information on transfusions

[caraiti]

taken from

http://www.merck.com/mmhe/sec14/ch171/ch171c.html

Most blood donations are divided (fractionated) into their components: red blood cells, platelets, clotting factors, plasma, antibodies (immunoglobulins), and white blood cells. Depending on the situation, people may receive only the cells from blood, only the clotting factors from blood, or some other blood component. Transfusing only selected blood components allows the treatment to be specific, reduces the risks of side effects, and can efficiently use the different components from a single unit of blood to treat several people.

Red Blood Cells: Packed red blood cells, the most commonly transfused blood component, can restore the blood's oxygen-carrying capacity. This component may be given to a person who is bleeding or who has severe anemia. The red blood cells are separated from the fluid component of the blood (plasma) and from the other cellular and cell-like components. This step concentrates the red blood cells so that they occupy less space, thus the term “packed.” Red blood cells can be refrigerated for up to 42 days. In special circumstances—for instance, to preserve a rare type of blood—red blood cells can be frozen for up to 10 years.

Platelets: Platelets can help restore the blood's clotting ability. They are usually given to people with too few platelets (thrombocytopenia), which may result in severe and spontaneous bleeding. Platelets can be stored for only 5 to 7 days.

Blood Clotting Factors: Blood clotting factors are proteins found in blood plasma that normally work with platelets to help the blood clot. Clotting factors may be obtained from plasma or manufactured. Manufactured proteins are called recombinant factor concentrates. Without clotting factors, bleeding would not stop after an injury. Individual concentrated blood clotting factors can be given to people who have an inherited bleeding disorder, such as hemophilia or von Willebrand's disease, and to those who are unable to produce enough clotting factors (usually because of severe infection or liver disease).

Plasma: Plasma, the fluid component of the blood, contains many proteins, including blood clotting factors. Plasma is used for bleeding disorders in which the missing clotting factor is unknown or when the specific clotting factor is not available. Plasma also is used when bleeding is caused by insufficient production of all or many of the different clotting factors, as a result of liver failure or severe infection. Plasma that is frozen right after it is separated from the cells of donor blood (fresh frozen plasma) can be stored for up to 1 year.


 
   
Did You Know...

Doctors can specify what type of blood cells are given during a transfusion so that people get only those cells that are needed to treat their disorder.

 
 
Antibodies: Antibodies (immunoglobulins), the disease-fighting components of blood, are sometimes given to provide temporary immunity to people who have been exposed to an infectious disease or who have low antibody levels. Infections for which antibodies are available include chickenpox, hepatitis, rabies, and tetanus. Antibodies are produced from treated plasma donations.

White Blood Cells: White blood cells are transfused to treat life-threatening infections in people who have a greatly reduced number of white blood cells or whose white blood cells are functioning abnormally. The use of white blood cell transfusions is rare, because improved antibiotics and the use of cytokine growth factors have greatly reduced the need for such transfusions. White blood cells are obtained by hemapheresis and can be stored for up to 24 hours.

Blood Substitutes: Blood substitutes that use certain chemicals or specially treated solutions of hemoglobin (a protein that allows red blood cells to carry oxygen) to carry and deliver oxygen to tissues are being developed. These solutions can be stored at room temperature for up to 2 years, making them attractive for transport to the site of trauma or to the battlefield. However, further research is needed before these blood substitutes become available for routine use.

Last full review/revision July 2007 by Harold S. Kaplan, MD; Donna L. Skerrett, MD
 
 
 
 
 

[caraiti]

taken from
http://www.merck.com/mmhe/sec14/ch171/ch171e.html

Precautions and Adverse Reactions
 
To minimize the chance of an adverse reaction during a transfusion, health care practitioners take several precautions. Before starting the transfusion, usually a few hours or even a few days beforehand, a technician mixes a drop of the donor's blood with the recipient's to make sure they are compatible. This procedure is called cross-matching.

After double-checking labels on the bags of blood that are about to be given to ensure the units are intended for that recipient, the health care practitioner gives the blood to the recipient slowly, generally over 1 to 2 hours for each unit of blood. Because most adverse reactions occur during the first 15 minutes of the transfusion, the recipient is closely observed at first. After that, a nurse checks on the recipient periodically and must stop the transfusion if an adverse reaction occurs.

Most transfusions are safe and successful; however, mild reactions occur occasionally, and severe and even fatal reactions, rarely. The most common reactions are fever and allergic reactions (hypersensitivity), which occur in about 1 to 2% of transfusions. Symptoms of an allergic reaction include itching, a widespread rash, swelling, dizziness, and headache. Less common symptoms are breathing difficulties, wheezing, and muscle spasms. Rarely, an allergic reaction is severe enough to cause low blood pressure and shock. Another rare reaction, called transfusion-related acute lung injury, or TRALI, is caused by antibodies in the donor's plasma. This reaction, which is more common when the donor is a woman who has been pregnant, may cause serious breathing difficulties. More general use of male donor plasma has decreased the number of people who have this reaction.

Treatments are available that allow transfusions to be given to people who previously had allergic reactions to them. People who have allergic reactions to donated blood may have to be given washed red blood cells. Washing the red blood cells removes components of the donor blood that may cause allergic reactions. More commonly, the transfused blood is filtered to reduce the number of white blood cells (a process called leukocyte reduction). Leukocyte reduction is usually done by placing a special filter in the tubing through which the transfusion is flowing. Alternatively, the blood may be filtered before it is stored.

Despite careful typing and cross-matching of blood, mismatches due to subtle differences between donor and recipient blood (and, very rarely, errors) can still occur that cause the transfused red blood cells to be destroyed shortly after the transfusion (a hemolytic reaction). Usually, this reaction starts as a general discomfort or anxiety during or immediately after the transfusion. Sometimes breathing difficulty, chest pressure, flushing, and severe back pain develop. Very rarely, the reactions become more severe and even fatal. A doctor can confirm that a hemolytic reaction is destroying red blood cells by checking to see whether hemoglobin released from these cells is in the person's blood and urine.

Transfusion recipients can become overloaded with fluid. Recipients who have heart disease are most vulnerable, so their transfusions are given more slowly and they are monitored closely.

Graft-versus-host disease is an unusual complication that affects primarily people whose immune system is impaired by drugs or disease. In this disease, the recipient's (host's) tissues are attacked by the donated white blood cells (the graft). The symptoms include fever, rash, low blood pressure, low blood counts, tissue destruction, and shock. These reactions can be fatal but are eliminated by treating with radiation those blood products that are intended for people with a weakened immune system.

Last full review/revision July 2007 by Harold S. Kaplan, MD; Donna L. Skerrett, MD
 
 

[amanda]

The most common treatment for all major forms of thalassemia is red blood cell transfusions. These transfusions are necessary to provide the patient with a temporary supply of healthy red blood cells with normal hemoglobin capable of carrying the oxygen that the patient's body needs.

[caraiti]

You are quite correct Amanda
How ever it is not just any blood, it is the blood that has been out of the blood the latest.
Because blood expires, it wouldn't be good to transfuse with old blood as this would die sooner and the patient would need a transfusion sooner.
The other problem with this is that with every transfusion, the body gets too much iron that it can't get rid of.
Leucoycte depleted or blood that has only red blood cells is given, because my body doesn't need the white cells.

For me, I am transfused leucoycte depleted blood that is never 7 days or more old.

The other thing to note is that the only treatment available is tranfusions and chelation therapy.
There are some "cures" but as with everything, there is a risk.
At the moment some of these "cures" have more risks than cures.
My personal solution has been to continue with what I have because I am still alive. Some of these "cures" don't give that high percentage of a guarantee.