Blood Transfusion

"In the process of selecting candidates to donate blood, we exclude those who have risk practices for the spread of infectious diseases that can be transmitted by donated blood".

DR. ESTHER PENA CARBÓ
SPECIALIST. HAEMATOLOGY AND HAEMOTHERAPY DEPARTMENT

Blood transfusion, both in the form of whole blood, as well as in that of some of its components, is a therapeutic replacement for something in which the body is deficient, causing important clinical manifestations.

A blood bank is a health center or establishment in charge of promoting the altruistic donation of blood and of carrying out the collection, preparation, conservation, storage and supply of human blood and its components.

Before each donation, the state of health of the blood donor is evaluated through a clinical history, physical examination and biological study of the blood obtained.

With this evaluation it is tried to assure the innocuousness of the donation for himself, besides protecting the future recipient from possible foreseeable risks.

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When is a blood transfusion indicated?

You can be a donor:

  • A healthy person between 18 and 65 years old who altruistically donates blood or any of its components.
  • Another modality of donation is through cellular separators that allow the selective donation of some of the components of the blood, concentrate of red blood cells, platelets, plasma, with return to the donor of the rest of the components.
  • The universal donor of whole blood or red blood concentrate must be of the group O and Rh D negative, antigen CE negative and antigen Du negative. The universal plasma donor is of group AB.

Most frequent indications of this treatment:

  • Anemia
  • Bleeding
  • Bleeding after surgery

Do you have any of these diseases?

You may need to have a blood transfusion

Learn more about blood transfusion

This is the test that is carried out to ensure the compatibility of the recipient with the donor's red blood cells.

It involves the incubation of the recipient's serum with the donor's red blood cells at different temperatures and by different means, to show the identification of any clinically significant antibody that may exist in the recipient's serum against the donor's red blood cells.

Autotransfusion is the procedure by which blood or one of its components is extracted from a given patient for subsequent re-infusion into himself. In other words, the donor-patient is the same person.

The benefits that they represent are evident: it eliminates the risk of alloimmunization, of hemolytic, allergic or febrile reactions; of transmission of infectious diseases such as hepatitis and HIV; it stimulates erythropoiesis by repeated phlebotomies; it is accepted in patients opposed to receiving homologous blood because of religious beliefs as Jehovah's Witnesses.

There are different modalities of autotransfusion:

Pre-operative autologous donation:
It is the most used modality. It consists of the extraction of approximately 450 ml. of total blood from the patient, with an interval between extractions of 3-7 days, carried out the last 72 hours before the operation. Between extractions, iron is administered and, depending on the basal analysis, erythropoietin may be added.

Acute normovolemic haemodilution:
Depending on the basal haematocrit, between 1 and 3 units of whole blood are extracted immediately before or during anaesthetic induction, replacing the extracted volume with crystalloid solutions and/or colloids. Postoperatively, the patient is transfused with his or her own blood, which, having been stored for only a few hours, provides platelets and labile coagulation factors.

Pre-operative erythropheresis:
It is performed 18-24 hours before surgery through a pheresis procedure that collects only concentrated red blood cells, returning the plasma to the patient.

Intraoperative autologous recovery:
Using special machines, blood is recovered and anticoagulated from the operating field and, after processing, reinfused into the patient.

Post-operative and post-traumatic autologous recovery and transfusion
Recovery of blood accumulated in the postoperative period. The blood is collected through drains in sterile equipment that filters the blood and is reinfused within 6 hours of collection to prevent bacterial proliferation.

Whole blood
In Blood Banks, whole blood is processed to obtain the different blood products: red blood cells concentrate, platelets concentrate, fresh frozen plasma. This allows each patient to be administered only the component he or she needs.

Red cells concentrate
It is indicated for transfusion in chronic symptomatic anemia not correctable by other therapeutic means and in moderate or acute blood loss associated with other blood products.

Frozen red blood cells concentrate
It is used as a method of autotransfusion of polysensitized patients and as conservation of rare phenotypes.

Concentrated washed red blood cells
It is used in patients with IgA deficit, and in those who have severe allergic reactions to plasma proteins.

Leukocyte-poor red blood cell concentrate
Its use would be indicated in patients who present shiver-hyperthermia reactions by antileucocyte antibodies, in prevention of alloimmunization by leukoplaktary antibodies and as an alternative to negative cytomegalovirus products.

Platelet concentrate
It is used therapeutically in patients with bleeding from thrombopenia or functional disorders of platelets.

Fresh frozen plasma
Its transfusion is indicated in patients with hemorrhagic symptoms and coagulation test alterations. Another use of fresh plasma is as a raw material for obtaining hemoderivatives such as albumin, immunoglobulins, coagulation factors, etc.

They are rare. Those with the highest incidence occur in 1-2% of cases and are mild reactions that are easily treated, such as fever, chills, hives, etc., occurring mainly in patients with a history of transfusions. Other more serious reactions, such as hemolysis, circulatory overload, acute non-cardiogenic pulmonary edema, anaphylactic shock, are very rare and even exceptional.

On the other hand, at present, each unit of blood is subjected to rigorous scrutiny to prevent the transmission of infectious diseases.

Where do we do it?

IN NAVARRA AND MADRID

The Hematology and Hemotherapy Service of the
at the Clínica Universidad de Navarra

The Hematology Service of the Clinic, formed by specialists of recognized national and international prestige, has integrated molecular diagnostic techniques and the use of new personalized treatments in its assistance work, allowing a more precise and fast diagnosis of the hematological diseases.

The joint work of the medical staff and the researcher facilitates the development and application of the new treatments and at the same time the precise evaluation of the result of the treatments.

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Why at the Clinica?

  • Experts in the development of Cellular Therapy treatments.
  • International reference center in lymphomas, multiple myeloma and monoclonal gammopathies.
  • Experts in the diagnosis and treatment of hemorrhagic and thrombotic problems.

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