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Blood Transfusion Indications

Transfusion of whole blood from one individual to another is indicated for two main reasons: firstly, when the volume of blood within the circulation system of the patient is less than that required to sustain life and, secondly, when the red blood cells are deficient either in quantity or quality. If we have insufficient red cells, or if our red cells are abnormal, there will not be enough hemoglobin to maintain the body efficiently and we are then said to be anaemic.
Reasons for transfusion of blood from one individual to another:

  • People who have surgery need blood transfusions because they lose blood during the operation.
  • People who have serious injuries-such as from car wrecks, war, or natural disasters-need blood transfusions to replace blood lost during the injury.
  • People need blood or parts of the blood because of illnesses. You may need a blood transfusion if you have:
    • A severe infection or liver disease that stops your body from properly making blood or some parts of blood.
    • An illness that causes anemia, such as kidney disease or cancer.
    • A bleeding disorder, such as hemophilia or thrombocytopenia.

Blood loss through accident, surgery, or hemorrhage at childbirth or from such a condition as the bleeding of a stomach ulcer may reduce the amount of circulating fluid in our bodies below safe limits and we may die unless this loss is speedily replaced.

Indications of blood transfusion can be summed up as:

  • Anaemia
  • Major Surgical Operation
  • Accidents resulting in considerable blood loss
  • Cancer patients requiring therapy
  • Women in childbirth and newborn babies in certain cases
  • Patients of hereditary disorders like Haemophilia and Thalassaemia
  • Severe burn victims.

Components
Normally, 7-8% of human body weight is from blood. This essential fluid carries out the critical functions of transporting oxygen and nutrients to our cells and getting rid of carbon dioxide, ammonia, and other waste products. It plays a vital role in our immune system and in maintaining a relatively constant body temperature. Blood can be separated into its components: red cells, white cells, platelets, plasma, cryoprecipitate which are used to treat certain conditions. One of the components, plasma, can be further subdivided by chemical procedures into its constituent parts, the so called (plasma fractions] anti-hoemophilic factor concentrate, immunoglobulins, plasma protein fraction and albumin etc. All humans produce these blood components--there are no populational or regional differences.

Blood is transfused either as whole blood (with all its parts) or, more often, as individual parts. The type of blood transfusion you need depends on your situation. Transfusion of whole blood has long been a well-recognised life saver during and after major surgery and where there has been massive loss of blood in an accident or in childbirth.

There are, however, various conditions which do not need whole blood replacement. For example, chronic anaemic condition requires transfusion of only the red cells of blood, Indeed, transfusion of unnecessary plasma may be harmful if the patient has a weak heart. Separation of red cells from plasma can be achieved either by allowing the container in which the blood is collected to stand for some hours during which the red cells will separate themselves from the plasma by gravity, or by spinning the container in a centrifuge, a machine which spins the container around a central axis. Adjustment of the number of revolutions per minute and the duration of spinning allow the different cells, e. g. red cells and blood platelets, to be separated from each other.

Platelet transfusion
These cells circulate in the body with the red and white cells and play an important role in the clotting process of the blood. Platelets and clotting factors help stop bleeding, including internal bleeding that you can't see. Transfusion of platelets separated from several units of blood is now an important part of the treatment of platelet deficiency. Some people have low numbers of platelets. This may be caused by disease, certain medications (such as chemotherapy) or treatments (such as radiation therapy). Platelets are given to prevent or control bleeding in these people. If you have hemophilia, you may bleed for a longer time than others after an injury or accident. You also may bleed internally, especially in the joints (knees, ankles, and elbows). Platelets may be given once or more to treat a single incident or repeated transfusions may be required over a period of time.

White cell transfusion
White cells, or leukocytes, exist in variable numbers and types but make up a very small part of blood's volume--normally only about 1% in healthy people. Leukocytes are not limited to blood. They occur elsewhere in the body as well, most notably in the spleen, liver, and lymph glands. Most are produced in our bone marrow from the same kind of stem cells that produce red blood cells. Others are produced in the thymus gland, which is at the base of the neck. Some white cells (called lymphocytes) are the first responders for our immune system. It is now established that successful transfusion of white cells can assist patients to combat infections when, as it sometimes happens in certain blood diseases, the patients' body is unable to produce its own white cells, These transfusions involve the use of specialised techniques and cell separation equipment. It is not possible to collect sufficient white cells through conventional blood donation.