BLOOD TRANSFUSION
Blood transfusion is generally defined as the therapeutic use of blood and its components (red blood cells, platelets, fresh frozen plasma, etc.). Red blood cells carry oxygen, platelets help blood to clot, while plasma contains specific proteins that enable blood clotting and healing.
The first blood transfusion from an animal (sheep) to a human was performed by Dr. Jean-Baptiste Denys, in France on June 15, 1667.
In the early 19th century in 1818, British obstetrician Dr. James Blundell successfully transfused human blood into a patient who had suffered from hemorrhage during childbirth, using the patient's husband as a donor.
The term "blood banking" encompasses the process of collecting, separating, and storing blood. The first blood bank was established in the United States in 1936. Blood banks collect blood and separate it into its various components to be used more effectively according to the patient's needs.
Although research has yielded drugs that help the bone marrow produce new blood cells quickly, the body's response can take weeks, so donated blood remains an important and immediate life-saving resource. The number of blood donors in Iraq exceeds one million donors annually, providing it to those in need, whether those with cancer or those with thalassemia and sickle cell anemia, and these large numbers are half collected through blood donation campaigns.
Blood components are administered by trained and qualified health staff. It should be considered whether there are sufficient staff to monitor the patient throughout the blood transfusion period, by individuals trained in the management of patients undergoing blood transfusion, including dealing with blood transfusion reactions and emergency treatment for anaphylaxis. If there is no clear medical necessity for a blood transfusion overnight, consideration should be given to postponing the blood transfusion to the next day.
Blood groups and matching
Red blood cells contain inherited chemical structures on their surface known as antigens, which may lead the immune system to respond by producing antibodies against them. Humans have 35 major groups or families of these antigens, plus other subgroups, the ABO group and the RhD group being crucial to ensuring that a blood recipient receives compatible blood. The presence of antigens within these groups determines a person's blood type. Blood types are known as: type A, type B, type AB (which has both A and B antigens), or type O (which has neither A nor B antigens), followed by a plus or minus sign indicating the presence or absence of the RhD antigen. People who are RhD do not have the RhD antigen in their blood.
Blood Types
ABO Antigen Group RhD Antigen Group
A Positive
A Negative
B Positive
B Negative
AB Positive
AB Negative
O Positive
O Negative
People who have a particular antigen do not produce antibodies against their own antigen, but they do produce antibodies against other antigens in the same group. For example, if a person has blood type A, they will produce antibodies against the B antigen, but they will not produce antibodies against the A antigen. This means that if that person is given red blood cells of type B or type AB, their antibodies will attack and destroy the red blood cells that carry the B antigen, causing a transfusion reaction.
Similarly, a person who has the RhD antigen will not produce antibodies against that antigen, but a person who does not have the RhD antigen will -) RhD) will produce antibodies against blood containing RhD positive red blood cells.
Recipient Blood Type Matching Donor Blood Type
A+ A+, A-, O+, O-
A- A-, O-
B+ B+, B-, O+, O-
B- B-, O-
AB+ Compatible with all blood types
AB- AB-, A-, B-, O-
O+ O+, O-
O- O-
Antibodies present in the plasma of donors of different blood types cause the opposite situation. For example, because a person with blood type AB does not produce antibodies against blood types A or B, their plasma can be given to a person with blood types A, B, AB, or O.
In emergency situations, when the recipient's blood type is unknown, they can be given type O- red blood cells without causing a reaction due to ABO or RhD incompatibility.
In non-emergency situations, when the recipient's blood type is known but no matching blood is available, a compatible type can be used if its compatibility is determined through cross-match testing.
TYPES OF TRANSFUSIONS
There are several types of blood transfusions, some common types include:
1 . Whole blood transfusion involves the transfer of all blood components, including red blood cells, white blood cells, platelets, and plasma. Whole blood transfusions are less common today, as the components are separated to provide more targeted treatment.
2. Red cell transfusion :This is the most common type of transfusion and is used to treat anemia, blood loss from trauma or during surgery. The red blood cells are usually separated from whole blood so they can be used more efficiently.
3. Platelet transfusion : are essential for blood clotting. Platelet transfusions are often necessary for patients with conditions such as leukemia, lymphoma, or other blood disorders in which the body cannot produce enough platelets.
4. Plasma : is the liquid component of blood that contains water, electrolytes, and proteins. Plasma transfusions can be used to treat clotting disorders, burns, or liver failure.
5. Cryoprecipitate Transfusion :This involves transfusing a plasma component that contains clotting factors and is often used for patients with hemophilia or during surgery to help the blood clot properly.
DONOR SAFETY
Since the establishment of blood banks, safety for both donors and recipients has improved dramatically and continuously. Because a safe and reliable source of blood is essential to providing effective blood products to recipients, blood banks rely on voluntary donations from citizens. As a result, blood banks pay great attention to making the donation process as convenient and safe as possible for donors.
The donation process begins with a screening to determine whether the donor is in good health and does not suffer from any conditions that might make their donation dangerous. Donors are asked about their general health, as well as their travel history and possible exposure to blood-borne diseases, such as HIV, malaria, and hepatitis. A simple screening is performed that includes measuring blood pressure, pulse rate, and temperature to rule out other risks. A simple laboratory test is also performed to ensure that the donation will not cause the donor anemia.
If the donor is found to be suitable for blood donation, about half a pint of blood is collected from a vein in the arm into a special plastic bag. The donor usually tolerates the procedure well, with the average blood volume of a donor being about 11 pints. The body replaces lost fluids within 24 hours, and red blood cells are replenished within four to six weeks. Therefore, there should be a gap of at least eight weeks between donations of whole blood.
Complications of blood donation are rare and usually minor. Fainting is the most common complication, but it is mitigated by asking the donor to wait a short time after donation before standing up, eating and drinking fluids before leaving the donation site.
RECIPIENT SAFETY
The risks that may be encountered by the person receiving blood can be divided into several categories and by strictly adhering to standardized procedures, these risks are minimized.
• Allergic transfusion reactions: Some patients may experience mild allergic reactions, such as a rash or itching.
• Fever: A fever may develop in response to the white blood cells present in the transfused blood.
• Hemolytic Reaction (HTR): If there is an incompatibility between the donor and recipient's blood, a serious reaction can occur that destroys red blood cells. This can cause severe complications and organ failure.
• Infection (TTI): Although blood is carefully tested for diseases such as HIV, hepatitis, and syphilis.
• Iron Overload: Receiving repeated blood transfusions over time can lead to iron buildup in the body, which may require additional treatment.
• GvHD: In rare cases, the transfused white blood cells can attack the recipient's tissues.
AUTOLOGOUS BLOOD DONATION
This type of transfusion allows an individual to store their own blood for use in a blood transfusion during an upcoming surgical procedure. Patients for whom autologous blood donation or transfusion is most beneficial are those with very rare blood types and those with multiple antibodies that make finding compatible units difficult or impossible. The donor must be free of anemia or any signs of infection, and must not have medical conditions that could cause problems during or after donation, such as unstable angina, a history of stroke or heart attack within the past six months, or severe high blood pressure.
The advantage of this type is that it is the safest form of blood transfusion for the recipient because it eliminates the risk of blood-borne infections from other donors. In this case, the blood is usually drawn three to five weeks before the anticipated surgery and stored, and is reserved for use only by the donor. If it is not used, it is discarded and not used for others. The disadvantages of autologous donation or transfusion include the high cost due to the additional administrative processes and special labeling requirements to ensure that the units are transferred to the appropriate patient.
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