14755 Blood Transfusion

Overview

A blood transfusion is when you receive blood, or a part of blood, from a donor. The blood goes into your body through a thin plastic tube placed in a vein (called a cannula). It is given slowly over a few hours. A transfusion tops up blood you have lost, or replaces blood that isn't working properly. It can give you more energy, help you breathe more easily, and protect your heart and other organs.

Yes, very common. Millions of blood transfusions are given around the world every year. Many are given during surgery, after an injury, during or after childbirth, or to people having treatment for cancer.

Anyone can need a blood transfusion — babies, children, adults and older people. It is more likely if you have had major surgery, a serious injury, heavy bleeding, cancer treatment, kidney disease, or a blood condition such as anaemia (low red blood cells), sickle cell disease or thalassaemia.

Symptoms

Common symptoms

• Feeling very tired or weak, even with rest
• Getting out of breath when walking up stairs or doing light jobs
• Looking pale, or skin that looks washed out
• A fast heartbeat, or feeling your heart thumping
• Feeling dizzy or light-headed when you stand up
• Headaches or trouble concentrating
• Bleeding that keeps going, or bruising more easily than usual

Symptoms in children

• Being unusually sleepy or hard to wake
• Looking pale, especially around the lips, gums and nails
• Feeding poorly or not wanting to eat
• Being more irritable or clingy than usual
• Getting out of breath while playing or crawling
• Faster heartbeat or breathing than normal

Symptoms in older adults

• Breathlessness doing things that used to be easy, like dressing or making tea
• Chest pain or tightness, especially with effort
• Feeling dizzy, unsteady, or having a fall
• New confusion or memory problems
• Swollen ankles or feeling more tired than usual
• A racing heartbeat

Causes

Main causes

• Losing a lot of blood — from an injury, major surgery, or heavy bleeding during childbirth
• Anaemia from low iron, low vitamin B12, or low folate
• Anaemia caused by kidney disease, where the body makes fewer red blood cells
• Cancer, or cancer treatments that slow down the making of blood cells
• Blood conditions such as sickle cell disease or thalassaemia
• Bone marrow problems, where blood cells are not made properly
• Some long-term illnesses and infections that lower blood counts

Risk factors

• Having major surgery, especially orthopaedic or heart surgery
• Giving birth with heavy bleeding
• Receiving chemotherapy or radiotherapy
• Having a long-term condition such as kidney disease, cancer or a blood disorder
• Being seriously unwell and in hospital
• Having a low iron level or poor diet over a long time

When to see a doctor

See a doctor urgently if:

• You are bleeding and cannot stop it
• You feel faint, very short of breath, or have chest pain
• You have a fever or feel unwell within a few days of a transfusion
• Your skin or eyes turn yellow, or you pass dark urine after a transfusion
• You have new bruising or small red spots on your skin

Book a routine appointment if:

• You feel more tired than usual for more than a few weeks
• You get out of breath doing things that used to be easy
• You look pale and feel light-headed
• You are told your blood count is low and want to talk it through
• You have questions before or after a planned transfusion

Diagnosis

Your doctor will talk to you about your symptoms and examine you. A simple blood test, usually called a full blood count, shows how much blood you have and how well it is working. If your level is low, your doctor will look for the cause. Before a transfusion, your blood is tested to find your blood group, and a sample is checked against the donor blood so the match is safe. This is called cross-matching.

Tests that may be done

• Full blood count — counts your red cells, white cells and platelets
• Blood group and antibody screen — finds your blood group and any antibodies you carry
• Cross-match — checks that donor blood is a safe match for you
• Iron, vitamin B12 and folate levels — to look for the cause of anaemia
• Kidney and liver function tests
• Tests for bleeding or clotting problems
• Occasionally a bone marrow test, if the cause is unclear

What to expect at your appointment

Most of this is done with a small blood sample from your arm. You may feel a brief sting when the needle goes in. Results often come back within hours to a few days. If you need a transfusion, a nurse will explain what will happen, check your details carefully, and ask for your consent. You will be given an identity wristband — staff will check it several times, which is a normal safety step.

Treatment

A blood transfusion is given through a thin plastic tube in a vein, usually in your arm or hand. The blood drips in slowly over a few hours. Your pulse, blood pressure and temperature are checked before, during and after. You can sit or lie down, read, or rest. Most people feel no pain and go home the same day, though some need to stay in hospital. Your medical team will also treat the reason you needed blood in the first place, so the problem does not simply come back.

Self-care at home

• Eat iron-rich foods such as beans, lentils, leafy green vegetables, eggs and lean meat
• Have vitamin C with meals — it helps your body absorb iron from food
• Drink plenty of fluids unless your doctor has told you to limit them
• Rest when you feel tired, and build activity back up slowly
• Keep any follow-up blood test appointments so your levels can be checked
• Tell your doctor or nurse about any new symptoms after a transfusion
• Carry a card or note if you have had a reaction to blood in the past

Medical treatments

The transfusion itself is the main treatment when your blood level is low or you have lost a lot of blood. Alongside it, doctors treat the underlying cause. This may mean iron or vitamin supplements, dietary changes, medicines that help your body make more blood cells, or treatment for the condition causing the problem, such as infection, kidney disease or cancer. Your team will decide what is right for you and explain the choices.

When is surgery considered?

Some people are given blood before, during or after an operation — for example, major joint surgery, heart surgery, or an operation to stop internal bleeding. In some cases, surgery is needed to find and stop the source of bleeding rather than relying on transfusions alone. Your surgical team will discuss this with you beforehand.

Living with this condition

Many people feel noticeably better within a few days of a transfusion — less breathless and less tired. Some need regular transfusions, for example if they have a long-term blood condition. If that is you, it helps to plan around appointment days, keep a simple diary of how you feel, and let your team know about any changes. Your employer or school can often make adjustments if you need them.

Lifestyle tips

• Pace yourself — spread heavier tasks across the day and rest in between
• Stay active with gentle walking, which helps your heart and circulation
• Avoid smoking, as it makes breathlessness worse
• Keep alcohol within recommended limits
• Eat regular balanced meals rather than skipping meals
• Keep a list of your medicines and bring it to appointments
• Tell your team if you take blood-thinning medicines or have bleeding problems

Diet and exercise

Food cannot replace a transfusion, but a good diet helps your body rebuild. Include iron-rich foods, enough protein, and foods with vitamin B12 and folate, such as dairy, eggs, fish and green vegetables. Gentle exercise such as walking or stretching is good for you — start slowly and stop if you feel dizzy or very tired. Ask your doctor or a physiotherapist what is safe for you, especially after surgery.

Mental health and emotional wellbeing

It is common to feel worried, shaky or low after needing a transfusion, especially if it came after an accident, bleeding or a difficult birth. Some people feel uneasy about receiving blood from someone else. These feelings usually settle, but it is fine to ask questions and to ask for extra support. If low mood, worry or flashbacks last more than a couple of weeks, or affect your sleep and daily life, please speak to your doctor. If you ever have thoughts of harming yourself, contact your local emergency number or a crisis line in your country straight away.

Prevention

Not every transfusion can be avoided — heavy bleeding after an injury or during childbirth can happen to anyone. But some needs can be lowered. Treating low iron early, eating well, managing long-term conditions, and checking blood counts before planned surgery all help. Hospitals also use careful planning to reduce blood loss during operations and only give transfusions when they are truly needed.

Screening programmes

Routine blood tests in pregnancy, before surgery, and during treatment for long-term conditions can spot low blood counts early, often before you feel unwell. If you have a long-term blood condition, regular check-ups help your team keep your levels steady.

Complications

If left untreated

• Severe tiredness and breathlessness that make daily life very hard
• Strain on the heart, which can cause chest pain or heart problems
• Dizziness and falls, especially in older people
• Poor concentration and difficulty working or studying
• In very heavy bleeding, a life-threatening drop in blood pressure
• Reduced oxygen reaching organs, which can cause lasting damage

Long-term outlook

For most people, the outlook is good. A transfusion often brings quick relief, and many people need only one. Serious problems from transfusion are uncommon, and staff follow strict safety checks. Some people need transfusions now and then for a long-term condition, and modern care helps them live full, active lives. Your team will keep checking your blood and adjust your plan as needed.

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