Safety tips you should know before undergoing blood transfusion - health-care system safe blood transfusions

Blood Transfusion Safety

Before a recipient receives a transfusion, compatibility testing between the donor and recipient blood must be done.

Blood transfusion is the process of transferring blood products into one's circulation intravenously. Transfusions are used for various medical conditions to replace lost components of the blood.

Nearly 120 million units of blood are donated every year. However, this is not sufficient to meet the global need many patients requiring a transfusion do not have timely access to safe blood. Blood cannot be stored indefinitely, meaning there is a constant need for donations.

Blood transfusions are needed for a wide range of health conditions including anemia, complications during pregnancy and childbirth, severe trauma due to accidents, and surgical procedures. They are also regularly used for patients with conditions such as sickle cell disease and thalassemia and for products to treat hemophilia.

Maintaining safe and effective procedures around the collection, storage and use of donated blood is essential. Collectively called haemovigilance, these procedures cover the entire blood transfusion chain and are used to standardize the use of blood in healthcare. 

Donated blood is used in many ways beyond whole blood transfusions. Processing can convert it into plasma, red cell concentrates, platelet concentrates, and more, with each used for specific cases in healthcare delivery. In some cases, this allows a unit of donated blood to meet the needs of more than one patient and is an important aspect of the transfusion train. However, not all countries have facilities to process blood in this way, and only 50 of 173 reporting countries produce plasma-derived medicinal products domestically.

The inability of healthcare systems to adequately screen donated blood has caused a lot of problems and led to several deaths and as such one most important SAFETY TIPS you should know before blood transfusion is to ensure the blood is properly screened.

Compounding insufficient collection rates is the inability of many healthcare systems to adequately screen donated blood for diseases such as HIV, hepatitis B, hepatitis C, and syphilis according to quality system requirements. The inability to test blood can be due in part to the irregular supply of testing kits, particularly in low-income areas. Inadequate testing contributes to the spread of transfusion-transmissible infections, which can compromise the patient’s wellbeing and further strain healthcare systems.

Processing and testing

Donated blood is usually subjected to processing after it is collected, to make it suitable for use in specific patient populations. The collected blood is then separated into blood components by centrifugation: red blood cells, plasma, platelets, albumin protein, clotting factor concentrates, cryoprecipitate, fibrinogen concentrate, and immunoglobulins (antibodies). Red cells, plasma, and platelets can also be donated individually via a more complex process called apheresis.

Compatibility testing

Before a recipient receives a transfusion, compatibility testing between the donor and recipient blood must be done. The first step before a transfusion is given is to type and screen the recipient's blood. Typing of the recipient's blood determines the ABO and Rh status. The sample is then screened for any alloantibodies that may react with donor blood. It takes about 45 minutes to complete (depending on the method used). The blood bank scientist also checks for special requirements of the patient (e.g. need for washed, irradiated, or CMV negative blood) and the history of the patient to see if they have previously identified antibodies and any other serological anomalies.

Infection

The use of a greater amount of red blood cells is associated with a high risk of infections. In those who were given red blood only with significant anemia infection rates were 12% while in those who were given red blood at milder levels of anemia infection rates were 17%

Guidelines recommend blood transfusions should be reserved for patients with or at risk of cardiovascular instability due to the degree of their anemia. In these cases, parenteral iron is recommended.

WHO - World Health Organization