Sometimes cancer patients require blood transfusions. If the doctor said that he plans to prescribe a blood transfusion, the patient usually has a lot of questions. Why is the procedure needed? Did something terrible happen? How safe is blood transfusion? Can you get HIV and other dangerous infections from a donor? How will the body react to someone else's blood? Will there be any complications? Is it possible to refuse blood transfusion or replace it with something else? [1,2]
Below you will find answers to many questions.
- What you need to know about blood?
- In what cases do cancer patients need blood transfusions?
- What are the types of blood transfusion?
- Red blood cell transfusion
- Plasma transfusion
- Platelet transfusion
- Cryoprecipitate transfusion
- Leukocyte transfusion
- How is the blood transfusion procedure performed?
- From whom can a blood transfusion be given?
- How is donor blood tested?
- Are there any alternatives?
- How safe is it?
- Is it possible to refuse a blood transfusion?
- Price
What you need to know about blood?
Doctors and scientists often refer to blood as the body's internal environment. It washes all organs. Blood performs many important functions: it carries oxygen, nutrients and hormones, removes waste products of metabolism, provides immune protection, and helps regulate body temperature.
Blood consists of two main parts:
- The liquid part is plasma. It is a solution of salts, ions, proteins and other substances.
- Blood cells. Erythrocytes (red blood cells) contain hemoglobin and transport oxygen. Leukocytes (white blood cells) provide nonspecific and immune protection. Platelets (blood platelets) form a clot when bleeding needs to be stopped. [1,3,4]
Book a consultation 24 hours a day
+7+7+78
In what cases do cancer patients need blood transfusions?
Conditions requiring blood transfusion may be caused by the malignant tumor itself or by side effects of anticancer treatment.
Some types of cancer, especially tumors of the gastrointestinal tract and tumors of the female genital area (vagina, cervix, uterus), can cause internal bleeding.
With a long course of cancer, various disorders occur in the body, which cause the so-called anemia of a chronic disease.
Some malignant tumors affect the red bone marrow (the main organ of hematopoiesis), or organs that are necessary to maintain a normal number of blood cells (spleen, kidneys). These types of cancer may also require blood transfusions.
Transfusion of donor blood is needed for patients after complex operations that are accompanied by large blood loss.
Chemotherapy and radiation therapy affect not only tumor cells, but also other rapidly dividing cells in the body. Sometimes they cause quite a lot of damage to the red bone marrow. It disrupts the production of blood cells, which threatens anemia, bleeding, and severe infections against the background of decreased immunity. Blood transfusion helps normalize the patient's condition and prevent complications. [5-7]
If a blood transfusion is necessary for an oncology patient, the Euroonko clinic organizes this procedure as quickly as possible. We cooperate with the largest blood banks. The Euroonko clinic has a license for “transfusiology in outpatient and inpatient settings”; we employ experienced medical specialists.
Ivan Vyacheslavovich Petkiev Medical Director, Head of the Department of Resuscitation and Intensive Care
Indications for blood transfusion from a vein into the buttock
The procedure is recommended for:
- activation of the body’s protective and rehabilitation processes;
- elimination of purulent-inflammatory processes;
- treatment of furunculosis;
- accelerating wound healing after operations and injuries;
- increasing physical performance;
- treatment of anemia, pneumonia, infectious arthritis, trophic ulcers;
- improving metabolism;
- removing toxins and waste from the body;
- improving blood microcirculation.
Autohemotherapy is effectively used to treat gynecological diseases. Blood injected intramuscularly helps cure genital herpes, eliminate chronic inflammatory processes, and get rid of papillomas and condylomas. In addition, the procedure has a positive effect on infertility, adhesions in the uterus, and menopausal syndrome.
Red blood cell transfusion
The main function of erythrocytes (red blood cells) is the delivery of oxygen to tissues and the return transport of carbon dioxide to the lungs. A condition in which the number of red blood cells in the blood decreases is called anemia. Actually, this is an indication for red blood cell transfusion. The doctor makes a decision depending on how quickly the anemia increases:
- With chronic anemia, which increases gradually, there is no need to rush. The doctor monitors the patient’s condition, controls the level of red blood cells and hemoglobin. If these indicators decrease significantly, or the patient’s condition worsens, red blood cells are transfused. For heart and lung diseases that impede oxygen delivery to tissues, transfusions may be required even if there is a relatively small decrease in hemoglobin levels.
- Acute blood loss requires immediate action. This usually happens during surgery. If the doctor is planning a complex operation during which the patient will lose a lot of blood, blood transfusion may be performed in advance. [8]
Red blood cell mass
Plasma transfusion
Plasma, the liquid part of blood, appears as a clear, yellowish liquid. It contains blood clotting factors - substances that are necessary for the formation of a blood clot and stop bleeding. Plasma also contains substances that protect the body from infection.
Plasma can be stored frozen for up to 12 months. When necessary, it is thawed and the resulting fresh frozen plasma is transfused into the patient.
The main indication for plasma transfusion in cancer patients is increased bleeding. The procedure is also necessary for DIC syndrome (disseminated intravascular coagulation syndrome) - a serious condition in which blood clots form in small vessels, ultimately depleting the entire supply of platelets and coagulation factors, and there is a risk of severe bleeding. [9-10]
Blood plasma transfusion
Platelet transfusion
Platelets, or blood platelets, take part in the formation of a blood clot and stop bleeding. Their levels may drop due to chemotherapy, radiation therapy, or if the tumor has replaced normal red bone marrow tissue. Platelet transfusions are usually required for cancer patients in one of three cases:
- if the level of platelets in the blood has fallen below a critical value;
- if there is increased bleeding, risk of bleeding;
- if you are undergoing surgery during which significant blood loss is expected. [11,12]
Platelet mass
When was transfusion in vogue?
The ban on transfusions appeared even before the formation of WADA - the IOC equated transfusions with doping after the 1984 Games. In the 1970s, athletes often resorted to this method, which even then received the secret name “blood doping.”
In the late 1980s, erythropoietin established itself in sports for a long time, which gave the same effect as a transfusion. In 2001, WADA introduced a direct test for EPO, which led to a renewed fashion for blood fraud.
American cyclist Tyler Hamilton was deprived of gold at the 2004 Games precisely because of a transfusion, and Alexander Vinokurov was caught doing the same thing at the 2007 Tour de France. The main hero (and later the main doper) of cycling, Lance Armstrong, also could not do without this prohibited method.
If you think that the experience of cycling has taught other sports something, then you are mistaken: the latest scandal with transfusion occurred at the 2019 World Ski Championships in Seefeld.
The police have busted a doping scheme involving skiers from Austria, Estonia and Kazakhstan. The athletes were promptly disqualified, and it seems that skiing no longer remembers the scandal. But the confused face of the Austrian Max Hauke, who was caught giving a transfusion, is very difficult to forget.
This is what it looks like.
How is the blood transfusion procedure performed?
Although blood transfusion is formally equated to surgical interventions, this procedure is not at all scary and is practically painless. Blood transfusion is carried out through a needle that is inserted into a vein. It is no more painful than a regular intravenous injection. If the patient already has a central venous catheter, donor blood can be administered through it.
The blood transfusion procedure can take different times, depending on which blood components are transfused: from 30–60 minutes (platelet transfusion) to 2–4 hours (red blood cell transfusion).
Interesting Facts
Article on the topic
Extend youth and avoid stroke. An expert on the benefits of donation In 1926, the world's first blood transfusion institute was organized in Moscow (today it is the Hematological Research Center of the Russian Academy of Medical Sciences), and a special blood service was created.
Direct blood transfusion, directly from a donor to a patient, is currently practically prohibited due to the danger of contracting AIDS and hepatitis and is carried out only in particularly extreme situations.
In addition, the transfusion of donor blood and its components that have not been tested for AIDS, hepatitis B surface antigen and syphilis is completely prohibited.
And contrary to popular belief, ambulances never give blood transfusions.
How is donor blood tested?
A person who donates blood for the first time must fill out a questionnaire, undergo an examination by a therapist, a dermatovenerologist, and take tests for blood type, Rh factor, and infections: HIV, viral hepatitis B and C, syphilis, cytomegalovirus. Sometimes the examination program can be expanded.
If signs of a particular infection are found in the donor’s blood, it is discarded and not used in the future.
The compatibility of the blood of the donor and the recipient is checked using a special test - a cross-blood compatibility test.
Complications
{banner_banstat10}
Complications during blood transfusions can have different origins, but, mainly, they are caused by errors of medical personnel during the preparation, storage, and conduct of blood transfusion operations.
Main causes of complications:
- Group incompatibility of donor and recipient (transfusion shock with increasing intravascular hemolysis);
- Sensitization of the patient's body to immunoglobulins (allergic reactions);
destruction (hemolysis) of foreign red blood cells
- Poor quality of the introduced biological environment (potassium intoxication, pyrogenic reactions, bacterial toxic shock);
- Errors in the methodology of blood transfusion (air embolism, thromboembolism);
- Massive blood transfusion (homologous blood syndrome, citrate intoxication, acute dilated heart - with rapid administration of blood, massive transfusion syndrome);
- Infection with infectious diseases through transfused blood (although quarantine storage significantly reduces the risk of these complications).
It should be noted that complications during blood transfusion require immediate response from medical staff. Their clinical picture is quite eloquent (fever, chills, shortness of breath, cyanosis, decreased blood pressure, tachycardia), and the condition can worsen every minute with the development of even more serious complications: acute renal failure, pulmonary embolism, pulmonary infarction, intravascular hemolysis, etc.
Errors during blood transfusion are mainly made by health workers who have not sufficiently studied the basics of transfusiology, but they can cost the patient’s life, so this issue must be approached seriously and responsibly (measure seven times and only then cut off).
Having decided to undergo a blood transfusion, you need to correctly determine the indications and contraindications, that is, weigh the pros and cons.
Are there any alternatives?
Sometimes blood disorders can be corrected with medications without blood transfusion. For example, colony-stimulating factors are used to increase the number of white blood cells.
However, in cases where blood transfusion is necessary, there are no alternatives. There are no blood substitutes that can provide similar effects. That is why donation is constantly promoted in all countries of the world, including Russia, and donor days are held periodically. It is important. This helps save the lives of many people. [15]
How safe is it?
Is it possible to get an infection from donated blood during a blood transfusion? Donated blood goes through rigorous testing, but there are still risks, even though they are negligible. Thus, the likelihood of becoming infected with HIV through donated blood is lower than the likelihood of being struck by lightning during a person’s lifetime. The risk of contracting hepatitis C is 1 in 2,000,000. Doctors and scientists are constantly working to reduce the risks to zero. [16]
Can incompatible blood be transfused? Before blood transfusion, the recipient's blood type and Rh factor must be determined; the doctor must make sure that the blood of the donor and recipient are compatible.
But the blood of different people can differ not only in group A0 and Rh factor. It is very difficult to take into account all the nuances. Therefore, there is a slight risk of an allergic reaction during blood transfusion. Most often it manifests itself in the form of fever, chills, and rash. Such complications are rarely life-threatening. In order to provide assistance to the patient, if necessary, a medical professional is constantly monitoring his condition during the procedure.
An allergic reaction can occur not only directly during a transfusion, but also within 48 hours after the blood transfusion. You should immediately tell your doctor if your body temperature rises above 38°C, chills, rash, itching, redness of the skin, shortness of breath, difficulty breathing, nausea, lower back pain, blood in the urine, weakness. The most dangerous symptom after blood transfusion is chest pain, which requires immediate attention. If you are at home, you should immediately call an ambulance. [5]
History of donation Blood transfusion: why is it needed
On June 15, 1667, the French physician Jean-Baptiste Denis performed the first blood transfusion on a human. Today, this therapeutic technology is indicated for many diseases, while remaining a dangerous procedure.
French physician Jean-Baptiste Denis is famous for being the personal physician of King Louis XIV and for his discovery that he performed the first documented human blood transfusion on June 15, 1667. Denis transfused just over 300 ml of sheep blood into a 15-year-old boy, who subsequently survived. Later, the scientist performed another transfusion, and the patient also survived. Denis later gave a blood transfusion to the Swedish baron Gustav Bond , but he died. According to one version, the first patients survived thanks to a small amount of blood transfusion. After another patient died, Denis was accused of murder, but even after receiving an acquittal, the doctor left medical practice.
However, although experiments with blood transfusions continued, it became possible to carry out the procedure without fatal complications only after the discovery of blood groups in 1901 and the Rh factor in 1940 .
The procedure is called blood transfusion.
Indications
The most common indication for transfusion is blood loss. Acute loss is defined as the patient losing more than 30% of their blood volume within a couple of hours. In addition, absolute indications for blood transfusion include shock, incessant bleeding, severe anemia, and surgical interventions.
Frequent indications for transfusion of blood components are anemia, hematological diseases, purulent-septic diseases, severe toxicosis, acute intoxication.
Among the contraindications are heart failure due to defects, myocarditis, cardiosclerosis, purulent inflammation of the inner lining of the heart, third stage hypertension, impaired blood flow to the brain, a general disorder of protein metabolism, and an allergic condition.
Often, when there are absolute indications for blood transfusion, the procedure is performed despite contraindications, but at the same time preventive measures are organized, for example, to prevent an allergic reaction. Sometimes, during surgical operations, the patient's own blood is used in advance.
Technology
Before a blood transfusion, the patient must be checked for contraindications, the blood type and Rh factor are checked again, and the donor’s blood is tested for individual compatibility. After this, a biological test is performed - the patient is injected with 25–30 ml of donor blood and the patient’s condition is monitored. If the patient feels well, then the blood is considered compatible and a blood transfusion is performed at a rate of 40–60 drops per minute.
After transfusion of incompatible blood, complications can arise, almost all body systems fail. For example, it is possible to disrupt the functions of the kidneys and liver, metabolic processes, gastrointestinal tract, cardiovascular and central nervous systems, respiration, and hematopoiesis.
Interesting Facts
In 1926, the world's first blood transfusion institute was organized in Moscow (today it is the Hematological Research Center of the Russian Academy of Medical Sciences), and a special blood service was created.
Direct blood transfusion, directly from a donor to a patient, is currently practically prohibited due to the danger of contracting AIDS and hepatitis and is carried out only in particularly extreme situations.
In addition, the transfusion of donor blood and its components that have not been tested for AIDS, hepatitis B surface antigen and syphilis is completely prohibited.
Key Facts
Every year, about 112.5 million blood donations are collected worldwide. About half of these are in high-income countries, home to 19% of the world's population.
In low-income countries, up to 65% of blood transfusions are given to children under 5 years of age, while in high-income countries, blood transfusions are most often given to patients over 65 years of age, accounting for up to 76% of all blood transfusions. .
The number of donations per 1000 people is 32.1 in high-income countries, 14.9 in high-middle-income countries, 7.8 in low-middle-income countries and 4.6 in low-income countries.
Indicators of free blood donation by voluntary donors increased in 2013 by 10.7 million blood donations compared to 2008. In 74 countries, more than 90% of national blood supplies are provided by voluntary unpaid donors.
Today, the main document regulating the quality of donor blood safety in the EU is Directive 2002/98/EC <2>, which was adopted by the EU Council and Parliament on the basis of Art. 152 of the Treaty establishing the European Community, as amended by the Treaty of Amsterdam, which first assigned such powers to the EU. In accordance with this article, the Parliament and the Council of the European Union shall take measures, in accordance with the ordinary legislative procedure, establishing high standards of quality and safety for organs and substances of human origin, blood and its derivatives.
The main law regulating blood donation in the Republic of Belarus is the Law of the Republic of Belarus dated November 30, 2010 No. 197-Z “On the donation of blood and its components.”
Since July 12, 2015, amendments and additions have been made to the Labor Code of the Republic of Belarus and the Law of the Republic of Belarus “On the donation of blood and its components” concerning the issues of donation of blood and its components (Law of the Republic of Belarus dated January 8, 2015 No. 238-Z). The legislation on blood donation independently provides guarantees for donors who donate blood free of charge. Here are some explanations of the provisions of these laws.
The employer is obliged to freely release the employee on the day the donor function is performed, and if it is impossible for production reasons to release the employee on the day specified by him, offer another day chosen in agreement with the employee (except for cases of performing the donor function on an emergency basis in order to preserve life and recipient's health). At the same time, the donor will be obligated to notify the employer no later than 2 working days about the dates for performing the donor function and using rest days, as well as the obligation to promptly provide the employer with documents confirming the fulfillment of the donor function.
On the day of donating blood and its components, the donor is released from work, regardless of what shift he works, as well as what time (working or non-working) he donates blood.
Leading laboratory assistant of the department of functional diagnostics Malakhovskaya S.N.
Is it possible to refuse a blood transfusion?
The patient always has the right to refuse prescribed treatment, be it chemotherapy, surgery or blood transfusion. But you need to remember some points:
- A doctor will not prescribe a procedure, especially one as serious as a blood transfusion, just like that. If the doctor decides to perform a blood transfusion, then there are good reasons for this, and first of all it is in the interests of the patient.
- Large blood loss during surgery and significant blood disorders can lead to death or serious complications and impair the effectiveness of antitumor treatment.
- There are some risks during blood transfusion, but they are negligible, and the procedure often helps save the patient's life.
Euroonko clinics officially cooperate with the largest blood banks in the country. We operate on the basis of a license for “transfusiology in outpatient and inpatient settings” issued by the health departments of Moscow and St. Petersburg.
Scheme of autohemotherapy
With the classic treatment option, blood is taken from a vein (volume from 5 to 25 ml) and immediately injected into the gluteal muscle. If you miss the moment, clots will appear that can no longer be used. 1-2 days – break between procedures. As a rule, the result is achieved after 8-12 injections. It is unacceptable to administer more blood than the specified volumes; this can cause inflammatory reactions, chills, and muscle pain. In addition to the classic version, there are others - stepwise, with ozone, the use of blood subjected to various chemical influences, laser treatment.
With ozone
This method is more modern, superior in efficiency to the classical one. On average, treatment requires no more than 5-7 procedures. Course – 1-2 times a week. Before use, the blood is mixed with ozone in a certain concentration. Specialists use:
- Minor autohemotherapy . About 10 ml of blood is drawn from a vein into a syringe containing an ozone-oxygen mixture and injected into the patient.
- Major autohemotherapy . In a sterile container, stir 100 to 300 ml of the mixture and approximately 100-150 ml of blood. After mixing, use as directed.
- How to make a presentation in powerpoint
- Homemade cream for sour cream cake. Sour cream recipes with photos
- Oatmeal: benefits and recipes
Stepped
Stepped autohemotherapy involves the introduction of a small amount of blood - about 0.1-0.2 ml. It is pre-mixed with several homeopathic medicines. As a rule, the procedure takes 4 stages. For injections, you can use one syringe, the main thing is that after each injection a small amount of blood remains in it. From stages 2 to 4, the contents are intensively shaken and administered to the patient.
Drugs for stepwise autohemotherapy are selected individually for each person. Sometimes it is enough to use complex remedies containing nosodes; a little less often, ampoule homeopathic monopreparations and symptomatic medications are prescribed. Stepped autohemotherapy has proven itself as a proven way to get rid of viral infections, arthrosis, chronic eczema, migraines, and toxic liver damage.
Price
- Consultation with a transfusiologist - 5,100 rubles.
- Complete blood count (CITO) - RUB 2,400.
- Compatibility test before blood transfusion - 3,200 .
- Erythrocyte suspension, depleted of leukocytes (filtered) - 24,000 rub.
- Transfusion of blood components - 5,300 rubles.
- The cost of fresh frozen plasma (1 dose 250 ml) is 25,300 rubles.
- Platelet concentrate (1 dose) - 86,100 rub.
In accordance with the legislation of the Russian Federation (Law of the Russian Federation of June 9, 1993 N 5142-I “On the donation of blood and its components”), the procurement of blood, the receipt of blood components and their storage are carried out exclusively by state budgetary institutions. Blood transfusions to our patients are carried out on the basis of licenses for “transfusiology in outpatient and inpatient settings”.
Book a consultation 24 hours a day
+7+7+78
Bibliography:
- G.I. Kozin. Practical transfusiology. Practical medicine, Moscow 2005.
- Igonina M. E. Donate blood to save a life // BMIK. 2013. No. 2.
- O. A. Rukovitsyn. Hematology. National leadership. GEOTAR-Media.
- S. M. Lewis, B. Bain, I. Bates. Practical and laboratory hematology. Moscow, GEOTAR-Media, 2009.
- Seth Lotterman; Sandeep Sharma. Blood Transfusion. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.
- Sandhya Yaddanapudi and LN Yaddanapudi. Indications for blood and blood product transfusion. Indian J Anaesth. 2014 Sep-Oct; 58(5): 538–542. doi: 10.4103/0019-5049.144648.
- Lawrence Tim Goodnough, MD and Anil K. Panigrahi, MD, PhDa. Blood Transfusion Therapy. Med Clin North Am. Mar 2022; 101(2): 431–447. Published online 2016 Dec 24. doi: 10.1016/j.mcna.2016.09.012.
- Giancarlo Liumbruno, Francesco Bennardello, Angela Lattanzio, Pierluigi Piccoli, and Gina Rossetti. Recommendations for the transfusion of red blood cells. Blood Transfus. 2009 Jan; 7(1): 49–64. doi: 10.2450/2008.0020-08.
- Ryan A. Lawless, MD and John B. Holcomb, MD Plasma Transfusion. Trauma Induced Coagulopathy. 2015 Dec 11: 323–337. Published online 2015 Dec 11. doi: 10.1007/978-3-319-28308-1_20.
- Giancarlo Liumbruno, Francesco Bennardello, Angela Lattanzio, Pierluigi Piccoli, Gina Rossetti, and as Italian Society of Transfusion Medicine and Immunohaematology (SIMTI) Working Party. Recommendations for the transfusion of plasma and platelets. Blood Transfus. 2009 Apr; 7(2): 132–150. doi: 10.2450/2009.0005-09.
- Atif I. Khan; FaizAnwer. Platelet Transfusion. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.
- Neil Blumberg, Joanna M Heal and Gordon L Phillips. Platelet transfusions: trigger, dose, benefits, and risks. F1000 Med Rep. 2010; 2: 5. Published online 2010 Jan 27. doi: 10.3410/M2-5.
- B. Nascimento, L. T. Goodnough, and J. H. Levy. Cryoprecipitate therapy. Br J Anaesth. 2014 Dec; 113(6): 922–934. Published online 2014 Jun 27. doi: 10.1093/bja/aeu158.
- Juan Gea-Banacloche, MD. Granulocyte Transfusions: A Concise Review for Practitioners. Cytotherapy. 2022 Nov; 19(11): 1256–1269. Published online 2022 Sep 12. doi: 10.1016/j.jcyt.2017.08.012.
- A. A. Kerimov Blood transfusion: is there an alternative? // Biomedicine (Baku). 2004. No. 3.
- Polunina N.V., Gubanova M.N., Zhiburt Evgeniy Borisovich Risk of infection transmission during blood transfusion // Russian Medical Journal. 2016. No. 6.
