Types of Blood Transfusions

Blood is transfused either as whole blood (with all its parts) or, more often, as individual parts. The type of blood transfusion you need depends on your situation.

For example, if you have an illness that stops your body from properly making part of your blood, you may need only that part to treat the illness.

Red Blood Cell Transfusions

Red blood cells are the most commonly transfused part of the blood. These cells carry oxygen from the lungs to your body's organs and tissues. Red blood cells also help your body get rid of carbon dioxide and other waste products.

You may need a transfusion of red blood cells if you've lost blood due to surgery or an injury. You also may need this type of transfusion if you have severe anemia (uh-NEE-me-uh) due to a disease or blood loss.

Anemia is a condition in which your blood has a lower than normal number of red blood cells. Anemia also can occur if your red blood cells don't have enough hemoglobin (HEE-muh-glow-bin).

Hemoglobin is an iron-rich protein that gives blood its red color. This protein carries oxygen from the lungs to the rest of the body.

Platelet and Clotting Factor Transfusions

Platelets and clotting factors help stop bleeding, including internal bleeding that you can't see. Some illnesses can prevent your body from making enough platelets or clotting factors. If you have one of these illnesses, you might need regular platelet or clotting factor transfusions to stay healthy.

For example, if you have hemophilia (heem-o-FILL-ee-ah), you may need a special clotting factor to replace the clotting factor you're lacking. Hemophilia is a rare, inherited bleeding disorder in which the blood doesn't clot normally.

If you have hemophilia, you may bleed for a longer time than others after an injury or accident. You also may bleed internally, especially in the joints (knees, ankles, and elbows).

Plasma Transfusions

Plasma is the liquid part of your blood. It's mainly water, but it also contains proteins, clotting factors, hormones, vitamins, cholesterol, sugar, sodium, potassium, calcium, and more.

If you have been badly burned or have liver failure or a severe infection, you may need a plasma transfusion.

Apheresis  ( ἀφαίρεσις (aphairesis, “a taking away”)) is a medical technology in which the blood of a donor or patient is passed through an apparatus that separates out one particular constituent and returns the remainder to the circulation. It is thus anextracorporeal therapy.

Blood taken from a healthy donor can be separated into its component parts during blood donation, where the needed component is collected and the "unused" components are returned to the donor. Fluid replacement is usually not needed in this type of collections. There are large categories of component collections:

·              Plasmapheresis - blood plasma. Plasmapheresis is useful in collecting FFP (fresh frozen plasma) of a particular ABO group. Commercial uses aside from FFP for this procedure include immune globulin products, plasma derivatives, and collection of rare WBC and RBC antibodies.

·              Erythrocytapheresis- red blood cells. Erythrocytapheresis is the separation of erythrocytes from whole blood. It is most commonly accomplished using the method of centrifugal sedimentation. This process is used for red blood cell diseases such as sickle cell crises or severe malaria. The automated red blood cell collection procedure for donating erythrocytes is referred to as 'Double Reds' or 'Double Red Cell Apheresis.'^[1]

·              Plateletpheresis (thrombapheresis, thrombocytapheresis) - blood platelets. Plateletpheresis, like it sounds, is the collection of platelets by apheresis; while returning the RBCs, WBCs, and component plasma. The yield is normally the equivalent of between six and ten random platelet concentrates. Quality control demands the platelets from apheresis be equal to or greater than 3.0 × 10¹¹ in number and have a pH of equal to or greater than 6.2 in 90% of the products tested and must be used within five days.

·              Leukapheresis - leukocytes (white blood cells). Leukopheresis is the removal of PMNs, basophils, eosinophils for transfusion into patients whose PMNs are ineffective or where traditional therapy has failed. There is limited data to suggest the benefit of granulocyte infusion. The complications of this procedure are the difficulty in collection and short shelf life (24 hours at 20 to 24°C). Since the "buffy coat" layer sits directly atop the RBC layer, HES, a sedimenting agent, is employed to improve yield while minimizing RBC collection. Quality control demands the resultant concentrate be 1.0 × 10¹⁰ granulocytes in 75% of the units tested and that the product be irradiated to avoid graft-versus-host disease (inactivate lymphocytes). Irradiation does not affect PMN function. Since there is usually a small amount of RBCs collected, ABO compatibility should be employed when feasible.

·              Stem cell harvesting - circulating bone marrow cells are harvested to use in bone marrow transplantation.

What are platelets and how are they used?

Platelets are tiny, colorless, disc-shaped particles circulating in the blood, and they are essential for normal blood clotting. Platelets are critically important to the survival of many patients with clotting problems (aplastic anemia, leukemia) or cancer, and patients who will undergo organ transplants or major surgeries like heart bypass grafts. Platelets can only be stored for five days after being collected. Maintaining an adequate supply of this lifesaving, perishable product is an ongoing challenge.

How often can I give platelets?

Every 7 days up to 24 apheresis donations can be made in a year. Some apheresis donations can generate two or three adult-sized platelet transfusion doses from one donation!

What is apheresis?  

Apheresis is the process by which platelets and other specific blood components (red cells or plasma) are collected from a donor. The word “apheresis” is derived from the Greek word aphaeresis meaning “to take away.” This process is accomplished by using a machine called a cell separator. Blood is drawn from the donor and the platelets, or another blood component, are collected by the cell separator and the remaining components of the blood are returned to the donor during the donation. Each apheresis donation procedure takes about one-and-one-half to two hours. Donors can watch movies or relax during the donation.