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When Blood Transfusions Stop Working

by Annabel Caldwell
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When Blood Transfusions Stop Working

When Blood Transfusions Stop Working

There can be complications that range from minor to life-threatening. One rare complication is a sudden immune reaction. This occurs when the person’s immune system attacks the transfused blood cells and damages the kidneys. Additional complications of a blood transfusion can include fever and infection.

The average American has about four pints of red blood cells in his or her body at any given time, and those cells are constantly being replaced with new ones as they’re destroyed by wear and tear (about 2 percent per day). When someone suffers a major injury or surgery, it usually takes two months for their body to replenish its stock. The process works something like this: First, white blood cells attack debris left over from an accident or trauma, then other white blood cells go after bacteria, viruses, cancerous cells and so on. Finally, red blood cells come along and pick up the pieces.
In medicine, there are times when we need more than our own blood can provide. For example, if you have been diagnosed with leukemia, your bone marrow isn’t producing enough healthy blood cells. In such cases, doctors will often perform a transplant procedure in which someone else’s blood is introduced into your bloodstream through a vein. There are many different reasons why someone might require a blood transfusion — whether it’s due to medical treatments or surgeries — but one common reason is because of a lack of available donors.
Blood transfusions aren’t always risk free. They do carry some risks that vary depending on what kind of blood is used and how it was collected. But these dangers don’t happen very often. More commonly, people who undergo a blood transfusion experience side effects that result from the foreign blood cells attacking their bodies’ tissues and organs. These reactions can range from mild to severe, and sometimes they even cause death.
One extremely uncommon problem that can occur during or immediately following a blood transfusion is called hemolytic transfusion reaction or HTR. It happens when the recipient’s immune system mistakenly identifies donor blood cells as harmful pathogens and begins to destroy them. Hemolysis refers to the breakdown of red blood cells by the immune system, and HTRs are caused when antibodies attach themselves to the surface of donated red blood cells. The immune response sends additional white blood cells to the site where the blood cells were attacked, causing damage to the kidney and liver. If not treated quickly, HTR may lead to kidney failure.
While HTR is relatively rare, another type of blood transfusion complication is far more common. About half of all patients who receive a blood transfusion develop an adverse event, which could include infections, allergic reactions and fevers. Less serious events include bruising, swelling, shortness of breath and nausea. Sometimes the patient doesn’t notice symptoms until days or weeks later. And sometimes, the severity of the reaction depends entirely upon the amount of blood taken from the donor. A small donation may produce no noticeable reaction while a large donation could trigger a negative one.
In order to understand these differences better, let’s talk about the components of blood. Red blood cells contain iron, which gives them color and helps them function properly. White blood cells fight off infections and control bleeding; they also help clear out cellular waste products. Platelets are tiny particles that prevent clots from forming inside arteries and veins. Plasma is plasma protein that makes up 80 percent of the human blood volume. Together, these elements make up the basic building blocks of blood.
Now let’s look at how blood donations work. Donors give whole blood, which contains both platelets and red blood cells. Whole blood is separated into three parts — packed red cells, fresh frozen plasma and cryoprecipitate (an anticoagulant made from pooled plasma proteins). Packed red cells are transfused directly into the body, while fresh frozen plasma is stored in liquid nitrogen tanks. Cryoprecipitate is given to patients who suffer from internal bleeding problems and clotting disorders.
People who donate blood can end up feeling ill afterward. Some feel nauseated, weak and tired, while others get headaches, backaches or chills. Allergic reactions to medications or environmental factors such as alcohol or smoking can also affect donors. Fortunately, most reactions are minor and resolve themselves within 24 hours. Serious issues requiring immediate attention generally involve donated blood that contained infectious agents such as hepatitis C virus or HIV.
If you think you’d benefit from donating blood, visit www.donateblood.gov today. Or simply call 1-800-RED CROSS (1-800-733-2767) Monday through Friday between 10am and 6pm EST.
Blood Types & Compatibility: How much does it really matter?
It’s important to know your blood type before giving blood. Knowing your blood type allows you to find compatible types of blood, which means that the transfusable blood will match your body better. Here’s how it works: We each have hundreds of different kinds of proteins floating around in our bloodstream. Each protein acts as a key that unlocks particular doors throughout our bodies. Your blood carries oxygen to every cell, transports nutrients to the heart, regulates body temperature and fights against invaders. Your blood also tells your immune system what to attack and defend itself against.
Your blood type is determined by the combination of two genes located on chromosome number 19. Every individual inherits one gene from each parent. However, certain combinations of genes determine different blood groups. There are six main blood group systems: A, B, AB, O, 0 and B0. Within each system, subtypes exist that differ slightly from the general blood type.
A positive test for Rh(D)(c), known as “positive” or Rhesus positive, indicates that you have inherited the dominant version of the RHCE gene, which determines your blood type. People with Rh-negative blood are therefore said to be Rh negative.
Most adults are Rh positive, meaning they have received the dominant version of the RHCE gene from their parents.
Rh incompatibility occurs when a mother donates blood containing Rh-negative red blood cells to a baby whose father is Rh-positive. If the baby receives the incompatible blood, it’ll begin destroying the donated cells within minutes. This leads to increased amounts of bilirubin, a substance produced when the red blood cells break down. Bilirubin builds up in the baby’s skin, urine and stool, eventually leading to jaundice (yellowing of the skin and whites of the eyes). Babies with Rh incompatibility should receive injections of anti-d antibody to neutralize the Rh-positive blood cells.
About 200 million Americans belong to the ABO blood system. Type O is the universal blood type, which means that everyone has this blood type. As a result, the vast majority of donors are Type O, making it easier to find a compatible blood type for a specific patient.
For information on becoming a volunteer, see http://www.redcross.org/volunteer/. To learn more about donating blood or seeing a list of current needs, please visit www.redcross.org/need_blood.

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