5. What are the risks of a blood transfusion?

Mild allergic reactions, such as hives or itchiness are common — about one in 300. These reactions are easily treated. Severe allergic reactions are extremely rare.

There is a one in 100 chance of having a fever following a blood transfusion. This is fairly common in patients who have been previously transfused or are pregnant. The reaction is generally not severe and is easily treated. Patients who have had severe fever reactions with transfusions may be treated for this prior to the transfusion. You should tell your doctor if you have had a severe fever with transfusions in the past.

In very rare cases, the patient’s blood destroys the donor red blood cells. This is called haemolysis. The chance of an acute haemolytic reaction is one in 25,000. This can be severe and may result in bleeding and in kidney failure. However, complications can usually be prevented by medical treatment.

The risk of chronic infection, injury or death from transfusion transmitted infections is very small but the risk cannot be completely removed by available testing. All volunteer donor blood is screened for infectious diseases. In addition, the donors have undergone a screening process to become eligible to donate. Donated blood is tested for hepatitis B, hepatitis C, HIV, and other infectious agents. Only blood that tests negative for infectious agents is allowed to be used.

When your body has lost so many red blood cells that your body is not getting enough oxygen, you run the risk of damaging vital organs such as the brain or heart. Transfusion may be necessary to prevent such damage, which can cause serious injury, permanent handicap or death. Your physician/surgeon or anaesthetist will recommend when transfusion is needed based on your individual case.

This is your own blood that is stored in a refrigerator and used for transfusion, if necessary, at the time of surgery.

Advantages of Using Your Own Blood

• You have no risk of being infected by contaminated blood.
• You will not become immune to other blood types. When you receive blood from someone else, you may become immune to other blood types leading to risks or difficulties in future transfusions if required.
• You won’t have possible allergic or other immune reactions.
• Possibility of a slightly lower risk of complications after surgery if your own blood is used.

Most people who plan to have major elective surgery are eligible. The medical staff at the Blood Conservation Program will determine your eligibility based on

• General medical condition.
• The procedure you are schedule to have.
• The amount of blood usually required for the procedure.

At the pre-admission unit, a staff person will review the autologous blood donation process with you and answer any questions you may have. An anaesthetist will check to see if you are medically and physically fit to donate. A request for your donation will be forwarded to the Apollo hospitals blood bank and you will be contacted to set-up a donation. The required amount of blood will be collected at a series of appointments about a week apart.

The blood will be stored at the Apollo Hospital blood bank. If your blood is not used, or it expires, it will be properly disposed of.

If more blood is required than what is donated, donor blood from the Apollo hospital blood bank will be used.

You may find that coming in for each donation session is inconvenient. Pre-donation testing, the actual donation and post-donation recovery may take one to two hours or more per donation.

There are minor side effects such as bruising or bleeding from the needle, light-headedness, fainting or dizziness, and mild anaemia. Severe complications can include low or high blood pressure, abnormal heart rhythm or rate, chest pains, heart attack or stroke.

Iron is a mineral that is essential for forming part of haemoglobin (red blood cells) which carries oxygen to the cells of the body. Oxygen is important for your body’s cells to grow and function.

If the levels of iron in your body are low you may experience

• a feeling of being tired.
• lack of energy.
• pale skin.
• problem concentrating.
• signs of irritability
• difficulty breathing

• Your body needs iron to help build new red blood cells.
• An increase in red blood cells will be needed before surgery to allow you to participate in some parts of the blood conservation program (donation of your own blood).
• A higher red blood cell level will allow oxygen to get to body cells and help you recover faster from your surgery.
• It also provides an adequate amount of red blood cells in case there is bleeding during or following your surgery.

Iron can be found in a variety of foods. There are two types of iron in foods: Heme and Non-Heme irons.

It is easily absorbed by the body and is found in foods such as organ meats (liver, kidney, heart), beef, lamb, pork, veal, poultry (dark meat), and fish or seafood.

It is not as easily absorbed and is found in foods such as whole grain cereals or fortified cereals, vegetables (beans, lentils, dried peas, chard), dried fruits (raisins, apricots), seeds and nuts, breads and pasta that are whole grain or enriched.

When you eat Non-Heme iron, you should include foods that help to increase iron absorption. Foods containing vitamin C, such as fruit (strawberries, kiwi, oranges, and raspberries), fruit juices, cauliflower, broccoli, brussels sprouts, tomatoes, turnip, and foods containing Heme irons, will help in the absorption of the Non-Haeme iron, when eaten at the same time.

Some combinations can include

• iron fortified cereal with orange juice.
• whole grain toast and strawberries
• egg salad and fruit.
• mutton with beans.

NOTE: You should avoid tea, coffee, caffeine soft drinks, cocoa and milk (calcium) with your meals because they lower the amount of iron that is absorbed. Have these drinks in between meals.