Blood transfusions

A blood transfusion is a treatment that involves giving blood or blood products to a person when an authorized health professional deems it necessary.

Depending on their state of health, a person may need to receive one or more of these blood products. The products most often transfused are red blood cells, platelets and plasma.

Blood is the fluid that flows through the arteries and veins of the human body. It is essential for the body to function properly. It carries oxygen, nutrients that nourish the cells of the body and other substances that help fight disease.

Blood is made up of red blood cells, white blood cells and platelets, which form in the bone marrow. It also includes a liquid part called plasma. An adult body contains an average of five to six litres of blood.

A drop of blood contains about five million red blood cells that carry oxygen. The red colour is caused by an iron-containing protein called hemoglobin. A transfusion of red blood cells is given to a person who has lost a lot of blood, for example as a result of an accident or major surgery. Red blood cells may also be given to people with anemia.

Plasma is yellowish in colour and is the liquid part of blood. It is rich in proteins that are essential for the body to function properly. Human blood is 55% plasma. A plasma transfusion is given to a person who has a clotting problem that could lead to heavy bleeding, during surgery, for example.

Different components of plasma are obtained in concentrated form using a process called fractionation. They are also called stable blood products. There are a wide variety of plasma derivatives, for example clotting factors, albumin and immunoglobulins (antibodies).

Platelets are cells in the blood, smaller than red blood cells. They play an essential role in forming clots to prevent or stop bleeding. A platelet transfusion is given in cases of severe blood loss, when platelets do not function properly or when platelet levels are too low.

White blood cells defend the body against bacteria and viruses. As soon as there is an infection in the human body, they fight it. White blood cell transfusions are very rare.

Most of the blood products mentioned on this page come from Québec donors, through Héma-Québec, or from donors in other parts of Canada, through Canadian Blood Services. Only plasma derivatives may be prepared from blood from donors who live outside the country.

In Québec, people who donate blood do so for the good of others. They do so voluntarily, that is, they are not paid for donating. A single blood donation can help save four lives.

A person who wants to donate blood must show a piece of I.D. and fill out a questionnaire about their health and other topics related to the transmission of certain diseases.

Each blood donation collected is carefully tested and screened, in particular for hepatitis B, hepatitis C, AIDS or human immunodeficiency virus (HIV) and syphilis. Other tests, such as for West Nile Virus (WNV), are done when necessary. If the result of any of the tests is abnormal or positive, the blood must be thrown away.

The blood is also analyzed to determine the blood type (A, B, AB or O) and to find out if it is Rh positive (+) or negative (-). In the hospital, before any transfusion, several checks are carried out to ensure the blood or blood product selected is the best one for the recipient.

The administration method and time vary depending on the blood product and the recipient’s condition. All the equipment used for the transfusion is new, sterile and disposable.

The average transfusion time for blood products varies:

• red blood cells: between 2 and 4 hours;
• platelets: between 30 minutes and 2 hours;
• plasma: between 1 and 2 hours;
• plasma derivatives: varies depending on the type of product and the amount administered.

Thanks to transfusions, surgeries and medical treatments can be carried out. For example, transfusions are often required for:

• treating premature babies;
• heart surgeries;
• organ transplants;
• cancer therapy;
• anemia;
• resuscitating people who lose a lot of blood after an accident.

In Québec, it is estimated that more than 75,000 people receive blood or blood products each year.

Strict measures are put in place to ensure the right product is administered to the right person. Before each transfusion, staff check the identity of the person who is going to receive the transfusion.

Blood transfusion is safe and may, in some cases, be the only way to save a life. Donors are selected based on rigorous criteria.

Thanks to the rigorous process, the risk of transfusion-transmitted diseases is very low in Québec.

Most transfusions do not have adverse effects. During a transfusion, health care providers monitor the recipient closely. Despite all the precautions taken, a transfusion sometimes causes adverse effects. Here are a few examples:

A blood product transfusion may cause an allergic reaction. This occurs in less than 1% of transfusions. An allergic reaction can present as hives or other skin reactions.

The blood product transfused can also cause fever, with or without chills. Less than 1% of transfusions result in a significant fever. It can be treated with an appropriate medication. In very rare cases, fever can be caused by bacteria in the product.

After a transfusion, some people develop antibodies. This complication, called alloimmunization, generally does not cause any symptoms. It can be detected using a blood test. Special attention will be given to these people if they have another transfusion.

Other reactions may occur. For example, if the amount of fluid circulating in the veins increases too rapidly during a transfusion, it could cause problems in the elderly or in people with heart problems.

In some cases, the person may have trouble breathing.

There is a possibility of adverse effects after receiving a transfusion, which may even be delayed.

These adverse effects are, for example:

• skin reactions;
• fever, chills;
• jaundice;
• back pain.

It is recommended to consult a health professional if an unusual symptom is noticed. A person who has had a reaction or an adverse effect after a transfusion must inform health care providers before they have another one.

In some cases, a blood transfusion can be avoided by recovering blood during surgery or taking medication to correct anemia before surgery.

Before a transfusion, the health professional must obtain the person’s free and informed consent.

The health professional must give the patient all the relevant information about the blood, blood products and other possible treatments. They must ensure the person understands the benefits and risks of transfusion. They must also answer any questions they might have. The final decision is up to the person. The health professional can advise the patient, but cannot force them to agree to the procedure.

A compensation plan is offered to people whose health has been seriously affected by using a product distributed by Héma-Québec, in particular a defective or contaminated blood product.

For more information, go to the Compensation plan for victims of a product distributed by Héma-Québec page or call 1-855-881-9870 (toll free).