Table of contents:
Blood transfusion: procedure and safety
Before a blood transfusion, various tests are carried out in the laboratory to ensure that the blood components are tolerated. This is to ensure that a given transfusion is compatible with the recipient's blood and that the risk of adverse reactions is minimized.
- Continue reading
- more on the subject
- Advice, downloads & tools
- Performing the transfusion
- Safety of blood
According to current standards, the examinations include:
- Blood grouping,
- Antibody determinations,
- serological tolerance test (cross match),
- if necessary antigen typing and
- further investigations if necessary.
The compatibility (compatibility) of donor and recipient blood can be precisely determined by the antibody determinations and the cross match.
Shortly before the transfusion, the responsible medical staff conducts the so-called bedside test at the patient's bedside. The ABO blood group of the patient and the can is checked again and the patient identity, the can data and the validity of the cross match are checked. Before a transfusion, the patient must be informed about possible risks and sign a declaration of consent.
Performing the transfusion
Transfusions are ordered by the treating doctor. The blood transfusion is carried out by qualified medical staff (qualified nurses or doctors). The patient's condition is continuously monitored, especially at the beginning, but also during the transfusion. If there are signs that indicate an undesirable transfusion reaction, the transfusion will be stopped immediately.
Safety of blood
Blood and blood components are only used in humans according to clearly defined criteria and after a corresponding medical risk assessment has been carried out, ie within the framework of a strict indication. Side effects of transfusions cannot always be avoided despite various safety measures. However, most of the side effects are not life threatening. Very rarely, however, serious undesirable transfusion reactions can occur.
- Immunologically induced transfusion reactionsare caused by antibodies, which are usually directed against cells or plasma proteins of the recipient. The most common and usually harmless immunologically induced transfusion reactions are the febrile non-hemolytic transfusion reaction (with brief fever with chills) and the allergic transfusion reaction (skin rash). Serious immunological transfusion reactions, such as hemolytic transfusion reactions (with destruction of the transfused cells), are very rare. This can occur if, despite all precautionary measures, the patient was given, for example, incompatible donor blood in the ABO blood group, for example as a result of confusing blood reserves and / or the recipient. How severe the reaction is depends onhow strong the recipient's antibodies are against the donor blood. Typical signs are fever, chills, hot flashes, headaches, pain in the heart and lungs. These symptoms can occur up to 24 hours after a transfusion.
- Non-immunological reactions are chemical or physical reactions to substances in the blood products, e.g. hypothermia or iron overload in the case of chronic transfusion needs.
- Infectious complications can result from the transmission of viruses (e.g. hepatitis B, hepatitis C, HIV) or bacterial contamination. The risk of transmission of infections through blood transfusions is now very low due to prescribed quality measures, tests and pathogen inactivation procedures. The residual risk of HIV transmission through a blood bag is around 1 in 4.3 million, and for the hepatitis C virus 1 in 10 million transfusions
High quality and safety standards for blood and blood products are a central goal of the health system and are now comprehensively regulated by law. Since 2002 there has also been a uniform EU directive that specifies in detail all requirements in the area of blood collection, further processing and testing. In spite of all safety measures, as with all biological products, there is always a residual risk of adverse reactions with blood products. Serious transfusion-related incidents and adverse reactions are required by law. The aim of the hemovigilance system is to record and minimize risks and dangers associated with transfusions of blood and blood components, but also within the framework of blood donation.