodulation, where transfused blood components can suppress the recipient’s immune system, increasing susceptibility to infections, is another concern [2][4][5].
Long-term complications include iron overload, which occurs with repeated transfusions and can lead to organ damage. Graft-versus-host disease (GVHD), caused by donor lymphocytes attacking recipient tissues, is a risk, particularly in immunocompromised patients. Long-term transfusion may also alter immune responses, impacting patient outcomes and infection risk [1][5].
Certain populations, such as those undergoing cardiac surgery or those with cardiovascular disease, may experience increased risks of mortality, acute kidney injury, infection, and stroke after red blood cell transfusions. Transfusion reactions are more common in patients receiving emergency or uncrossmatched blood [3][4].
To manage and prevent these risks, leucodepletion of blood components reduces febrile reactions. Irradiation of blood products helps prevent GVHD, while iron chelation therapy treats iron overload. Regular monitoring for transfusion complications is essential, particularly in patients requiring multiple transfusions [1][4].
In the United States, the chances of getting HIV from a blood transfusion is less than 1 in a million. The likelihood of contracting hepatitis B is 1 in 300,000, and the likelihood of contracting hepatitis C is 1 in 1.5 million. Before a blood transfusion, white blood cells are typically removed from the blood due to potential viruses [4].
In summary, while blood transfusions are lifesaving, they carry risks such as allergic reactions, lung injury, circulatory overload, infections, immune complications, and long-term effects like iron overload and GVHD. Careful patient selection, blood product processing, and vigilant monitoring are key to minimising these risks.
- The science of health-and-wellness indicates that long-term risks associated with blood transfusions can include immunomodulation, which increases the recipient's susceptibility to infections and various medical-conditions like iron overload and graft-versus-host disease (GVHD).
- A predictive model might suggest that certain populations, such as those with depression, obesity, or multiple previous transfusions, could potentially experience increased risks of immediate complications following blood transfusions, such as hemolytic transfusion reactions, febrile reactions, and transfusion-related acute lung injury (TRALI).
- In the realm of health-and-wellness and medical-conditions, questions have been raised about the potential link between repeated blood transfusions and the development of aq conditions, such as depression, due to the impacts of transfusions on the immune system and physical health over extended periods.
