Receiving a Blood Transfusion: Information for Patients

A summary answer is provided below.  For more information, click on the question.

Why do I need a blood transfusion?

Your doctor has determined that you have an abnormal level of some or all components in your blood.

If your body does not have enough of one of the components of blood, you may develop serious life-threatening complications.  Specific details about why you need blood are best answered by your doctor. Be sure to ask any questions if there is any part of your treatment that is not clear.

What preparation occurs?

Before you receive a transfusion, the hospital laboratory will draw a sample of your blood.

Staff will test it to ensure you receive the blood product most suited for you. A doctor that specializes in Transfusion Medicine oversees this testing. If you have received a blood transfusion anytime in the past, it is important to tell your doctor or nurse, so they can alert the blood bank in the hospital laboratory. Preparing the right blood for you involves:

  • choosing a compatible blood type (link to blood type compatibility chart)
  • selecting the right blood component – red blood cells, platelets and/or plasma
  • performing extra steps to look for antibodies
  • ensuring that a blood component is compatible with your blood
  • irradiating or washing cells, if needed

All of this is to provide the best blood product and outcome for you.

What's in the blood bag?

You may receive red blood cells, platelets and/or plasma.

  • Red blood cells carry oxygen to all parts of the body and remove waste products, such as carbon dioxide, from the body.  Red blood cells are transfused when blood is lost in a surgery or injury.  Cancer, blood diseases and treatments for them (like chemotherapy) can also deplete your red blood cells or cause them to not work correctly.
  • Platelets stop or prevent bleeding.  They form a plug to stop bleeding due to injury, surgery or illness.  They also help to repair damaged body tissue. The most common reasons for platelet transfusions are chemotherapy, marrow transplants, major surgeries, liver disease and severe trauma.
  • Plasma transfusions replace missing or low levels of blood proteins that may occur because of trauma, burns, surgery with severe blood loss or a medical condition, such as liver disease.

How long does it take to receive a transfusion?

This depends upon your condition.

In an emergency, for instance, it can be given as fast as your body will allow.  In non-urgent situations, a transfusion lasts approximately one to two hours, depending on what type of blood product you receive.

What happens during the transfusion?

A needle will be inserted into a vein in your arm with IV tubing attached. First, saline will be started; then, the blood.

Before starting the transfusion, a nurse or doctor will check your ID bracelet to properly identify you and the unit of blood sent by the blood bank. A nurse will monitor your blood pressure, temperature and pulse before, during and after the transfusion.  Most people do not feel any different during a transfusion.  Reactions are uncommon and usually, mild. If during a transfusion, you feel unwell or experience any of the following symptoms, tell the nurse so you can be assessed for a reaction needing treatment:

Chills or shaking chills

Abdominal, chest or back pain

Feeling hot or flushed

Difficulty breathing, wheezing or coughing

Pain where the needle is inserted

Nausea/vomiting

Hives or rashes

Are there things that can be done to make my transfusion more comfortable?

There are devices such as blood warmers that can be used by the nurses to make your transfusion more comfortable.

Are there other choices than a blood transfusion?

Blood is required to live, and certain treatments or surgeries can’t be safely carried out without a blood transfusion.

Sometimes medications can be used in order to help your body make more of its own blood. Some medications may also be used to prevent or control bleeding. Your physician will advise you if there is an option for a different treatment.

In some cases, it may be possible to donate your own blood for non-emergency use (such as before elective surgery.) This type of blood donation is called autologous. Since you are getting your own blood, many infectious risks are eliminated, but other risks associated with transfusion remain. It may be possible to arrange for blood donations from family members or friends. This type of donation is called Directed Donation. Directed Donation may not be safer than blood from the volunteer blood supply. Both autologous and directed donations may not be adequate for all of your transfusion needs. If that is the case, you will still need to receive volunteer-donated blood. Your doctor or the transfusion medicine doctor can answer questions about these special procedures.

Is a blood substitute available?

No, although products are currently under investigation.

In the USA, there are no FDA approved blood substitutes available for transfusion in humans at this time.

Are blood transfusions safe?

Blood transfusions are typically safe and an important life-saving treatment.

Our unpaid, volunteer blood donors complete a comprehensive screening about their health, behavior and travel history in order to ensure the blood supply is as safe as possible. They must meet strict guidelines. A comprehensive health screening is conducted. All blood products are tested for ABO and Rh type, HIV, Hepatitis B, Hepatitis C, Syphilis, and HTLV. These standards are established by the Food and Drug Administration (FDA) to provide the safest possible blood components. All tests must be negative before a donor’s blood is released for transfusion. If there is any question that a donor’s blood is unsafe, it is discarded.  However, it is not possible to say there is no risk. To put this into appropriate perspective, consider this comparison of your lifetime chances of getting a disease from a blood transfusion to other rare situations:

  • HIV: 1 in 2 million cases
  • Hepatitis C: 1 in 1 million cases
  • Hepatitis B: 1 in 137,000 cases
  • Struck by lightning: 1 in 700,000
  • Deadly plane crash: 1 in 500,000
  • Accidental drowning: 1 in 80,000
  • Deadly car accident: 1 in 5,000

What are the risks of having a reaction from a blood transfusion?

The risk of having a reaction to blood transfusion is very small.

Most transfusions do not cause serious side effects, but as with any medical treatment, are not without some risk.

  • Most transfusion reactions occur during or immediately after a transfusion; however, delayed reactions can occur up to 12 days after a transfusion.
  • Common, temporary side effects can include bruising or mild pain at the infusion site. A mild allergic reaction may cause hives or itching. Other mild reactions may cause fever or chills. Depending on the type of reaction, you may be given medicine such as Tylenol (acetaminophen) or Benadryl (diphenhydramine).
  • A SERIOUS REACTION such as hemolytic transfusion reaction (which is the destruction of red cells) is highly unlikely. If you have any symptoms (see previous list), tell the doctor or nurse immediately. A small number of patients may develop a blood antibody, which may interfere with future transfusions or pregnancy. If, after returning home, you notice a change in the color of your urine to pink, red, or brown, or notice a change in skin color to yellow, call your doctor, emergency room or hospital clinic immediately.

What are the charges for a blood transfusion?

Blood itself is a donated product. However, there are costs associated with testing, storage, and transfusion.

A processing fee is charged to recover those costs.

What happens if I refuse transfusion?

Adults have the right to refuse a blood transfusion;

however, you are responsible for the consequences or complications caused by your refusal.

How can I find out more?

If you have any questions about blood transfusion, ask your doctor.

The transfusion medicine doctors at Your Blood Institute can also talk to you about any concerns you may have about receiving a blood product.

Bob Grant