Blood transfusion therapy is a medical procedure involving the infusion of donor blood or its components into a patient, primarily used to supplement deficiencies in blood components caused by illness or trauma. This treatment can rapidly improve tissue hypoxia, stop bleeding, or enhance immune function, commonly used in cases of massive trauma bleeding, plasma loss during surgery, or patients with blood disorders. Its core purpose is to restore normal blood function in patients, preventing life-threatening crises caused by low hemoglobin levels or clotting factor deficiencies.
Based on patient needs, blood transfusions can be divided into four main types: red blood cell suspensions (to supplement oxygen-carrying capacity), platelet concentrates (to promote hemostasis), cryoprecipitate (to provide clotting factors), and whole blood transfusions (used in cases of severe acute blood loss). Hemoglobin in red blood cells binds with tissues to restore oxygen transport; platelets repair vascular endothelial damage and form clots. Fibrinogen in plasma works with thrombin to rebuild the coagulation mechanism.
Mainly indicated for acute massive bleeding (such as traffic accidents or uterine rupture), chronic anemia (such as renal anemia or post-chemotherapy for cancer), bleeding tendencies caused by thrombocytopenia (platelet count below 20,000/μL), and coagulation disorders (such as in cirrhosis patients). Special cases include immunosuppression after organ transplantation, neonatal hemolytic disease, or prophylactic transfusions during major surgeries.
Pre-treatment involves blood type matching and cross-matching tests to ensure compatibility between donor and recipient blood types. The transfusion is usually administered via a venous catheter at a slow rate, starting at 40-60 drops per minute to avoid acute reactions. Dosage is calculated based on patient weight and blood loss: red blood cells are typically transfused in 2-4 units per session (each unit approximately 250-350 mL), while platelets are commonly dosed at 5-10 units/m² of body surface area.
Common side effects include fever, chills, or skin rash, which can usually be alleviated with antihistamines. Serious risks include hemolytic reactions (destruction of red blood cells due to mismatched blood type within 1-2 hours post-transfusion), transfusion-related acute lung injury (TRALI), and infection transmission risks (such as hepatitis viruses or HIV). Long-term risks include iron overload, which may require chelation therapy with deferoxamine after multiple transfusions.
Contraindications include a history of severe allergic reactions to blood components, autoimmune hemolytic anemia, and cases of incompatible blood types. Prior to transfusion, coagulation function indices (such as INR) and renal function should be checked to avoid circulatory overload from excessive transfusion. Pregnant women should be especially cautious about Rh-negative antibody screening.
When used with anticoagulants (such as warfarin), dosage adjustments are necessary as transfusions may affect the International Normalized Ratio (INR). Patients on immunosuppressive therapy require enhanced viral screening, and those on dialysis should have potassium levels monitored, as stored blood may contain high potassium levels.
Clinical studies show that transfusing patients with acute massive bleeding increases 24-hour survival rates by 40%. For patients with platelet counts below 10,000/μL, transfusions reduce bleeding risk within 24 hours by 65%. However, over-reliance on red blood cell transfusions may increase the risk of thromboembolism, leading to a current preference for a "restrictive transfusion strategy" (transfusing when hemoglobin <7 g/dL) to balance benefits and risks.
In cases of red blood cell deficiency, erythropoietin (EPO) or iron supplements can be considered; for thrombocytopenia, IL-11 can stimulate bone marrow production. For clotting factor deficiencies, alternatives such as prothrombin complex concentrates can be used. However, in cases of acute massive blood loss or emergencies, actual blood transfusion remains the primary treatment.
Patients should undergo blood type identification and cross-matching tests to ensure compatibility. Healthcare providers will inquire about allergy history, familial hereditary blood disorders, and explain potential risks. Patients must sign consent forms and inform medical staff of current medications and health status before transfusion.
Is fever or chills during transfusion normal?Mild fever or chills may be non-hemolytic febrile reactions, usually occurring within hours after transfusion, often caused by immune responses to leukocyte antigens. If body temperature exceeds 38.5°C or is accompanied by chills or headache, notify medical staff immediately to adjust the transfusion rate or administer antipyretics.
When can normal activity resume after transfusion?Most patients can gradually resume light activities within 24 hours post-transfusion, but strenuous exercise should be avoided for at least 48 hours. If symptoms such as dizziness, chest pain, or swelling occur after transfusion, activity should be delayed, and medical evaluation should be sought immediately.
What dietary restrictions should be observed after transfusion?It is recommended to increase iron intake (such as red meat and dark leafy greens), but avoid excessive vitamin C-rich foods that may affect iron absorption. Patients with liver dysfunction should follow medical advice to limit high-protein foods; those receiving platelet transfusions should avoid blood-thinning herbs or alcohol to prevent bleeding risks.
How can patients requiring regular transfusions prevent iron overload?Patients on long-term red blood cell transfusions (such as those with thalassemia) should monitor serum ferritin levels every 3-6 months. When ferritin exceeds 1000 ng/mL, doctors may prescribe chelating agents like deferoxamine and recommend limiting iron supplements and red meat intake to reduce the risk of cardiac and liver damage.
%201.svg)
Copyright © 2025 MedFrontiers. All Rights Reserved.
