A large number of Australians rely on blood and blood products to support them through medical/surgical episodes or for regular transfusions to maintain health. During the course of your admission at Western Health, you may require a blood transfusion as part of your medical treatment.
What is a blood transfusion and why might I need one?
A blood transfusion is a medical procedure that gives you certain components or parts of blood that your body needs to stay healthy. The main components of blood that may be given by transfusion are:
Red blood cells
Their main job is to carry oxygen to the body's tissues and organs, which keep them healthy. If you have lost blood due to surgery, trauma, gastrointestinal (stomach) bleeding, or other conditions or you are anaemic (have a low red blood cell count) you may need a red cell transfusion.
Platelets
Platelets are small cells that prevent bleeding, or stop bleeding from getting worse. You may need a platelet transfusion if you do not have enough platelets or they do not work properly.
Plasma
Plasma contains many substances, such as proteins. These substances help fight infections and help the blood to clot.
Albumin
Albumin is a protein that comes from plasma. It may be used to restore fluids your body has lost.
Consent to having a transfusion
As a patient, you have the right to participate in the decision-making process about your treatment. If you require a blood transfusion you will be asked to give your permission, or what is called "informed consent". Your doctor will explain the risks and benefits of having the transfusion and also the risks if you do not have the transfusion. If you have a cultural or religious belief and objection to blood transfusion, it is extremely important to discuss this with your doctor.
How do I get a blood transfusion?
A blood transfusion is given through an intravenous (IV) line inserted into one of your blood vessels. The procedure usually takes 1 to 4 hours, depending on how much blood you need. Prior to the transfusion commencing two nurses/midwives will check the product at your bedside, asking you to state your name and date of birth. Because there are many people with similar names and the same date of birth, all details must match exactly or the blood product cannot be commenced. Even though you may be known to the staff, this check step is for your safety and must be done. The labels on the unit of blood product will also be checked carefully against details on your wristband and the paperwork.
During the course of the transfusion you will be closely observed and have you temperature, heart rate and blood pressure taken many times by the nursing staff caring for you.
Where does the blood for transfusions come from?
All blood transfused in Australia comes from voluntary unpaid donors. The Australian Red Cross Blood Service is responsible for collecting and testing blood from donors. Before giving blood a potential donor must undergo a confidential interview, and complete a detailed questionnaire about their medical history and any factors that may affect the safety of donated blood. Those not suitable cannot donate.
Is donated blood safe?
The Australian Red Cross Blood Service has many safeguards to ensure the safety of blood for transfusion. After collection blood is extensively tested for infections including Hepatitis B and C, the T-cell lymphotrophic virus (HTLV), syphilis and the Human Immunodeficiency Virus (HIV which causes AIDS) and the blood group is also determined. Donor blood must pass all tests otherwise it is destroyed.
Before you receive donated blood a blood sample is taken from you to establish your blood group. The hospital transfusion laboratory checks both, your blood, and the blood you will receive to make sure they are compatible - this is called cross matching. In some cases we may need to know if you have had a previous blood transfusion or have been pregnant in the last three months. When all tests are complete donated blood is released for transfusion.
Are there any risks in having a transfusion?
Some infectious agents, such as HIV, can survive in blood and infect the person receiving the transfusion. All donor blood is carefully tested for infectious diseases such as HIV and Hepatitis to prevent spread from person to person. The Australian Red Cross Blood Service estimate the risk of getting HIV from a transfusion is less than 1 in 1 million.
Each blood product transfused carries a small risk of an adverse reaction however most blood transfusions go very smoothly. Sometimes mild problems can occur. Fever, chills, itching, a rash and a headache are the most common side effects of transfusions.
Very rarely, serious problems occur. If incompatible donor blood is given to a patient in error, a haemolytic reaction can occur as a result of the patient's red blood cells being destroyed by the incompatible donor blood. This type of complication is rare since blood for transfusion is tested to make sure it is compatible and there are strict requirements for double checking before a transfusion commences to prevent such errors.
Can I donate my own blood in preparation for surgery?
Preoperative autologous donation is the process of collecting and storing a patient's own blood prior to an elective procedure where it is anticipated that the patient will most likely require a blood transfusion. A patient's suitability for preoperative autologous donation is based on their ability to tolerate several venesections (blood donations) taken over a short period of time, their age, adequate venous access (to enable blood to be taken) and reliable dates for elective surgery.
Preoperative autologous donation can deplete the body's iron stores and iron is very important to ensure your blood can carry enough oxygen. Even though it is your blood, risks still exist with autologous blood, including bacterial contamination, clerical error and the increased chance of receiving a blood transfusion. Whilst it is commonly perceived that autologous transfusion removes the risk of transfusion-transmissible infection, the overall safety of autologous blood transfusion is not significantly different from donor blood transfusion in Australia. For all these reasons routine autologous donation is not recommended except on occasion for patient's that have a rare blood group.
