FAQs ABOUT BLOOD AND BLOOD PRODUCTS: |
What are the different blood components? |
What is a "blood type?" |
What types of red blood cells can different types get? |
What are the different types of "transfusion reactions?" |
What are the infectious disease risks of blood transfusions? |
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Risk of infection from a single transfusion for selected diseases | |
Human Immunodeficiency Virus (HIV) | 1:2,000,000 |
Hepatitis C (HCV) | 1:1,600,000 |
Hepatitis B (HBV) | 1:200,000 |
HTLV I/II | 1:650,000 |
Transfusion reactions occur when the blood recipient has an adverse reaction to the transfused blood product. Reactions may be mild (not even noticed) to severe (life-threatening or fatal). | ||
Type of Reaction | What happens | How common? |
Allergic | The plasma contains something the recipient is allergic to (maybe the donor ate strawberries for lunch). Usually just itching and/or hives. Treat with Benadryl. | 1:30 |
Febrile | The recipient reacts to white blood cells (or cytokines) in the transfused products. Fever greater than 1.8 F above baseline. Treat with Tylenol. | 1:60 |
Delayed Hemolytic Transfusion Reaction | When the recipient makes antibodies against one of the antigens on the transfused red cells (not A or B antigens). The patient's system slowly removes this blood from the body. In the future, the patient will receive red cell products selected so that they lack the inciting antigen. | |
Acute Hemolytic Transfusion Reaction | This is the bad one. If this happens, it is most likely because someone made a mistake. The recipient receives ABO incompatible red cells, and his antibodies destroy the blood cells within the circulatory system. This releases a lot of chemical mediators that can shut the kidneys down, make the blood pressure drop dangerously low, and even cause death. |
A person's "blood type" refers to the combination of antigens (two types, designated "A" and "B") on his red cells, and the antibodies present in his plasma. Blood is made up of red cells, which have the A and B antigens, and plasma, which has antibodies against the A antigen (anti-A) and against the B antigen (anti-B). A person's plasma contains antibodies for the antigens his red cells lack. Group O designates the absence of both A and B antigens on the red cells. | ||
BLOOD TYPE | ANTIGENS ON RED CELLS | ANTIBODIES IN PLASMA |
O | NONE | Anti-A, Anti-B |
A | A | Anti-B |
B | B | Anti-A |
AB | A and B | NONE |
Blood is composed of: |
THE BASIC BLOOD COMPONENTS AND THEIR USES: |
RED BLOOD CELLS: Used to increase oxygen-carrying capacity in patients who have lost a lot of blood or have low "hemoglobin" levels due to anemia of other causes. Should not be used for "volume replacement"—solutions like "normal saline" are better for that. |
PLATELETS: Used to help clotting in patients with low platelet levels, or dysfunctional platelets. |
FRESH FROZEN PLASMA: Replaces coagulation factors (clotting factors) in patients with low levels of many factors. Single replacement factors are available (and a better choice) for most single-factor deficiencies. |
CRYOPRECIPITATE: (a derivative of plasma) Used for replacing fibrinogen or von Willebrand's factor. |
FOR RED BLOOD CELL TRANSFUSIONS | ||||
PATIENT GROUP | FIRST CHOICE (IN ORDER OF PREFERENCE) | SECOND CHOICE | IN EXCEPTIONAL CIRCUMSTANCES | CANNOT RECEIVE |
O+ | O+ | O- | A+, A-, B+, B-, AB+, AB- | |
O- | O- | O+ | A+, A-, B+, B-, AB+, AB- | |
A+ | A+, A- | O+, O- | B+, B-, AB+, AB- | |
A- | A- | O- | A+, O+ | B+, B-, AB+, AB- |
B+ | B+, B- | O+, O- | A+, A-, AB+, AB- | |
B- | B- | O- | B+, O+ | A+, A-, AB+, AB- |
AB+ | AB+, AB-, B+, B-, A+, A- | O+, O- | ||
AB- | AB-, B-, A- | O- | AB+, B+, A+, O+ | |
Note that group O people can ONLY receive group O, and that group AB can receive ANY group. |