What Are Possible Blood Transfusion Complications?
“The life of every person who receives blood depends on the honesty of the individual donors who have given their blood.” -sanbs.org
Transfusion reactions - the real story
The following is a typical response to the question – Are there any side effects? “Your child should not feel any pain when the blood goes in. However some children may develop a fever or a rash. These are usually due to an allergic reaction and are easily treated with paracetamol or by slowing down the blood transfusion. Severe reactions to transfusion are rare. All staff responsible for giving blood transfusions are specially trained to manage transfusion reactions.” -sch.edu.au
Here’s a list of the real risks involved. It differs greatly from the response above. Lesser known risks include:
• Multiple organ failure
• A three fold (300%) increased risk of heart attack and stroke following heart surgery…
• Increased recurrence of cancer
• Increased risk of stroke
• Increased risk of kidney failure
• A five fold (500%) increased risk of dying within 100 days
• A higher risk of death for all types of surgery
• Anaphylactic shock – which can result in death
Anaphylactic reactions occur in 1 per 20,000 transfused units.
• Hemochromatosis (from repeated transfusions)
• Some harmful medications may be transmitted in donated blood
• Microchimerism, a condition in which the transfusion recipient receives some of the donor’s genetic material. This may possibly increase the risk of non-hodgkin’s lymphoma and chronic lymphocytic leukemia. It is believed that this may cause autoimmune disease in the recipient.
• Acute immune hemolytic reaction
• Febrile Nonhemolytic Transfusion Reaction (FNHTR)
• Graft-versus-host disease (GVHD) 80-90% mortality rate
• Iron overload
• Volume overload
• Hypotension - abnormally low blood pressure
• Systemic Inflammatory Response Syndrome
Viral, bacterial and microbial infections:
• HIV the odds – 1 in 150,000 units
• Hepatitis B the odds – 1 in 50,000 units
• Hepatitis C the odds – 1 in 4,500 units
• Babesiosis – a malaria-like parasitic disease
• Epstein-Barr virus
• Human herpesvirus type 6 (HHV-6)
• Human parvovirus (HPV-B19)
• SEN virus (SEN-V)
• Suppressed Immunity
• Yersinia enterocolitica
• Treponema pallidum (causes syphilis)
• Chagas Disease
• Human T-lymphotropic virus (HTLV-1 and HTLV-2)
• West Nile virus
• Systemic bacterial infection
• CMV Cytomegalovirus
• “Mad Cow Disease” – variant Creutzfeldt – Jakob disease
• TRALI – transfusion-related acute lung injury 5% mortality rate
• Lyme disease
**The odds of HIV Hepatitis B & Hepatitis C
According to Emedicine the odds of contracting HIV (Aids) Hep B and C per unit (not per transfusion):
• HIV – 1 in 150,000
• Hepatitis B – 1 in 50,000
• Hepatitis C – 1 in 4,500
Divide this figure by the number of units received in a transfusion and the odds per transfusion don’t look promising.
The American Red Cross
The following 7 tests are performed on each donor at the time of donation:
• Antibody detection
• Automated test for Syphilis
• Antibody to Human Immunodeficiency Virus (anti HIV 1/2)
• Antibody to Hepatitis B Core Antigen (anti-HBc)
• Antibody to Hepatitis C Virus (anti-HCV)
• Antibody to Human T-Cell Lymphotropic Virus (anti HTLV I/II)
• Nucleic Acid Test for HIV 1/2/HCV and West Nile Virus (WNV)
Some areas perform even fewer tests
Dr. Ambedkar (a doctor in India) was asked:
What laboratory tests are performed in blood bank for each bag of collected blood?
“Jaundice (Hepatitis B & C). Malaria · HIV (AIDS) test. Venereal disease (STD). Blood Group. Before issuing blood, compatibility tests (cross matching) are done.”
We can’t list them all but Pakistan screens for only three things. Good luck when traveling.
“Particularly with emerging diseases… as in infectious diseases in general … it's not always possible to predict what the next problem [to the blood supply] will be or to potentially defend or study every single possible problem.” -Sept 19, 2002- Dr. Jesse Goodman, Deputy Director, FDA's Center for Biologics Evaluation and Research
Aetna's assessment of the risks of blood transfusion
Here’s a link to a comprehensive list of the risks involved from Aetna Life Insurance - why doesn’t every hospital and blood bank inform their patients of all these risks? -intelihealth.com
What about blood substitutes?
So far, there is no real substitute for human blood. But researchers are working to develop a blood substitute that will not have the risks of blood transfusions. Products that are being tested include hemoglobin-based oxygen carriers and perfluorochemical compounds. They can do some of the work of red blood cells, such as carrying oxygen to tissues, but they do not replace human blood. Of the 2 oxygen-carrying compounds that are being tested in US clinical trials, neither has been approved by the FDA as of early 2008.
Most blood substitutes are experimental and are rarely used. They may be used as a temporary measure in patients whose religious beliefs do not allow them to have blood product transfusions. They may also benefit patients with rare blood types and those whose immune systems would destroy available donated blood. The substitutes may be used until matching donated blood can be found, which in some cases might take several days. -cancer.org
What are the odds of contracting any of the above pathogens during a Bloodless Operation?
Consider if Bloodless Surgery is the best option for you
• It’s available now
• The technology is safe
• It is cheaper
• No risks of disease
• Faster recovery
• Lower mortality rate
• Less hospital time
• Less worries
• Learn more
• Bloodless Hospital List
Here’s what the experts say
“[Patients] who received blood transfusions from donors were five times more likely to die within 100 days of their operation than those who did not.” Patient Safety Enhancement Program (PSEP) at the University of Michigan Health System -Medical News Today
“Patients who received blood transfusions after heart surgery had a three-fold increase in the risk of suffering from heart attack or stroke.” -British Heart Foundation Study 2007
“Blood transfusion is a significant independent predictor of multiple organ failure in trauma.” -JR Dunne et al University of Maryland School of Medicine and The R. Adams Cowley Shock Trauma Center, Pub Med
“The controversial practice of blood transfusions for patients suffering from cardiac episodes may lead to an increased risk of mortality…” -ScienceDaily Webpage, Mar. 20, 2006
“Millions of patients are apparently receiving transfusions with blood that is impaired in its ability to deliver oxygen.” -Duke University website, Oct 8, 2007
“Patients who underwent blood transfusions had strikingly higher rates of deaths and stroke in-hospital, as well as at 30 days and one year post heart attack.” -Columbia University Medical Center Study, Medical News Today
“The rate of in-hospital death increased by 8.5 percent each additional day the transfused blood had been on the shelf.” -New York Times, June 27, 2006
“Generally, donors are not allowed to give blood more than once every 56 days. The practice of paying donors for blood has almost disappeared, because it encouraged needy people to present themselves as donors and then sometimes to deny having any conditions that would disqualify them.” -merck.com
“Blood transfusion is essentially different from medicine administration and is similar to organ transplantation, so that merit and demerit must be sufficiently considered.” -sciencelinks
Is a cooperative bloodless surgeon enough?
Patient Blood Management
What is a Blood Conservation Program?
What is a Bloodless Surgery and Medicine Program?
Are all Bloodless Surgery and Medicine Programs the same?
Ethical blood management
What is a Bloodless Surgeon?
Is Bloodless Surgery safe?
What kind of surgeries can a Bloodless Surgeon perform?
Is Bloodless Surgery experimental?
Is Bloodless Surgery more expensive than conventional surgery?
Are there disadvantages of Bloodless Surgery?
Transfusion Alternatives and Bloodless Medicine
Is preoperative autologous blood donation (PABD) the answer?