Blood Transfusions in Children
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Why are blood transfusions performed?
There are several different components of the blood that can be transfused. Red blood
cells are most commonly transfused. If your child's healthcare provider has decided
your child might need a transfusion of blood, or blood products, he or she will explain
the reasons for the transfusion. There are several reasons why your child may need
a blood transfusion, including the following:
A sudden loss of blood because of trauma
An anticipated or actual loss of blood during surgery
A low blood count before, during, or after surgery
Severe heart, lung, liver, or kidney disease
Bone marrow failure
Moderate to severe anemia due to radiation treatments or medicine, such as chemotherapy
What is blood made of?
Human blood is made of a fluid called plasma that carries red and white blood cells
and platelets. Each part of blood has special functions and can be separated from
each other. The bone marrow is the soft, spongy material in the center of the bones
that makes most of the body's blood cells.
What are red blood cells?
Red blood cells carry oxygen from the lungs to other body organs and carry carbon
dioxide back to the lungs. A certain number of these cells are needed for the body
to function. Bleeding due to trauma, surgery, or disease may cause a low red blood
What are white blood cells?
White blood cells fight infections by destroying bacteria, viruses, and other germs.
White blood cells are rarely transfused. They are usually reserved for children who
have a low white cell count and severe infection that does not respond to antibiotic
What are platelets?
Platelets help control bleeding by making clots in the blood vessels opened by injury
or surgery. The body may not be able to make enough platelets because of bone marrow
disorders, increased destruction of platelets, or medicines, such as chemotherapy.
Platelets may be transfused before a procedure that may cause a child with a low platelet
count to bleed.
What is plasma?
Plasma carries the blood cells throughout the body and contains proteins, vitamins, and
minerals. Some of the proteins help the blood to clot. Plasma or fresh frozen plasma
can be transfused in children who have a severe deficiency of certain clotting components
of the blood.
Are blood transfusions safe?
The blood used at most hospitals is from volunteer donors. Donors are not paid for
giving blood or blood products. Each blood donor must answer medical history questions
and be given a limited physical exam before being accepted as a donor. The donated
blood is carefully tested for hepatitis viruses B and C, syphilis, Chagas disease,
West Nile virus, and antibodies to two immunodeficiency viruses, including HIV. These
tests decrease the chances of transfusion-related infections.
How is blood transfused?
Blood is collected and stored in sterile bags. The bags are used once and then thrown
away. Before blood is given to your child, it is typed and cross-matched with his
or her own blood to make sure it is compatible. The blood will be given through a
needle or catheter placed in the vein. Your child's temperature, blood pressure, and
heart rate will be checked many times while the blood is being given. It may take
a few hours to complete the process.
What is directed donation?
A directed (or designated) blood donation is one in which a person donates blood that
is reserved (at the time of donation) for the transfusion of a specific patient at
a later date. The donor is usually a family member or a close friend that has been
chosen by the patient's family. Talk with your child's healthcare provider if you
are interested in learning more about directed donation. It is recommended that families
donate in the child's name versus directed donation, because if directed blood is
not needed, it is wasted. Blood must be donated within a month of the surgery. If
not used, it will be released. An autologous donation is blood collected from the
patient in advance of planned surgery.
Are directed donors safer than volunteer donors?
There is no proof that directed donors are safer than volunteer donors. Not all directed
donor blood will be compatible with the patient's blood.
Are there risks in receiving a blood transfusion?
Most transfusions are performed without any problems. Mild side effects may include
symptoms of an allergic reaction such as headache, fever, itching, or rash. This type
of reaction can usually be treated with medicine, should your child need additional
transfusions. Serious side effects are rare and may include difficulty breathing and
sudden drops in blood pressure. Transfusion reactions can happen even if the donated
blood is the correct blood type. Transfusion with blood of the wrong type can be fatal,
but this is unlikely to happen because all blood is checked multiple times by medical
Online Medical Reviewers:
- Berry, Judith, PhD, APRN
- Levy, Adam S., MD