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Red Gold - the epic story of blood Blood Journey: Phase 5: The Transfusion
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Who Needs Transfusions?
Equipment monitors patients in need.
Blood is used for treatment in a variety of clinical settings including surgery, trauma, cancer chemotherapy, and diseases of the blood (e.g., sickle cell disease and thalassemia). While RBCs, the most commonly transfused component, are used to correct anemia (low red blood cell count), platelet and plasma components are used to treat bleeding disorders, either to halt further bleeding or to reduce risk of bleeding during surgery.

Transfusion is used for treatment in a variety of clinical settings including surgery, trauma, cancer chemotherapy, and diseases of the blood. Many surgeries today can be safely performed without use of blood; hernia and gallbladder surgeries are just two examples. Often, patients undergoing such relatively "minor" surgeries do not get their blood typed, but this is left to the discretion of the surgeon. For more complex surgeries where blood loss is expected to be significant, a set amount of blood is usually reserved for the patient based on the average amount of blood used for the type of surgery performed in the hospital.

A depiction of an early blood transfusion.

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Open heart, aortic aneurysm bypass, brain tumor, and orthopedic joint replacement (i.e., hip replacement) cases are examples of surgeries that usually require blood transfusion support. Organ transplant surgery, performed in more specialized hospitals, also requires considerable support by transfusion of blood components. For some types of elective surgery such as orthopedic joint replacement, it may be desirable for the patient to pre-donate blood (i.e., autologous blood donation).

Surgeons must also notify the blood bank if any special needs are anticipated, such as transfusion of platelets or plasma, so that the blood bank can prepare these components on a timely basis. (Frozen plasma, for example, requires 30-40 minutes thawing time.) Regardless of the type of surgery, however, since there is always the potential need for blood, it is important for hospital blood banks to inform surgeons and other physicians of the status of the blood supply as it may be necessary to postpone elective surgical procedures during times of severe blood shortage.

Dr. Neville Colman
Chairman of Pathology
Continuum Health Partners

Dr. Mark Friedman
Associate Director of the Blood Bank
St. Luke's/Roosevelt Hospital Center

Photo: Drawing of a transfusion at the Hôpital de la Pitié in Paris, courtesy of the National Library of Medicine.

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