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During a blood transfusion, a person (the
recipient) receives healthy blood from another person (the donor). The donated
blood is carefully screened for diseases before it is used. Before receiving a
blood transfusion, the recipient's blood is analyzed closely (using
blood type) to make sure the donor blood is a close
match to the recipient's.
Blood is transfused into an arm vein
slowly over 1 to 4 hours (except in an emergency when blood is transfused more
Blood transfusions can:
Blood transfusions aren't usually used to treat
painful events or mild to moderate
Following a blood transfusion, doctors
keep a close watch on the person for any negative reactions.
Your doctor might check for iron buildup in the body
(iron overload). This can happen when a person gets many transfusions.
A blood transfusion lowers the amount
hemoglobin S red blood cells in the body. When there
are fewer sickled hemoglobin S cells in the bloodstream, they are less likely
to build up and block blood vessels.
Blood transfusion also
increases the number of normal red blood cells in the body, increasing the
supply of oxygen to the body.
Some sudden complications of sickle cell
disease cause the body's red blood cell count to drop to life-threatening
levels (severe anemia). When severe, these conditions (including
acute chest syndrome, and
aplastic crisis) can be fatal if not treated with
Chronic severe anemia from kidney failure may
need treatment with periodic blood transfusions.
general anesthesia and surgery, people who have sickle
cell disease are at risk for sickling-related problems and acute chest
syndrome. Blood transfusions before surgery can prevent or treat these
Blood transfusions can treat acute chest
syndrome and leg ulcers.
Frequent blood transfusions may help
prevent strokes in children who already had a stroke or are at high risk for a
Blood transfusion is an effective and proven treatment for some severe complications of
sickle cell disease.2
reduce the risk of some complications of sickle cell disease and reduce symptoms of severe anemia.
Blood transfusion may help prevent a first stroke in children who have sickle cell
disease. Transfusions can help prevent a second stroke in most children. But some children
who get repeat transfusions will still have a second stroke.3
A person receiving many blood transfusions will
gradually collect too much iron in the body (iron overload). Very high levels
of iron can lead to
hemochromatosis, which can be fatal if untreated.
chelation treatment can help rid the body of excess
A person receiving repeat blood transfusions may develop
antibodies to the donor blood. This is called
alloimmunization. Alloimmunization makes repeated
transfusions more difficult. It occurs in about 1 out of 4 people who have sickle
cell disease and who get frequent transfusions.4
A transfusion reaction can result from mismatched blood type. And it may
occur immediately or days later. An acute
transfusion reaction ranges from mild (fever, chills, and rash) to severe
(shock, severe anemia, painful event, and death).
Donated blood is carefully screened for diseases before it
is used. It is very rare for a disease to be transmitted through donated blood.
If you have repeated blood
transfusions, you'll have routine testing for iron buildup in your body.
Though blood transfusions are an effective treatment for sickle
cell disease complications, they are only used selectively. The risks of
hemochromatosis and alloimmunization from repeat transfusions makes this
procedure more suitable for severe and high-risk conditions.
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Goldstein LB, et al. (2010). Guidelines for the primary prevention of stroke: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. Published online December 2, 2010 (doi: 10.1161/STR.0b013e3181fcb238).
Wang WC (2009). Sickle cell anemia and other sickling
syndromes. In JP Greer et al., eds., Wintrobe's Clinical Hematology, 12th ed., pp. 1038–1082. Philadelphia: Lippincott Williams
National Heart, Lung, and Blood Institute, National
Institutes of Health (2002). The Management of Sickle Cell Disease (NIH Publication No. 02-2117). Available online:
Steinberg MH (2012). Sickle cell disease and other hemoglobinopathies. In L Goldman, A Shafer, eds., Goldman's Cecil Medicine, 24th ed., pp. 1066–1075. Philadelphia: Saunders.
October 1, 2012
E. Gregory Thompson, MD - Internal Medicine & Martin Steinberg, MD - Hematology
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