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Why would my doctor recommend a blood transfusion? |
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You may require a transfusion to replace blood that is lost during surgery
or an accident.
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If you are receiving chemotherapy, your bone marrow may be temporarily
unable to make new blood cells.
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Anemia is the result of many illnesses, and the symptoms from anemia may
make a transfusion necessary.
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Where does the blood for my transfusion
come from? |
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Nearly all blood donations in the United States and other developed
nations are from volunteer donors who give their blood through a network
of nonprofit community blood centers and hospital blood banks. Donors are
eligible to give whole blood five times a year and can donate some blood
components, such as platelets, more
frequently. |
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Is it safe to get a blood transfusion? |
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All medical therapy involves some degree of risk. Most patients and
their families are concerned about the risk of contracting disease (hepatitis,
AIDS, bacterial infection) through a transfusion. The safety of the blood
supply is a shared responsibility of many organizations including community
blood banks and the federal government.
Donors are carefully screened for a history which suggests the potential
for transmission of a disease. Only a person with a clean bill of health
is allowed to give blood. In addition, the blood goes through extensive
testing for various infectious disease markers including HIV and hepatitis.
In almost every case, the lifesaving benefits of receiving a blood transfusion
outweigh the risk of contracting an infectious disease. The risk of contracting
HIV from a blood transfusion is currently one in 680,000. While the blood
supply has never been safer, blood transfusions are not risk-free.
If your doctor recommends a transfusion, you will need to decide if
you want to have the transfusion at all and get options explained through
informed consent prior to the transfusion. Your
physician can advise you about all the adverse consequences of transfusion,
its benefits and how to reduce the risks of any adverse consequences including
infectious agents. |
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What are the risks associated with blood
from volunteer donors, beyond HIV? |
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Most of the blood transfused is allogeneic (al-O-je-nay-ik)
blood from others. Allogeneic blood is compatible with, but different from
your own, which increases the risk of an undesired reaction. Ninety percent
of transfusion reactions are caused by the donor’s white blood cells or
leukocytes transfused along with the red cells or platelets.
Leukocytes or white blood cells carry certain viruses and can suppress
the immune systems of patients increasing their risk of infections after
surgery. Just as you may drink filtered water to protect yourself from
contaminants, you have the right to ask for filtered or leukocyte reduced
blood and platelet transfusions to protect yourself from these contaminating
donor white blood cells or leukocytes.
Filtered, leukocyte reduced blood has been shown in government funded
and university studies to reduce disease transmission, eliminate immune
sensitivity reactions and protect surgical patients from postoperative
bacterial infections. |
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If nearly all blood comes from volunteers,
why is there a charge? |
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While blood is freely donated by volunteers, blood centers charge a
fee to hospitals to cover the costs of collecting, testing, processing
and distributing the blood. These “service fees” also apply when you’re
donating blood for your own use.
Hospitals also charge a fee for laboratory work, necessary to ensure
that the donated blood matches your blood type and for the transfusion
procedure. |
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Will there be blood substitutes available
soon? |
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Despite promising research, a true substitute for blood cells (red
cells and platelets) may not be routinely available for many years. More
likely, blood transfusions will continue to become safer because of improved
blood donor screening and testing and filtration. In addition, scientists
are exploring new technologies to sterilize and eliminate infectious disease
from blood transfusion.
New drugs and medical techniques can sometimes significantly reduce
or eliminate the need for blood transfusion. For example, most surgeries
today require far less blood than just a few years ago. In another example,
patients on kidney dialysis who previously needed monthly blood transfusions,
now take a drug (recombinant human erythropoietin) that promotes their
own red cell production. This eliminates their need for blood transfusion. |
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Can I donate my own blood for transfusion? |
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Using your own blood, called autologous (au-tol-o-gus) donation,
significantly reduces the risk of a reaction or disease. You can donate
blood for up to six weeks before your surgery. Doctors may also collect
your blood at the beginning of the surgery and return it to you at the
end of the operation.
Another method used to replace blood loss with your own blood is intraoperative
autologous transfusion (IAT). This procedure allows the doctors in
the operating room to recover blood lost during surgery and immediately
return it to you. |
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Can I use blood donated by my family and
friends? |
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Family members or friends who have the same blood type as you can provide
a directed blood donation for you, however, most studies show that
directed donations are no safer than blood donated by healthy community
volunteers. In fact, blood donations from close relatives are more likely
to cause a serious immune reaction. In these situations, doctors must treat
the blood with radiation before it can be used safely. |
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How is the risk of using blood from a volunteer
allogeneic donor decreased? |
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The safety of volunteer donor blood results from actions taken at several
levels.
By the Donor
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Self exclusion from the donor process for confidential reasons.
At the Blood Center (collection facility)
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Thorough donor interviews.
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Careful testing of blood for transfusion transmissible disease.
At the Hospital
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Monitoring and careful blood storage.
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Precise compatibility testing.
By You
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Through Knowing Your Options.
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Understanding the transfusion process and benefits, risks and alternatives
prior to consenting to a transfusion. These alternatives include the use
of drugs to assist your bone marrow to replace blood, use of autologous
(pre and perioperative) donation and removing contaminating white blood
cells associated with adverse consequences from blood by a process called
leukocyte reduction by filtration.
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Does it cost more to have blood filtered
to remove white blood cells? |
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Typically filtration adds 10% to 20% to the cost of preparing blood.
The significant cost savings in hospital charges and reduced patient hospital
stay associated with the use of filtered, leukocyte reduced blood and platelet
transfusions, more than offsets the cost to leukocyte reduce by filtration.
It has been estimated that for surgery patients alone the use of filtered
blood would save the U.S. healthcare system six to twelve billion dollars
per year. |
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Will leukocyte reduction be beneficial
to me if I am having surgery and need a transfusion? |
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Leukocyte reduced blood has been shown in colorectal and cardiac surgery
to reduce infectious complications such as wound infection and pneumonia.
In addition patients who have received leukocyte reduced blood typically
go home several days sooner than patients who have not received leukocyte
reduced transfusions.
Filtered Blood Improves Surgical Patient Outcomes
and Reduces Patient Charges
*Adapted from Jensen et al5
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What are my blood transfusion options? |
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Your blood transfusion options are:
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Donating blood for your own use.
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Using blood donated by family and friends that is your blood type and may
require radiation.
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Using filtered, leukocyte reduced blood from volunteer donors.
To get the best out of the transfusion you need to ask questions, explore
alternatives and demand the quality of filtered blood products. |
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