Definition and Overview

Blood transfusion follow-up is an appointment with a doctor, particularly a hematologist, after a certain amount of blood has been introduced into the patient’s body.

Although it’s normal to lose blood once in a while—for example, women who menstruate every reproductive cycle—massive blood loss can be a serious issue as it can lead to organ failure. Certain conditions such as liver and bone marrow diseases as well as cancer and severe anemia can significantly reduce the body's needed blood supply, resulting in dire health consequences. For these scenarios, a blood transfusion is one of the treatment options.

Who Should Undergo and Expected Results

Below are some of the scenarios that would require a blood transfusion:

  • Surgery – One of the major risks of surgery is internal and external bleeding, which can both result in significant blood loss. For this reason, the surgeon always requests for a certain amount of reserved blood during and after the procedure.
  • Trauma – Many types of injuries caused by trauma can also cause serious bleeding. Blood transfusion helps stabilize the patient during an emergency situation.
  • Pregnancy – Blood transfusion is not common during pregnancy, but may be required in cases of severe anemia caused by iron deficiency and serious hemorrhaging.
  • Disorders – Disorders of the blood including but not limited to hemophilia, aplastic anemia, thalassemia, liver infection, cancer and kidney disease can affect the production of healthy blood cells or cause the patient to bleed out much longer than the others.
    A follow-up is often conducted following a blood transfusion to monitor risks and complications. Although these problems are rare, they can be very serious and life-threatening. For example, if the patient is transfused with the wrong type of blood, his own body may attack the new blood. Also, if the source of the blood is doubtful, which usually happens when it’s not screened properly, the patient may be infected with a virus that causes conditions such as HIV or hepatitis.

How Does the Procedure Work?

A follow-up care is discussed with the patient even before the procedure is initiated. This is particularly important for those who are scheduled for surgeries or transplants and if these procedures involve children, older people and mothers-to-be. The consultation is also more important when (1) the amount of blood available is very limited or (2) the source may not be clear.

The follow-up may begin within 24 hours after transfusion as there’s a good chance that complications, such as fever, chills, allergic reactions, iron toxicity and infectious agent transmission, may appear around this time.

In such cases, the doctor can order the transfusion to be stopped and assess the patient based on his symptoms, the short- and long-term effects of transfusion, age, and underlying conditions to name a few. Medications may be provided as an initial treatment and while the doctor is investigating the causes of the reaction. The patient’s medical team may also coordinate with the blood bank and other blood services such as Red Cross, particularly if the cause of the problem is the transmission of contaminated blood.

Depending on the assessment and treatment, the patient may need only one follow-up. While those who need regular blood transfusions are usually monitored for contamination and iron overload.

Possible Risks and Complications

Some of the signs and symptoms of complications like fever and chills may not be immediately attributed to the blood transfusion, which can then delay medical intervention. The biggest danger is that the patient will not receive the needed medical care and attention promptly. By the time the complications are discovered, the condition may have already turned for the worse.

References:

  • Cushing MM, Ness PM. Principles of red blood cell transfusion. In: Hoffman R, Benz EJ Jr, Silberstein LE, et al., eds. Hematology: Basic Principles and Practice. 6th ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 112.

  • Hall BA, Chantigian RC. Blood products, transfusion, and fluid therapy. In: Hall BA, Chantigian RC. Anesthesia: A Comprehensive Review. 5th ed. Philadelphia, PA: Elsevier; 2015:chap 5.

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