In this term paper we will discuss about:- 1. Definition of Blood Transfusion 2. Indications for Blood Transfusion 3. Hazards of Incompatible 4. Dangers.
Term Paper on Blood Transfusion
Term Paper # 1. Definition of Blood Transfusion:
Intravenous administration of blood to help replenish excess blood loss due to haemorrhage or otherwise, is known as blood transfusion. It is a most effective therapeutic tool when judiciously applied.
Total blood transfusion allows the transfer of those elements that are required for the defence against infection, the transport of oxygen, and the formation of platelet plug (a white thrombus). It permits the circulating blood to be re-established and corrects condition of shock and vascular collapse. It also supplies those clotting factors which are required for haemostasis.
Modern transfusion methods not only use transfusion of stored blood from bottles in acid citrate dextrose (ACD) solution, but it also uses cellular transfusions, plasma component transfusions, plasma transfusions, depending as the case may be, on the requirement of the patient. The blood may be stored for two or three weeks in a refrigerator at +4°C.
Blood Bank:
Maintenance of a constant volume of blood is essential for our life. If due to any reason, there is excessive loss of blood, it must be transfused from other sources. Due to this reason blood should always be kept handy for emergency and establishment of blood bank is essential in every hospital.
So, blood bank is a specialised medical centre which collects and stores human blood for transfusion and for operation with the artificial heart-lung. The blood thus collected is separated into fractions, each of which has a particular use, serum, red cells, white cells, platelets, etc.
Whole blood in presence of acid citrate as anticoagulant can be preserved with dextrose solution at +4°C for several weeks. Red cells kept in such a condition are destroyed in a similar way as the normal R.B.C. and so older samples contain lesser number of cells.
Frozen separated plasma can be kept for years at—20° C. Lyophilised (frozen dried) plasma, from which the water has been removed, can even be stored at room temperature. Required amount of water is added to it during use.
Term Paper # 2. Indications for Blood Transfusion:
i. Haemorrhage either acute or chronic (especially if the haemoglobin falls below 40%).
ii. Shock in order to increase the blood volume.
iii. Blood diseases, e.g., in all varieties of server anaemia where the haemoglobin is below 40% aplastic anaemia, haemorrhagic diathesis of the new-born, haemophilia, purpura haemorrhagica, etc. in haemorrhagic diseases blood transfusion increases coagulability.
iv. In carbonmonoxide poisoning, coalgas poisoning, etc., where haemoglobin has formed some other abnormal compounds, blood transfusion provides a fresh supply of oxyhaemoglobin.
When blood of one species of animal is mixed with that of another, it is often seen that the corpuscles are at first agglutinated and then haemolysed. Amongst human beings this phenomenon of haemoagglutination is also seen.
The red corpuscles of one subject may be agglutinated by the serum or plasma of another, but may not be affected in any way by that of a third man. These facts are of extreme importance in connection with blood transfusion.
In various diseases, it is sometimes necessary to inject a large quantity (even 500 ml) of blood, taken from a healthy man (donor), directly into the vein of the patient (recipient). If the two bloods be not compatible haemolysis of the donor’s corpuscles will take place, leading to disastrous effects to the recipient. For this reason, before undertaking blood transfusion, compatibility between the donor’s and the recipient’s blood must be carefully tested.
After observing the interaction between the red cells and plasma of a large number of cases, Landsteiner in 1901 demonstrated that human being can be divided into several groups.
Term Paper # 3. Hazards of Incompatible Blood Transfusion:
When mismatched blood is injected intravenously to a recipient whose serum contains antibodies like α, β or Anti-D, serious symptoms even leading to death may occur. The red cells are agglutinated, which later on undergo haemolysis.
The results of incompatible blood transfusion may be summarised as follows:
i. Agglutination of red cells and haemolysis.
ii. Jaundice:
It is due to breakdown of red cells. Haemoglobin is released and is broken down to form bilirubin. When the concentration of bilirubin rises in blood it produces jaundice.
iii. Haemoglobinuria:
Red cells are agglutinated and then haemolysed. Large amount of haemoglobin is released and partly converted into bilirubin. Part of the released haemoglobin is excreted in urine as such.
iv. Renal Failure:
There is fall in renal arterial blood pressure, and so reduced formation of glomerular filtrate. Haemoglobin filtered through the glomeruli is converted into acid haematin and blocks the renal tubules and lessens the flow of urine which may lead to anuria. The nitrogenous constituents of the blood accumulate in it and uraemia may develop.
Term Paper # 4. Dangers of Blood Transfusion:
Dangers Pertaining to Compatible Blood:
a. Transmission of diseases, like AIDS, viral hepatitis, syphilis, and malaria.
b. Over loading of the heart, if the volume of blood transfused is more than what is required. This happens in massive transfusion.
c. Ionic imbalances leading to hypokalemia, and hypocalcemia. This affects the excitability of nerve and muscle.
d. Reactions of transfusion, like fever, and shivering.
Dangers associated with Incompatible Blood:
a. Minor reaction:
In-apparent hemolyis because the donor’s red blood cells react with recipient’s plasma and hence the red blood cells will get hemolyzed. Consequent to hemolysis, there is release of hemoglobin from the hemolyzed cells.
b. Moderate reaction:
After about a day or two, the serum bilirubin level rises. This is because of the hemolysis of red blood cells and production of more amount of bilirubin. Due to an increase in the bilirubin level, the person develops jaundice. Since the jaundice is consequent to transfusion, it is called as post-transfusion jaundice.
c. Severe reaction:
The agglutinated mass, which is in circulation, blocks the circulation in the capillaries. Because of this, the blood flow through the organs and tissues suffers. This results in compression in chest, pain at the back and may also lead to the failure of organs, like kidney and brain.
The renal failure can also be due to filtration of hemoglobin into the renal tubules and affecting the functioning of the kidneys. The loss of kidney function leads to oliguria or anuria. This leads to uremia, hyperkalemia or hypokalemia.