Blood Transfusion Complications

Blood transfusion is the process of receiving blood products intravenously. There are various reasons for doing blood transfusion which include; Anemia, Surgical procedures, Hemorrhage, Patients with cancers, Hereditary blood disorders like Thalassemia and burns. Blood transfusion is lifesaving, however, before deciding on it, it is good to exhausted other avenues for your patient like iron therapy or plasma substitutes. Over the years, the procedure has been made safer with introduction of screening methods for infections like Hepatitis B and HIV. it is important to note that, blood should be transfused 48hrs preoperative to prevent red blood cell depletion of 2,3-biphosphoglycerate that can lead to a reduced red blood cell capacity in the body.

There are two types of Blood transfusion complications; Early and Late.

Early complications

Fluid overload- patients with reduced renal or cardiac failure are prone to this, it is the practice to give IV 20mg of furosemide while transfusing.

Coagulation disorders- blood contains red blood cells, as the run into a patient’s body; they tend to dilute platelets and coagulation factors. Transfused blood contains citrate which is an anticoagulant. It is therefore advisable to monitor patient and correct any coagulation issues.

Hyperkalemia-transfused blood tend to be leaky, this in return increases serum potassium. Patients with no kidney damage can clear it, but those with damage can complicate, therefore it is important to check urea and creatinine during the procedure.

Incompatibility reaction-this occurs when patient reacts to the blood given. It can be treated by holding the transfusion, giving fluids and antihistamines.

Thrombophlebitis

Late complication

Infections- this is not common but can occur in unscreened blood. Hepatitis B and HIV are among the highest. Malaria is also a common infection. In different practice, antimalarial have been given during blood transfusion.

Reduced cell immunity- it has been noted that wound infections and metastasis rise in patients with carcinomas who have received transfusion.

Hemochromatosis- over the years, patients who have received multiple transfusions later on develop iron overload.

As a clinician, it is important to ensure before transfusion, the blood is correct and well screened, patients vitals are monitored every 15mins, an input-output chart and in case of a reaction, proper management is executed.