Resident and Fellow Policy Manual

Appendix 1 - Informed Consent for Blood Transfusion:

Strong Memorial Hospital

Information Sheet for Providers

SMH Hospital Policy requires written informed consent for blood transfusion.

1. Benefits:  Blood or components are administered to improve oxygen carrying capacity,

correct a bleeding disorder due to platelet or plasma factor defect or deficit.

2. Risks:  No transfusion can ever be 100% safe, even though testing makes the risk

of infectious complication very low.  Approximate risk per unit given:

Complication	Risk
Virus
HIV	1:1,900,000
HTLV-I and –II	1:641,000
Hepatitis A virus	1:1,000,000
Hepatitis B	1:63,000
Hepatitis C	1:1,600,000
Parasites
Babesia and Malaria	<1:1,000,000
Trypanosoma cruzi (Chagas’ Disease)	1:42,000
Bacteria
RBC’s	1:1,000
Platelets	1:2,000
Acute hemolytic reaction	1:25,000
Delayed hemolytic reaction	1:2,500
Transfusion related acute lung disease (TRALI)	1:10,000
Anaphylaxis	1:150,000
Graft vs. Host Disease	Very rare

    

Approximately 1:100-200 transfusions results in hives, rash, fever or chills.

Other adverse effects such as increased post-operative infection or increased incidence

of tumor recurrence have been associated with blood transfusions. 

3.  Alternatives to Homologous Transfusion:

a.  No transfusion - This may have life-threatening consequences.

b.  Autologous Donation - Advance planning.  Medical conditions may preclude.

c.  Blood Salvage - Precluded when infection and/or tumor are present.

d.  Intra-op Hemodilution - Blood collected immediately pre-op, given as needed.

e.  Designated Donor - Blood from donor of patient’s choice. Advance planning. Not necessarily safer than community supply. Extra charge. Women must not receive blood from potential or actual fathers of their children.

 f.  For b. through e. above, additional blood may be required.

4.  Document: Once per course of therapy, SMH 419 or SMH 821

5.  Additional questions:      Call the Blood Bank, x52251.

         Rev. 8/02