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Blood transfusion 

Blood transfusion
Chapter:
Blood transfusion
Author(s):

D.S. Giovanniello

, and E.L. Snyder

DOI:
10.1093/med/9780198746690.003.0548
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date: 02 March 2021

Transfusion of blood components is a life-saving treatment for patients with severe haemorrhage and can also be used to replace coagulation factors and to ameliorate the effects of severe anaemia, thrombocytopenia, and impaired platelet function. With greater understanding of red cell, platelet, and leucocyte antigen structure and function, transfusion therapy has improved. In addition, understanding current and emerging infectious agents has ensured patient safety. Transfusion medicine has expanded over recent decades to include multiple disciplines, such as therapeutic apheresis, cellular therapy, and tissue banking. One of the most important technological improvements in transfusion therapy was the development of sterile, disposable, and flexible plastic containers that allow separation of whole blood into cellular (e.g. red cells, platelets) and noncellular (e.g. plasma, cryoprecipitate) components, known as apheresis. This technology allows the blood of a donor or patient to pass through an apparatus that separates out one particular constituent and returns the remainder to the circulation. Anticoagulants and additives currently used to collect blood allow storage of liquid suspensions of concentrated red cells for 35 to 42 days. These advances have essentially eliminated the use of whole blood. Blood transfusion is used to treat patients with severe anaemia, haemorrhage, thrombocytopenia, and coagulation disorders. Although the hazards of blood replacement are relatively small, the expected benefit of a transfusion must outweigh the risk to the patient. Therefore, a thorough understanding of the indications of blood transfusion is required to minimize unnecessary blood replacement and to prevent wastage of limited blood resources. Clinicians who prescribe blood transfusion must also be familiar with the risks and be able to recognize and treat transfusion reactions.

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