When we transfuse 'blood', we actually transfuse only part of the blood donated by some kind volunteers at blood donor clinics. Most transfusions are of the red blood cells. The red color is due to the hemoglobin, the protein in red blood cells, which carries oxygen from the lungs throughout the body.

The heart pumps the blood through tubes called arteries and veins (blood vessels), the ends of which are connected by thin tiny tubes that are called capillaries. Without enough blood in the blood vessels, the heart cannot maintain enough pressure to push new blood to the tissues, which can die due to lack of oxygen.

When Do We Need Transfusions?

Transfusion of red blood cells is needed for two major types of problem:

Are There Any Options To Blood Transfusion?

During massive hemorrhage (loss of blood), blood transfusion is the only practical way to keep the system working and to prevent death. We can maintain the pressure of the system by infusing plasma or certain artificial materials. During World War II, many lives were saved by transfusion of plasma (U.S. forces) or a plastic in solution (German army), but others were lost because red blood cells were not as readily available to these armies as were to those other groups. To prevent disastrous reactions between the infused blood and the body's defenses, the blood must be typed and marked properly and found to be 'compatible' with the components of the recipient's body.

Is There Any Danger To Blood Transfusion?

There are several dangers:

If Blood Transfusion Is So Risky, Should Anyone Accept A Blood Transfusion?

If your doctor recommends that you receive a transfusion, then he or she has calculated that the risk to your life and health from the transfusion is less than the benefits to be obtained from it. Except in the case of massive blood loss, transfusion is elective - a treatment chosen by your doctor to reduce the risk of infection, edema, or heart failure.

Are There Options To Blood Transfusions?

Artificial blood has been developed for many years but remains experimental and of doubtful benefit. As indicated above, young patients often can be resuscitated with plasma and other compounds to fill the circulation but there is no real replacement for blood. This means that without volunteer donors, the health care system would be helpless to treat a wide variety of illnesses.

In some situations, a hormone which stimulates blood formation (erythropoietin, procrit, epogen) can be injected to increase the rate at which you make your own blood. This might prevent subsequent need for transfusion. In such situations, your doctor will wish to give you additional iron to be sure that deficiency of this does not limit blood production.

Is Blood Donation By The Family Useful?

It is possible to store blood from selected donors so that should you need blood, this material would be available for use. Published data indicate that these 'directed transfusions' are not safer than are those from our regular blood banks. Stored blood is good only for 3-5 weeks, so that the timing of the collection must be precise. Blood can be processed and frozen for future use. This requires some hours to reconstitute, and there is a loss of cells in the process. Storage is expensive and usually reserved for very rare blood types for which donors cannot readily be found.

What Happens To The Rest Of The Blood When The Red Blood Cells Are Taken off?

The platelets are used in people with bleeding disorders and hence are collected and used to prevent or stop bleeding in them. The white blood cells are discarded. The plasma (liquid) is collected or may be fractionated to make different protein components that may stop bleeding, give volume to the circulation or fight infection.

In summary, although many lives have been lost from infections that were transmitted by transfused blood, many many more have been saved. As indicated above, in the balance of risk and benefit, the benefits win by a mile. You should store your own blood or accept blood from the bank when it is needed for your life or health, and be grateful to the wonderful people who fought to establish blood transfusion services, and to the donors who give the gift of life.

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