Blood transfusion for sickle cell disease: Overview
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 quickly).
Blood transfusions can:
- Treat a sudden or short-term condition related to sickle cell disease.
- Treat severe complications of sickle cell disease.
- Prevent complications of sickle cell disease.
- Lower the risk of stroke in infants and children.
Blood transfusions aren't usually used to treat uncomplicated painful events or mild to moderate anemia.
Blood transfusion
Blood transfusion is a medical treatment to replace blood or portions of the blood lost through injury, surgery, or disease.
During a transfusion, people normally receive only the parts of blood needed to treat their conditions. Whole blood is now rarely given as a transfusion.
Blood for transfusions may come from anonymous donors, or a person can bank their own blood in preparation for surgery.
How can you care for yourself after a blood transfusion?
To prevent infection at the transfusion site
- Wash the area daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.
- Keep the area clean and dry.
How well does a blood transfusion for sickle cell disease work?
Blood transfusion is an effective and proven treatment for some severe complications of sickle cell disease.
Blood transfusions 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.
What are the risks of a blood transfusion for sickle cell disease?
Over time, a person who gets many blood transfusions will collect too much iron in the body (iron overload). Very high levels of iron can lead to hemochromatosis, which can be fatal if untreated.
Iron chelation treatment can help rid the body of excess iron.
A person who gets repeat blood transfusions may form antibodies to the donor blood. This is called alloimmunization. It makes repeated transfusions more difficult.
A transfusion reaction can result from mismatched blood type. It may happen right away 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's very rare for a disease to be transmitted through donated blood.
What is a blood transfusion for children?
Blood transfusion is a medical treatment to replace the blood or parts of blood that your child's body has lost. The blood goes through a tube from a bag to an intravenous (I.V.) catheter and into your child's vein.
Your child may need a blood transfusion after losing blood from an injury, a major surgery, an illness that causes bleeding, or an illness that destroys blood cells.
Transfusions are also used to give your child the parts of blood. These may include platelets, plasma, or substances that cause clotting. These may be needed if your child's body needs to fight an illness or stop bleeding.
What can you expect as you recover from a blood transfusion for sickle cell disease?
After a blood transfusion, doctors watch you closely for any negative reactions. Your doctor might check for iron buildup in the body (iron overload). This can happen if you get many transfusions.
Blood transfusions in children: When to call
Call 911 anytime you think your child may need emergency care. For example, call if:
- Your child has severe trouble breathing. (Your child can't talk at all.) Young children may have flared nostrils, and their belly moves in and out with every breath.
- Your child passes out (loses consciousness) or is very hard to wake up.
Call your doctor now or seek immediate medical care if:
- Your child has new or worse trouble breathing.
- Your child is dizzy or lightheaded or seems like they may faint.
- Your child has a fever or chills.
- Your child has chest pain, back pain, or pain in the flank, which is just below the rib cage and above the waist on either side of the back.
- Your child has blood in their urine.
- Your child has abnormal bleeding, such as:
- Nosebleeds.
- New bleeding or oozing at an intravenous (I.V.) or blood draw site.
- Your child has little to no urine when they try to urinate.
- Your child has belly pain, nausea, vomiting, or diarrhea.
- Your child has signs of an allergic reaction, such as hives, swelling, or a new rash.
- Your child has signs of an infection at the transfusion site, such as redness, swelling, pain, bleeding, or pus.
- Your child seems weaker or more tired than usual.
- Your child has a yellow tint (jaundice) to their skin or the whites of the eyes.
Watch closely for changes in your child's health, and be sure to contact your doctor if your child has any problems.
Why is a blood transfusion for sickle cell disease done?
A blood transfusion lowers the amount of 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.
Anemia
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 splenic sequestration, acute chest syndrome, and aplastic crisis) can be fatal if not treated with blood transfusions.
Chronic severe anemia from kidney failure may need treatment with periodic blood transfusions.
Surgery
After having 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 complications.
Red blood cell sickling-related complications (vaso-occlusion)
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 first stroke.
How is a blood transfusion done?
Before the transfusion, you'll have a blood type test. Then your doctor will order blood that's a match with your blood type. This blood may be retested in the hospital lab to confirm the type. A sample of your blood is then mixed with a sample of the blood you will receive to make sure that it won't cause a problem.
Before starting the transfusion, a doctor or nurse will look at the label on the bag of blood. They will compare the label with the blood type on your medical record.
To receive the transfusion, you will have an intravenous (I.V.) catheter inserted into a vein. A tube connects the catheter to the bag with the blood. The transfused blood flows slowly into your vein. A doctor or nurse will check you several times during the transfusion to watch for problems.
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