Blood Transfusions: When and Why They Are Needed

Blood transfusion

Dr.
Liu: Hello, I have a question I would like to ask you.
My husband underwent a total blood exchange several years ago due to issues with his platelets, and recently, during a company-wide health check, it was discovered that his blood is problematic again.
He may need to undergo another blood exchange.
Since I am not very familiar with this area, I would like to know under what circumstances a total blood exchange is necessary, how long the procedure takes, and whether he needs to stay in the hospital during the process.
What are the costs involved? Is there health insurance coverage for this? Is it considered a major illness? Can he apply for national assistance? Besides blood exchange, are there other methods available? What are the risks associated with the blood exchange process? How long does it take to recover? What should he pay attention to after the exchange? What dietary restrictions should be followed? These are some of my questions.
I apologize for reaching out for medical advice for the first time, and I hope you can understand.
Thank you for your help! I look forward to your reply.

Mrs. Huang, 20~29 year old female. Ask Date: 2003/09/16

Dr. Shou Weijin reply Pharmacology

Dear Mrs.
Huang,
I have received your inquiry and would like to provide you with some answers.
The medical term for blood exchange in Chinese is "換血" (huàn xuè), which is primarily used to treat certain severe autoimmune diseases.
What are autoimmune diseases? They occur when the body's immune system mistakenly identifies its own tissues as foreign substances and produces antibodies to reject them.
These antibodies circulate in the bloodstream and attack our body tissues, which is detrimental to health.
Therefore, a procedure is performed to draw out plasma and filter out these antibodies, which is referred to as blood exchange; it is somewhat analogous to dialysis.
The blood exchange process typically takes about 2 to 4 hours, and the physician will assess the patient's condition to determine how often the procedure should be performed.
From your letter, I am unsure of your husband's exact diagnosis, making it difficult to provide specific health education related to that condition.
However, if it is indeed an autoimmune disease, it usually involves the use of large amounts of corticosteroids, which can lead to complications such as buffalo hump, osteoporosis, obesity, and decreased immunity.
Therefore, dietary intake should focus on quality rather than quantity, ensuring a balanced, fresh, and nutritious diet while avoiding infections.
It is advisable to wear a mask in public places.
After plasma exchange, patients may experience mild headaches, nausea, and a tingling sensation in their extremities and lips, but these symptoms typically do not last long.
If discomfort persists, please inform the healthcare staff.
Regarding health insurance coverage, since I am not a specialist in that field and do not know your husband's exact diagnosis, I recommend calling the National Health Insurance Administration at 0800-212-369 for free consultation regarding insurance coverage questions.
Sincerely,
Dr.
He Junqing
Physician and Director, Zhudong Township Health Center
Attending Physician, Family Medicine Department, Zhudong Hospital
September 18, 2003

Reply Date: 2003/09/16

More Info

Blood transfusions are a critical medical procedure used to treat various conditions, particularly those involving significant blood loss or disorders affecting blood production. Understanding when and why blood transfusions are needed is essential for patients and their families, especially in cases where the patient has a history of blood disorders or has undergone previous transfusions.

When Are Blood Transfusions Needed?
Blood transfusions are typically indicated in the following scenarios:
1. Severe Anemia: When a patient has a significantly low hemoglobin level (usually below 7-8 g/dL), a transfusion may be necessary to restore adequate oxygen-carrying capacity in the blood. This is particularly true for patients who exhibit symptoms such as fatigue, dizziness, or chest pain.

2. Massive Blood Loss: In cases of trauma, surgery, or gastrointestinal bleeding, where there is a substantial loss of blood, transfusions are critical to replace lost blood volume and maintain hemodynamic stability.

3. Blood Disorders: Conditions such as aplastic anemia, thalassemia, or sickle cell disease may require regular transfusions to manage symptoms and prevent complications.

4. Platelet Disorders: Patients with low platelet counts (thrombocytopenia) due to various causes may need platelet transfusions to prevent bleeding.

5. Postoperative Recovery: After major surgeries, especially those involving significant blood loss, transfusions may be necessary to support recovery.

The Transfusion Process
The transfusion process typically involves the following steps:
- Pre-Transfusion Testing: Blood typing and cross-matching are performed to ensure compatibility between the donor's blood and the recipient's blood. This is crucial to prevent transfusion reactions.

- Duration of Transfusion: A typical blood transfusion can take anywhere from 1 to 4 hours, depending on the volume of blood being transfused and the patient's tolerance.
- Hospital Stay: Patients usually need to be monitored during the transfusion, which may require a hospital stay, especially if they have underlying health issues or are receiving large volumes of blood.

Risks and Complications
While blood transfusions are generally safe, there are potential risks involved, including:
- Allergic Reactions: Some patients may experience mild allergic reactions, such as itching or rash.

- Fever: A febrile non-hemolytic reaction can occur, leading to fever and chills.

- Hemolytic Reactions: Incompatibility can lead to serious hemolytic reactions, which can be life-threatening.

- Infections: Although rare, there is a risk of transmitting infections through transfusions, which is why rigorous screening and testing are performed.

- Transfusion-Related Acute Lung Injury (TRALI): This is a rare but serious complication that can occur after transfusion.

Post-Transfusion Care
After a transfusion, patients should be monitored for any adverse reactions. It is also essential to maintain a balanced diet rich in iron and vitamins to support blood health, especially if the patient has a history of anemia. Foods such as leafy greens, red meat, beans, and fortified cereals can help improve hemoglobin levels.

Financial Considerations
The cost of blood transfusions can vary significantly based on the healthcare system, the type of blood product used, and whether the patient has health insurance. In many countries, blood transfusions are covered under health insurance plans, but it is advisable to check with the insurance provider for specific coverage details.

Conclusion
In summary, blood transfusions are a vital intervention for managing various medical conditions. Understanding the indications, risks, and post-care requirements can help patients and their families make informed decisions about their treatment options. If you have further questions or concerns about blood transfusions, it is always best to consult with a healthcare professional who can provide personalized advice based on the patient's medical history and current health status.

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