When a blood transfusion is brought blood from a blood donor in the veins of a patient who needs blood because of severe anemia such as blood loss or a problem with blood formation.
Compatibility
A blood transfusion is possible only if recipient and donor have the same or a compatible (interchangeable) blood, otherwise dangerous immune reactions. Prior to the blood transfusion is therefore always carried a compatibility study This research consists of the following steps.:
Determination of the AB0 blood group and rhesus D-factor of the receiver and from the donor. AB0 blood group and rhesus D-factor are the most immunogenic blood groups and should be. Therefore investigated
Antibody Screening: serum of the recipient is examined for irregular antibodies.
In all cases, except in the immediately life-threatening emergency is also a cross-test is carried out between the serum of the recipient and the red blood cells of the donor. These red blood cells from the donor were incubated with serum from the recipient. Occurs in these crossmatch clumping on (by the presence of antibodies) than that blood transfusion is not possible. It is then picked a new bag of blood for the deployment of a new crossmatch. Only when there is no agglomeration occurs between the serum of the recipient and the red blood cells of the donor, the blood may be given to the patient for transfusion.
If the antibody screening or crossmatch positive reactions then further studies should be performed.
Receiving Blood
Because there are a lot of different, mutually incompatible blood types, it is not possible to receive. Blood of everyone In general, who has not a particular factor may not receive blood which that factor is present. If that happens someone can get an immune response to the "strange" particles that suddenly present in the body. Blood group 0 rhesus D-negative (0 ~) is considered the universal donor, this blood can be given to each recipient. AB blood type rhesus D positive (AB +) is seen as universal receiver, they can receive blood from anyone. There are many other blood groups, but for the daily practice of blood transfusion of less importance. In emergency situations, there is always blood 0- given. The table below shows which blood transfusions are possible. A '+' indicates that the blood transfusion is possible, a '-' indicates that this is not possible. From top to bottom you can see which can donate blood and what blood type can receive. From left to right.
Risks Of Blood Transfusion
Blood may contain pathogens and can be transferred to a blood transfusion from the donor to the recipient. Within the Netherlands are working with very sophisticated systems to keep. The risk of transmission of the sick from a blood transfusion as small as possible Serious diseases that can be transmitted through blood transfusions include: HIV / AIDS, syphilis, hepatitis B and other forms of viral hepatitis, and malaria. For these reasons, blood donors are screened, among other diseases, by asking for both diseases or conditions associated with an increased risk of disease, as to be performed by the decreased blood tests. For example, because of HIV / AIDS for some time (a few weeks to months) elapses between the time of infection and the demonstrable are those of infection in the blood of a donor, while the disease than if it could be transmitted by transfusion the blood of new donors stored for a longer period of time. Only when a new analysis of the blood of the donor, some months later, it is proved that the donor is not infected with HIV, the bags are released for blood donation. People with a clearly increased risk of infection in most countries are also not accepted as a donor.
Partly because of these risks is attempted in all surgeries to prevent blood loss or to reduce the need for blood transfusion (and other risks) to minimize in any case. See further in the section "Alternatives to blood transfusion."
Blood Components
Previously, there was blood transfusion given whole blood. This meant that all of the blood that was coming from the donor was given to the patient. Whole blood transfusions may be serious side effects or consequences and are therefore no longer performed in the Netherlands. If there is now a blood transfusion are only red blood cells (PC, packed cells, EC, packed red cells) data. These red blood cells are obtained by centrifugation, resulting in separation of the various components of blood arises, such as red blood cells, plasma and whole blood. Red blood cells (erythrocytes, packed cells) are given for anemia, with major blood loss and before, during and after surgery. Other products that are extracted from donated blood include platelets and plasma. Platelets (thrombocytes) are given when the patient has a low platelet count, causing problems in blood clotting occur. Because such a transfusion of platelets only a few days effect this is only done when there is a view of restoring the normal situation in the patient. Plasma is given for major bleeding with red blood cells and in therapeutic plasmapheresis.
Alternatives To Blood Transfusions
There are also alternatives to transfusions of donated blood:
For replenishing blood plasma, which is lost, when bleeding is used for decades called crystalloids, such as Ringers lactate "or colloids, such as Dextran 'or' Hexastarch.
For the oxygen transport a PFC-emulsion (perfluorcarbonverbinding) can be injected.
At "autotransfusion" is some time before the operation of blood taken from the patient, so that it may optionally be administered later.
In time Fluosol could be as complete alternative, an "artificial blood" that a man could survive for 72 hours. Used The latter product is still strong in development and can not replace the current blood products (yet).
In addition to these alternatives, there are treatment methods which reduce the need for a blood transfusion may decrease, such as:
Hemodilution (artificial dilution of the blood) is a method to lower, so that the patient during the operation, while losing as much volume, but that loses less of red blood cells. The concentration of red blood cells This method can be applied in all operations, but will take place only in operations of which it is known that there is a lot of blood will be lost.
The operation for the administration of erythropoietin, a hormone which stimulates the bone marrow to make accelerated. Red blood cells
The Cell Saver is a device that is sucked up blood from the operative field by means of clean wash cycles and centrifugation, and there is a "packed red cells" from manufactures that can be used in the patient. Then reinfused In practice, the only major blood loss is a real option.
Compatibility
A blood transfusion is possible only if recipient and donor have the same or a compatible (interchangeable) blood, otherwise dangerous immune reactions. Prior to the blood transfusion is therefore always carried a compatibility study This research consists of the following steps.:
Determination of the AB0 blood group and rhesus D-factor of the receiver and from the donor. AB0 blood group and rhesus D-factor are the most immunogenic blood groups and should be. Therefore investigated
Antibody Screening: serum of the recipient is examined for irregular antibodies.
In all cases, except in the immediately life-threatening emergency is also a cross-test is carried out between the serum of the recipient and the red blood cells of the donor. These red blood cells from the donor were incubated with serum from the recipient. Occurs in these crossmatch clumping on (by the presence of antibodies) than that blood transfusion is not possible. It is then picked a new bag of blood for the deployment of a new crossmatch. Only when there is no agglomeration occurs between the serum of the recipient and the red blood cells of the donor, the blood may be given to the patient for transfusion.
If the antibody screening or crossmatch positive reactions then further studies should be performed.
Receiving Blood
Because there are a lot of different, mutually incompatible blood types, it is not possible to receive. Blood of everyone In general, who has not a particular factor may not receive blood which that factor is present. If that happens someone can get an immune response to the "strange" particles that suddenly present in the body. Blood group 0 rhesus D-negative (0 ~) is considered the universal donor, this blood can be given to each recipient. AB blood type rhesus D positive (AB +) is seen as universal receiver, they can receive blood from anyone. There are many other blood groups, but for the daily practice of blood transfusion of less importance. In emergency situations, there is always blood 0- given. The table below shows which blood transfusions are possible. A '+' indicates that the blood transfusion is possible, a '-' indicates that this is not possible. From top to bottom you can see which can donate blood and what blood type can receive. From left to right.
Risks Of Blood Transfusion
Blood may contain pathogens and can be transferred to a blood transfusion from the donor to the recipient. Within the Netherlands are working with very sophisticated systems to keep. The risk of transmission of the sick from a blood transfusion as small as possible Serious diseases that can be transmitted through blood transfusions include: HIV / AIDS, syphilis, hepatitis B and other forms of viral hepatitis, and malaria. For these reasons, blood donors are screened, among other diseases, by asking for both diseases or conditions associated with an increased risk of disease, as to be performed by the decreased blood tests. For example, because of HIV / AIDS for some time (a few weeks to months) elapses between the time of infection and the demonstrable are those of infection in the blood of a donor, while the disease than if it could be transmitted by transfusion the blood of new donors stored for a longer period of time. Only when a new analysis of the blood of the donor, some months later, it is proved that the donor is not infected with HIV, the bags are released for blood donation. People with a clearly increased risk of infection in most countries are also not accepted as a donor.
Partly because of these risks is attempted in all surgeries to prevent blood loss or to reduce the need for blood transfusion (and other risks) to minimize in any case. See further in the section "Alternatives to blood transfusion."
Blood Components
Previously, there was blood transfusion given whole blood. This meant that all of the blood that was coming from the donor was given to the patient. Whole blood transfusions may be serious side effects or consequences and are therefore no longer performed in the Netherlands. If there is now a blood transfusion are only red blood cells (PC, packed cells, EC, packed red cells) data. These red blood cells are obtained by centrifugation, resulting in separation of the various components of blood arises, such as red blood cells, plasma and whole blood. Red blood cells (erythrocytes, packed cells) are given for anemia, with major blood loss and before, during and after surgery. Other products that are extracted from donated blood include platelets and plasma. Platelets (thrombocytes) are given when the patient has a low platelet count, causing problems in blood clotting occur. Because such a transfusion of platelets only a few days effect this is only done when there is a view of restoring the normal situation in the patient. Plasma is given for major bleeding with red blood cells and in therapeutic plasmapheresis.
Alternatives To Blood Transfusions
There are also alternatives to transfusions of donated blood:
For replenishing blood plasma, which is lost, when bleeding is used for decades called crystalloids, such as Ringers lactate "or colloids, such as Dextran 'or' Hexastarch.
For the oxygen transport a PFC-emulsion (perfluorcarbonverbinding) can be injected.
At "autotransfusion" is some time before the operation of blood taken from the patient, so that it may optionally be administered later.
In time Fluosol could be as complete alternative, an "artificial blood" that a man could survive for 72 hours. Used The latter product is still strong in development and can not replace the current blood products (yet).
In addition to these alternatives, there are treatment methods which reduce the need for a blood transfusion may decrease, such as:
Hemodilution (artificial dilution of the blood) is a method to lower, so that the patient during the operation, while losing as much volume, but that loses less of red blood cells. The concentration of red blood cells This method can be applied in all operations, but will take place only in operations of which it is known that there is a lot of blood will be lost.
The operation for the administration of erythropoietin, a hormone which stimulates the bone marrow to make accelerated. Red blood cells
The Cell Saver is a device that is sucked up blood from the operative field by means of clean wash cycles and centrifugation, and there is a "packed red cells" from manufactures that can be used in the patient. Then reinfused In practice, the only major blood loss is a real option.