Red blood cell transfusion This leaflet explains more about red blood cell transfusion, including the benefits, risks and any alternatives and what you can expect when you come to hospital. If you have any further questions, please speak to a doctor or nurse caring for you. What is a red blood cell transfusion? A red blood cell transfusion is a treatment where blood is given to you through your veins from a drip (intravenous line). The blood has been taken from a healthy blood donor, and each blood donation is checked to make sure it is safe to be given to another person. Why should I have a blood transfusion? Your red blood cell levels may be so low that you are made ill. Red blood cells carry oxygen around the body and their numbers are measured by testing something called haemoglobin. If this is low you may have anaemia which may mean your body does not receive enough oxygen causing you to feel tired and short of breath. A blood transfusion can be used to treat this by increasing your haemoglobin with a bag of red blood cells from a blood donor. You may need a blood transfusion if you have recently lost a lot of blood e.g. after an operation. There are also other reasons you might need a blood transfusion. What are the risks? Blood transfusion has a number of possible risks and side effects: Infection Blood used for transfusions is taken from donors who are healthy members of the public. Blood is tested for viruses such as hepatitis and HIV, but there is still a small risk of these being present. Roughly 1.5 million bags of red blood cells were transfused in the UK last year. On average this resulted in one episode of hepatitis B infection (1 in 1.3 million). The risk for HIV is even lower (1 in 6.5 million). 1 of 5
Immune system reaction As the blood which you receive has come from someone else, there is a small risk that you may have an allergic reaction to it. This may be a mild fever or itching or it could be a more severe reaction with breathing difficulty and a sudden drop in blood pressure (anaphylaxis). Your body may also react if you are given blood which is the wrong blood group. This can cause your body to attack and destroy the transfused blood cells (haemolysis). This risk is very low as it can be avoided by carefully matching the donor blood with your blood sample, but it can still happen through human error. Simple allergic reactions can be treated with drugs such as antihistamines or paracetamol. More severe reactions may require us to stop the transfusion and give further treatment. You will be monitored regularly by your nurses throughout the transfusion and if you have a reaction, it will be recognised by healthcare staff and you will be treated for it. Fluid Overload If you have heart, liver or kidney problems, there is a risk that any blood or other fluid we give you through your veins could overload your circulation system and cause swelling of the legs or shortness of breath. This may need treatment with water tablets (diuretics) to remove the excess fluid. If we are aware of such a pre-existing health condition, we may give you this medication while you have your transfusion. Are there any alternatives? Not all patients with anaemia need a transfusion. If you are not experiencing any symptoms and your haemoglobin level is OK, then other treatments may be better. If your haemoglobin is low due to bleeding or low iron levels, we may give you iron tablets or an iron infusion (See our iron deficiency anaemia clinic leaflet). If it is low due to low folic acid or vitamin B12 levels, this can also be treated with tablets or injections. 2 of 5
In some cases blood transfusion is the only appropriate treatment (also see our alternatives to blood transfusion leaflet). If there is any reason why you would not accept a blood transfusion (e.g. on religious grounds) then please tell the doctor or nurse caring for you as soon as possible. How can I prepare for blood transfusion? Unless you are unwell for another reason, you do not usually need to be admitted to hospital for a blood transfusion. The blood transfusion can be given in a day unit and you can go home later that day. Sometimes you may need to come back again the following day or later that week for another transfusion. You do not need to bring anything with you, but having a blood transfusion may take several hours, so you may wish to bring a book to read. Asking for your consent It is important that you feel involved in decisions about your care. For blood transfusion, you will be asked to give verbal consent to say that you agree to have the treatment and understand what it involves. You can withdraw your consent at any time, even if you have said yes previously. What happens during blood transfusion? You will have a blood sample taken. This will be sent to the laboratory to be matched to a bag of blood in the lab to see if it is suitable for you (a cross-match). Once the blood is ready, it will be collected from the lab by one of your nurses. A small plastic tube (cannula) will be placed in your arm and you will be given the blood through a drip. We will monitor you throughout the process for any reactions and will treat them as needed. Will I feel any pain? You should not feel any pain. If you do, you must tell the doctor or nurse looking after you straight away as this is not normal. 3 of 5
What happens after my blood transfusion? We may take another blood sample to see if you will need another transfusion in the future. We may start other treatments (e.g. iron tablets) to treat your anaemia and prevent any need for more transfusions. We may recommend tests to look for a cause of bleeding (e.g. a camera test of the bowels). We will discuss this with you if this is the case. What do I need to do after I go home? You do not need to do anything. If you feel unwell for any reason, you should contact your doctor or nurse. Will I have a follow-up appointment? You may have another appointment if you require further transfusions. Can I donate blood after a blood transfusion? You cannot donate blood once you have had a blood transfusion in the UK. Useful sources of information NHS Choices www.nhs.uk/conditions/blood-transfusion Contact us If you have any questions or concerns about blood transfusion, please contact the transfusion team on 020 8725 4652 (Monday to Friday, 8am to 6pm). For more information leaflets on conditions, procedures, treatments and services offered at our hospitals, please visit www.stgeorges.nhs.uk 4 of 5
Additional services Patient Advice and Liaison Service (PALS) PALS can offer you on-the-spot advice and information when you have comments or concerns about our services or the care you have received. You can visit the PALS office between 9am and 5pm, Monday to Friday in the main corridor between Grosvenor and Lanesborough Wing (near the lift foyer). Tel: 020 8725 2453 Email: pals@stgeorges.nhs.uk NHS Choices NHS Choices provides online information and guidance on all aspects of health and healthcare, to help you make decisions about your health. Web: www.nhs.uk NHS 111 You can call 111 when you need medical help fast but it s not a 999 emergency. NHS 111 is available 24 hours a day, 365 days a year. Calls are free from landlines and mobile phones. Tel: 111 5 of 5 Reference: CLH_TRBC_01 Published: August 2016 Review date: August 2018