Some sickle cell patients need blood transfusions (simple or exchange) because of severe anemia, before surgery or to help control pain.
What is a Red Blood Cell Transfusion?
- A red blood cell transfusion involves the transfer of red blood cells from one person to another.
- Red blood cells are obtained when a person donates blood.
- Donated blood cells are carefully tested for infections and closely matched to the person receiving the blood to prevent reactions.
Why Blood Transfusion?
- Normal red blood cells carry oxygen throughout the body.
- People with sickle cell disease do not deliver oxygen as well as normal red blood cells do.
- When a person with sickle cell disease has certain complications from their disease, transfusions can help improve delivery of oxygen to the body and decrease blood vessels blocked by sickle cells.
- For some problems, a blood transfusion may be a life-saving measure.
- Sometimes a single transfusion is needed and other times patients need to be on chronic transfusions, which means receiving blood every 4-6weeks for extended planned amount of time.
- Stroke is a complication in which the brain suffers damage. A transfusion can help prevent further damage and more strokes from happening. Strokes can happen in two ways:
- When blood leaks into the brain.
- When blood flow is blocked to the brain
- Acute chest syndrome is a life threatening complication of sickle cell anemia and may require blood transfusion. It is similar to pneumonia in that there is a change in the appearance of the lung in an X-ray. Sickle cells become trapped in the blood vessels of the lung. These blood vessels can cause chest pain, fever and increased oxygen needs.
- Other reasons for blood transfusion include special circumstances such as - priapism, pregnancy, pain, before surgery (general anesthesia), very low hemoglobin value or other critical illnesses.
How and Where are Transfusions Given?
- Blood transfusions may be given through a regular IV or temporary specialized catheter such as port, midline, PICC line or a mahurkar.
- They can be given in the infusion clinic and then the patient can go home afterward. Blood transfusions might also be given while a patient is in the hospital.
Benefits of Blood Transfusion
- Blood transfusion provides normal red blood cells that can:
- Increase hemoglobin to improve delivery of oxygen in the body.
- Decrease blockage of flow in blood vessels from sickle cells.
- Blood transfusion can decrease the drive to produce new sickle cells
Possible Risks of Blood Transfusion
- Iron overload happens when excess iron from transfused blood builds up and remains in the body. This can lead to major damage in the heart, liver and other organs. Patients are monitored when they consistently have an elevated iron number. If that happens, chelation is discussed.
- The body’s immune system may have a reaction to parts of the transfused blood. Symptoms include rash, itching, chills, fever and pain. More serious reactions may cause shortness of breath. Transfusion reactions also occur when the body’s immune system makes proteins called antibodies against the transfused blood cells. These antibodies can form at any time after a transfusion and make it harder to find matched blood in the future. Sometimes, patients may need to stop receiving chronic transfusions and consider other types of medical treatment when experiencing antibody development.
- Transmission of infections can occur, but are very rare. All blood products are carefully screened to prevent the patient receiving the blood from getting an infectious disease such as hepatitis or HIV. Fortunately, the chance of getting an infection from a blood transfusion is extremely small. For example, at the present time, the risk of getting HIV from a blood transfusion is less than one (1) in a million.