Granulocytes are a type of white blood cell a body needs to fight bacterial and fungal infections. Some patients may have serious, life-threatening infections that do not respond to appropriate antibiotics and they may have low levels of granulocytes.
This may be due to their disease or treatment for their disease. These patients may require transfusions of granulocytes for a short time period to help fight their infections. Granulocytes are collected from donors using apheresis. As with platelets, it is best if a patient receives granulocytes from a donor of the same blood type.
Skip to main content. Congenital dysfibrinogenemia Information from references 12 and Transfusion-related complications can be categorized as acute or delayed, which can be divided further into the categories of noninfectious Table 5 16 and infectious Table 6 16 , Therefore, patients are far more likely to experience a noninfectious serious hazard of transfusion than an infectious complication.
Mistransfusion transfusion of the incorrect product to the incorrect recipient. Noninfectious serious hazards of transfusion. Anesth Analg. I nformation from references 16 and Hemolytic transfusion reactions are caused by immune destruction of transfused RBCs, which are attacked by the recipient's antibodies.
The antibodies to the antigens of the ABO blood group or alloantibodies to other RBC antigens are produced after immunization through a previous transfusion or pregnancy. There are two categories of hemolytic transfusion reactions: acute and delayed. Nonimmune causes of acute reactions include bacterial overgrowth, improper storing, infusion with incompatible medications, and infusion of blood through lines containing hypotonic solutions or small-bore intravenous tubes.
In acute hemolytic transfusion reactions, there is a destruction of the donor's RBCs within 24 hours of transfusion. Hemolysis may be intravascular or extravascular. The most common type is extravascular hemolysis, which occurs when donor RBCs coated with immunoglobulin G IgG or complement are attacked in the liver or spleen.
Symptoms of acute hemolytic transfusion reactions include fever, chills, rigors, nausea, vomiting, dyspnea, hypotension, diffuse bleeding, hemoglobinuria, oliguria, anuria, pain at the infusion site; and chest, back, and abdominal pain.
The incidence of acute hemolytic reactions is approximately one to five per 50, transfusions. Allergic reactions range from mild urticarial to life threatening anaphylactic. Urticarial allergic reactions are defined by hives or pruritus.
These antigens are soluble, and the associated reaction is dose-dependent. Allergic transfusion reactions occur in 1 to 3 percent of transfusions. Patients with anaphylactic transfusion reactions, like those with urticarial reactions, may present with hives, but they are distinct in that they also develop hypotension, bronchospasm, stridor, and gastrointestinal symptoms. For example, anaphylaxis occurs because of donor IgA being infused into a recipient who is IgA deficient and has preexisting circulating anti-IgA.
Prevention of anaphylactic transfusion reactions includes avoiding plasma transfusions with IgA in patients known to be IgA deficient. Cellular products e. Transfusion-related acute lung injury TRALI is noncardiogenic pulmonary edema causing acute hypoxemia that occurs within six hours of a transfusion and has a clear temporal relationship to the transfusion.
Antineutrophil cytoplasmic antibodies or anti-HLA antibodies activate the recipient's immune system, resulting in massive pulmonary edema. Donor products that contain large amounts of plasma from multiparous women are associated with TRALI.
Mortality in the United Kingdom decreased significantly after donor plasma from men was used exclusively. Two mechanisms have been proposed to explain FNHTRs: a release of antibody-mediated endogenous pyrogen, and a release of cytokines.
Common cytokines that may be associated with FNHTRs include interleukin-1, interleukin-6, interleukin-8, and tumor necrosis factor. Transfusion-associated circulatory overload is the result of a rapid transfusion of a blood volume that is more than what the recipient's circulatory system can handle. It is not associated with an antibody-mediated reaction.
Those at highest risk are recipients with underlying cardiopulmonary compromise, renal failure, or chronic anemia, and infants or older patients. Cardiomegaly and pulmonary edema are often seen on chest radiography. The diagnosis is made clinically, but may be assisted by measuring brain natriuretic peptide levels, which are elevated in response to an increase in filling pressure.
Transfusion-associated graft-versus-host disease is a consequence of a donor's lymphocytes proliferating and causing an immune attack against the recipient's tissues and organs. It is fatal in more than 90 percent of cases. Risk factors include a history of fludarabine Oforta treatment, Hodgkin disease, stem cell transplant, intensive chemotherapy, intrauterine transfusion, or erythroblastosis fetalis.
Other probable risk factors include a history of solid tumors treated with cytotoxic drugs, transfusion in premature infants, and recipient-donor pairs from homogenous populations. Already a member or subscriber? Log in. Interested in AAFP membership? Learn more. LISA N.
Reprints are not available from the authors. A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. N Engl J Med. Transfusion strategies for patients in pediatric intensive care units. King KE, Bandarenko N. Bethesda, Md. Red blood cell transfusion in clinical practice. Perioperative blood transfusion and blood conservation in cardiac surgery: the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists clinical practice guideline.
Ann Thorac Surg. Transfusion thresholds and other strategies for guiding allogeneic red blood cell transfusion. Cochrane Database Syst Rev. Some people with leukemia, lymphoma, myeloma and other blood diseases or disorders such as hereditary anemias and aplastic anemia need periodic blood transfusions for several reasons: The disease process itself can sometimes interfere with the normal production of red cells, white cells and platelets in the bone marrow.
For example, almost all patients with leukemia which primarily affects the marrow and blood require some transfusions during their care. Many chemotherapy drugs can temporarily impair blood cell production in the marrow and depress immune system functions.
Stem cell transplantation patients receive high doses of chemotherapy, which depletes stores of normal blood cells. Patients with insufficient blood counts can develop: Anemia low red cells Thrombocytopenia low platelets Leukopenia low white cells, either granulocytes or lymphocytes, or both Doctors take different approaches when deciding if transfusion is appropriate.
Blood Components When you receive a transfusion, you won't be getting whole blood. Components that you can receive separately by transfusion are: Red cells Platelets Granulocytes white cells Plasma and cryoprecipitate Gamma globulin Albumin Blood Irradiation A rare but potentially life-threatening complication of transfusion is graft versus host disease , which occurs when a donor's white cells attack the recipient's immune system.
Red Cell Transfusion Low red cell counts anemia , if untreated, can cause weakness, fatigue and, in extreme cases, shortness of breath or rapid heartbeat. Leukoreduction reduces the risks of: Fever and chills after transfusion Not responding to platelet transfusions Transmission of some viral infections such as cytomegalovirus and HTLV-1 If you receive ongoing red cell transfusions, you're at risk of developing iron overload, which, if not treated, can damage your heart and liver.
Platelet Transfusion Platelet transfusions are given to prevent or treat bleeding because of severely low platelet counts thrombocytopenia. Granulocyte Transfusion Granulocytes are a type of white cell. Plasma and Cryoprecipitate Transfusion Fresh frozen plasma FFP , the fluid that carries blood cells, and cryoprecipitate, the portion of the plasma that contains clotting factors often called cryo for short , may be transfused to patients whose blood has abnormal or low levels of blood-clotting proteins.
Intravenous Gamma Globulin Gamma globulins are portions of proteins in plasma that play a key role in preventing infection. Your doctor may want to increase low gamma globulin: If you're undergoing a stem cell transplant To reduce your risk of cytomegalovirus, its immune complications or its treatment Albumin Transfusion Albumin is the most common human blood protein.
Blood Transfusion Safety Every patient and doctor is concerned about blood supply safety. Complications of Blood Transfusions Most patients who receive a transfusion don't suffer any adverse reactions.
Symptoms and side effects that may occur during or soon after transfusion include: Fever called febrile reactions, these are the most common complications and usually aren't serious A skin rash or hives called uriticaria, these are the second most common reaction Chills Nausea Pain at the transfusion site arm vein Back pain Shortness of breath A drop in blood pressure Dark or red urine If you notice any of these changes during a transfusion, however slight, alert the nursing staff promptly.
Reactions that aren't immediate include: Alloimmunization. Alloimmunization occurs if you produce antibodies against certain antigens in transfused blood. While it doesn't necessarily cause immediate symptoms, blood center staff needs to be aware of this reaction and take precautions if you undergo subsequent transfusions. It takes platelets from several units of whole blood to help keep a person from bleeding.
A unit of platelets is defined as the amount that can be separated from one unit of whole blood. For platelet transfusions, 6 to 10 units from different donors called random donor platelets are combined and given to adult patients at one time they are called pooled platelets. Platelets can also be collected by apheresis. This is sometimes called plateletpheresis.
In this procedure, the donor is hooked up to a machine that removes blood, and keeps just the platelets. The rest of the blood cells and plasma are returned to the donor. Platelets collected in this way are called single donor platelets.
You can find more information about this in Donating Blood. Cancer patients may need platelet transfusions if their bone marrow is not making enough. This happens when platelet-producing bone marrow cells are damaged by chemo or radiation therapy or when they are crowded out of the bone marrow by cancer cells. A normal platelet count is about , to , platelets per microliter mcL of blood, depending on the lab.
Doctors consider giving a platelet transfusion when the platelet count drops to this level or even at higher levels if a patient needs surgery or is bleeding. If there are no signs of bleeding, a platelet transfusion may not be needed even if the platelet count is low. Different medicines can be used to help with low platelets depending on the cause of the low platelets. Cryoprecipitate, or "cryo," is the name given to the small fraction of plasma that separates out precipitates when plasma is frozen and then thawed in the refrigerator.
It has several of the clotting factors found in plasma, but they are concentrated in a smaller amount of liquid. A unit of whole blood has only a small amount of cryoprecipitate, so about 8 to 10 units from different donors are pooled together for one transfusion.
Chemotherapy can damage cells in the bone marrow, and patients getting chemo often have low white blood cell WBC counts. The normal range for WBCs is 4, to 10, per mcL of blood. White blood cells, especially the type called neutrophils NEW-trow-fills , are very important in fighting infections. When patients have low WBC counts, doctors carefully watch the number of neutrophils or the absolute neutrophil count ANC. People with neutropenia are at risk for serious infections , even more so if the count stays low for more than a week.
White blood cell transfusions are given rarely. Research does not show that giving white blood cell transfusions lowers the risk of death or infection in people with low white blood cell counts or white blood cells that are impaired. Instead of transfusing WBCs, doctors now commonly use drugs called colony-stimulating factors or growth factors to help the body make its own.
These drugs stimulate the body to make neutrophils and other types of granulocytes. The American Cancer Society medical and editorial content team. Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
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