Blood Transfusions — Benefits and Options: Part 2

Many types of blood transfusions exist depending on the blood parts a person needs. The most common type involves replacing red blood cells to quickly increase the body’s oxygen supply.

Key takeaways:
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    Red blood cell transfusions are the most common type of blood transfusion.
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    The main function of red blood cells is to carry oxygen from the lungs to body tissues.
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    Anemia occurs when a person doesn’t have enough healthy red blood cells to carry oxygen throughout the body. Most cases of anemia are due to iron deficiency.
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    People usually only require a blood transfusion if anemia is severe or causes symptoms. In some cases, alternative options are available to prevent a blood transfusion.

This type of transfusion is usually given to treat acute blood loss or chronic anemia and is often the only option for those who have lost too much blood or whose life is at risk. However, each situation is unique, and alternatives are available in some cases.

The importance of red blood cells

Of the various blood products, red blood cells (RBCs) are the most common type people receive through blood transfusions. Red blood cells are responsible for transporting oxygen from the lungs to the rest of the body, including the heart and brain. The essential part of RBCs that enables them to transport oxygen is a protein called hemoglobin — the body uses iron to make it.

If a person has a low number of healthy RBCs, it’s known as anemia. Mild anemia often has no symptoms. In moderate to severe anemia, a person may feel tired, dizzy, weak, cold, and short of breath. These symptoms are due to the body’s cells not getting enough oxygen.

Although many health problems can cause anemia, including low iron levels, most causes fall into three main categories. These include:

  • Blood loss.
  • Insufficient RBC production.
  • Too much RBC destruction.

Some people with anemia may need to be treated with an RBC transfusion. What determines the need for a transfusion can be complex and may include factors such as the severity of anemia, how quickly it develops, and how well a person’s body can cope with it.

Acute blood loss

Acute blood loss is when a person quickly loses lots of blood from surgery, injury, childbirth, or a ruptured blood vessel. Initial symptoms are typically severe, especially if anemia develops rapidly due to a sudden drop in RBCs. When this occurs, it’s known as acute anemia.

Because rapid blood loss may cause life-threatening complications such as heart attack, stroke, and shock, it requires immediate treatment. The first goal of treatment is to find and stop the source of bleeding. If the blood loss is life-threatening, a blood transfusion is also necessary. An RBC transfusion is the primary treatment to restore lost blood.

Chronic anemia

Chronic anemia can result from a wide variety of health conditions, including:

  • Kidney disease.
  • Autoimmune diseases.
  • Cancer.
  • Chronic infection.

Because chronic anemia develops slowly and often causes mild to moderate anemia, the need for blood transfusions is rare. Thus, the first goal of managing chronic anemia is to find and treat its cause. However, a person may need an RBC transfusion if they can’t function due to anemia symptoms or for severe anemia that doesn’t improve with other treatments.

Iron infusion vs. blood transfusion

Iron infusions and RBC transfusions are two types of intravenous (IV) therapy that can treat iron deficiency anemia, the most common cause of anemia worldwide. This condition occurs when RBC levels drop due to a lack of iron. Without iron, the body can’t make hemoglobin, leading to fewer functional RBCs and a decreased ability to circulate oxygen around the body.

Treatment for iron deficiency anemia usually involves oral iron supplements or dietary changes. An IV iron infusion (giving iron through a vein) may be necessary in rare cases, such as when a person’s body can’t absorb iron or iron levels are very low. An RBC transfusion is typically only needed for severe or symptomatic cases of iron deficiency, such as acute blood loss.

Do blood transfusions change your DNA?

No. In most transfusions, the main blood product is red blood cells, which don’t have DNA. White blood cells are the only blood part with DNA. So, if a person receives white blood cells, donor DNA can potentially show up in small amounts. However, donor blood eventually disappears and doesn’t change the recipient’s DNA while it’s in the bloodstream.

Blood transfusion alternatives

A few alternatives to blood transfusion exist. However, depending on each person’s unique situation, including the specific need for a transfusion, these options may not work in all cases.

Possible methods to prevent the need for a blood transfusion include:

Volume expanders

Giving fluids can help maintain blood circulation without adding additional blood cells. Although this can help prevent life-threatening complications from a sudden loss of blood volume, it doesn’t increase the body’s oxygen supply.

Blood substitutes

Although they aren’t yet available, researchers continue investigating and developing products that can safely replace RBC transfusions in specific situations. One example is hemoglobin-based oxygen carriers (HBOCs), which can do some but not all of the work of RBCs. Their primary function is to help carry oxygen to tissues.

Bloodless surgery

Several techniques can minimize excessive bleeding and avoid needing a blood transfusion through careful planning before surgery. One example is using specialized surgical tools that reduce blood loss. It’s also possible to collect some of the blood lost during surgery and reinfuse it at the end of the operation.

The body needs a regular supply of oxygen to stay healthy. Red blood cells (RBCs) make this possible. People who don’t have enough healthy RBCs to carry oxygen to the body’s tissues have a condition called anemia. An RBC transfusion may be necessary when anemia is likely to reduce or has already reduced the oxygen supply to a level below a person’s needs.

Ultimately, the need for an RBC transfusion usually only arises when it can be life-saving. To determine the best course of treatment, patients should speak with their healthcare provider.

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