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Transfusion Medicine

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Are there risks associated with donating or receiving blood? The blood banking community assures the U.S. public that it is safe to donate blood. A new, sterile needle is used for each donation procedure. Therefore, you cannot get infected with viruses, such as HIV or hepatitis, by donating blood.

In addition, donors are screened before giving blood to ensure that they are in good health and have no complications that could cause them harm by donating. Mild side effects from the procedure that a donor might experience include stinging during insertion of the needle, upset stomach, dizziness, and possibly a small amount of bruising later at the site of the blood draw. In very rare cases, a donor may faint, have muscle spasms, or suffer nerve damage.

There are some risks with receiving blood transfusions. Some people fear that they may contract an infectious disease. However, donated blood is carefully screened for transmittable diseases, as noted earlier in this article. The risk of infection from transfusion is now extremely low (about 1 in 600,000 units transfused for hepatitis B and about 1 in 2 million units transfused for HIV and hepatitis C). Of greater concern is ABO incompatibility and transfusion reactions.

ABO incompatibility occurs when a unit of blood is transfused and the recipient has antibodies to the ABO antigens on the donor unit red cells (for example, a group O recipient receives a group A unit of red cells). The recipient of the blood transfusion could have an immune reaction against the foreign blood cells that can be very dangerous, even life-threatening. Besides just ABO incompatibility, there are other incompatibilities that can cause transfusion reactions. Antigens occur on other blood components, including white blood cells, platelets, and plasma proteins. The immune system will attack and destroy the donated blood cells, with serious side effects for the patient.

There are several types of transfusions reactions, such as allergic and febrile (characterized by fever). Treatment will depend on the type of reaction and the patient's symptoms (for example, antihistamines may be used to reduce rash and itching from allergic reactions while acetaminophen may be prescribed to reduce fever). Many transfusion reactions go undetected and, therefore, unreported. However, the reported rate of transfusion reactions is on the order of 1 per 1,000 components or 1 in 400 people. Nearly all of these are non-infectious complications and include mis-transfusion, volume overload, febrile or allergic reactions, and transfusion-related acute lung injury (TRALI), a serious but infrequent reaction where the patient can develop breathing problems and may have a high fever.

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