Blood transfusions

Why might I need a blood transfusion?

Blood contains many different cells. The red cells are essential for carrying oxygen around the body. A lack of these red blood cells is called anaemia. A blood transfusion may be given because of a shortage of red blood cells in the blood. In some cases anaemia can be treated with medicines; in other cases, a blood transfusion may be the best treatment.

Most people can cope with losing a moderate amount of blood without needing a blood transfusion. However, if larger amounts of blood are lost, a blood transfusion may be the best way of replacing blood rapidly. A blood transfusion may be needed to treat severe bleeding.

Is a blood transfusion my only option?

If you are told that you might need a blood transfusion, you should ask why it is necessary and whether there are any alternative treatments.

You do have the right to refuse a blood transfusion, but you need to fully understand the consequences of this before doing so. Some medical treatments or operations cannot be safely carried out without a blood transfusion being given.

Blood transfusion is only needed for a small number of patients having an operation. Sometimes it is possible to recycle your own blood during or after an operation. Ask if this is appropriate for you. This is not done if your operation is to treat cancer.

What can I do to reduce the need for a blood transfusion before an operation?

You will have a blood sample before your operation to see if you are anaemic. A shortage of iron can cause anaemia and correcting this before your operation may reduce the need for a blood transfusion. A varied and balanced diet should provide enough iron.

Some medicines, such as warfarin, aspirin and some anti-inflammatory drugs may increase the risk of bleeding during your operation. Always check with your doctor to find out if you should stop taking these before your operation and if so, when you should restart them. Do not stop taking any medications without asking your doctor.

Are blood transfusions safe?

Yes, the risk that a blood transfusion will make you ill is very low. One of the most important ways of achieving a safe transfusion is to make sure you get the right blood. You can help reduce the small risk of being given the wrong blood by joining in safety checks when you have a blood test and when the blood is connected to your drip.

You must be correctly identified at each stage of the transfusion to make sure that you get the right blood, including when blood samples are taken before the transfusion. Wearing an identification band with your` details is essential. You will be asked to state your full name and date of birth and this will be checked against your identification band. If you have your blood samples taken as an out-patient, you will not usually be given an identification band to wear, but it is still important that the staff ask you your full name and date of birth to confirm they are taking the samples from the right person. It is alright to remind your nurse or doctor to ask you for this information.

If you have previously been given a card which states that you need to have blood of a specific type, please show it as soon as possible to your doctor or nurse and ask them to tell the hospital transfusion laboratory.

Compared to other everyday risks, the likelihood of getting an infection from a blood transfusion is very low. All blood donors are unpaid volunteers and the risk of viral infections has almost been eliminated as a result of careful donor selection and testing.

It is calculated that hepatitis B might be passed on by fewer than one in 1.3 million blood donations. To put this in perspective, you are more likely to die in a gas incident (fire, explosion or carbon monoxide poisoning) than to get hepatitis B from a blood transfusion.

The risk is many times smaller for HIV (one in 6.5 million) and hepatitis C (one in 28 million).

The risk of getting the human version of mad cow disease (vCJD) from a blood transfusion is extremely low. Each year, approximately 2.5 million units of blood components are transfused in the United Kingdom and there have been only a handful of cases where patients are known to have become infected with vCJD. Note that as a precautionary measure to reduce the risk of transmitting vCJD, people who have received a blood transfusion since 1980 are not currently able to donate blood.

How will my blood transfusion be given?

A blood transfusion is usually given into a vein through a cannula. It may take three hours to give each bag of blood, but it can be safely given more quickly if needed. You may be given more than one bag of blood as part of your treatment.

How will I feel during my blood transfusion?

Most people do not feel anything whilst receiving a blood transfusion. You will be checked before, during and after your blood transfusion; if you feel unwell during or after it, you should tell your doctor or nurse straight away. Some people may develop a temperature, chills or a rash. These reactions are usually mild and are easily treated. Severe reactions to blood are extremely rare. If they do occur, staff are trained to recognise and treat them.

What if I have worries about receiving a blood transfusion?

If you have any concerns you should discuss these with your doctor or nurse. The Hospital Transfusion Team may be able to come and discuss your concerns with you.

NHS Blood and Transplant (NHSBT) is a Special Health Authority within the NHS, and provides the blood that patients receive. In order to plan for future blood demands, information about which patients receive blood needs to be gathered. We may ask a hospital or GP to provide limited medical information on a sample of patients who have received blood transfusions.

Any information that is passed on to NHSBT is held securely, and the rights of these patients are protected under the Data Protection Act (1998).