Treatment Transfusions Treating the symptoms of aplastic anaemia with blood transfusions What are transfusions? If you are diagnosed with severe or very severe aplastic anaemia, you are likely to need blood transfusions. A blood transfusion is a process where you are given blood that has been donated by someone else, usually through a vein in your arm. You may also receive other treatment such as anti-microbial drugs via infusion. Transfusion is a safe procedure; the risk of any harm associated with a transfusion is very low, and it can greatly improve your quality of life. Blood or platelet transfusions can be an important element of the supportive care treatment of aplastic anaemia. They cannot treat the underlying condition, but they do provide healthy blood cells for a period of time if the body is not producing its own. What happens during a blood transfusion? Before having a transfusion, the procedure will be explained to you. At some hospitals you may be asked to sign a consent form. How will a blood transfusion make me feel? There may be the sensation of a sharp prick when the needle is inserted into your vein, but you should not feel discomfort during the transfusion. Some people develop problems during a transfusion, such as a temperature, chills, a rash, or shaking. Sometimes this is treated simply with paracetamol, steroids, or antihistamines, or by slowing the transfusion. If you are already neutropenic and develop a fever during transfusion, you may need to stay in hospital for intravenous (IV) antibiotics for a few days. This will still be the case if you are neutropenic and the fever is thought to be due to the transfusion. This is because there is a chance that it may be due to infection, which could have serious consequences in a neutropenic patient. It is therefore important to tell a member of staff immediately if you feel unwell during the transfusion. If you feel unwell within 24 hours, it is important to contact your medical team, particularly if you have difficulty breathing, or have chest or back pain. You might find you have a little more energy afterwards! Some people tell us that they like to plan activities for after a blood transfusion. This isn’t the case for everyone. How safe are blood transfusions? Blood and platelet transfusions are very common and safe procedures. Donors have to meet strict criteria. All blood is screened and checked to make sure that it does not contain any serious infections. To make sure you receive the right blood or platelet transfusion for you, your identity will be confirmed by a member of your healthcare team, and they will then confirm the blood or platelets that you are to receive. During the transfusion, your temperature, pulse and blood pressure will be monitored. NHS Blood and Transplant have one of the most robust screening programmes among transfusion services anywhere in the world to ensure a safer transfusion practise. Always feel free to discuss any concerns you might have with your medical team. Side effects of blood transfusions There is a very small risk of complications due to a blood transfusion. These include allergic reaction to the donor’s blood, fever, development of antibodies, and breathing or circulation problems. However, severe complications are extremely rare. Possible side effects of red cell and platelet transfusions are fever and rigors (shaking). These usually go away by themselves without treatment. They can be controlled with injections of hydrocortisone (a short acting steroid) and Piriton™, an antihistamine that can make you feel sleepy. In some patients, your immune system may become sensitised and produce antibodies to so-called ‘minor’ blood groups and other proteins in the blood. If this happens, you will need carefully selected blood that may need to be specially ordered, otherwise the positive effects of the transfusions will not last as long. Patients’ experiences When going in for my blood transfusions I have already had my crossmatch the day before and my team have the blood ready and waiting for me when I arrive. The process is pretty simple. I have a cannula fitted and I am checked before and during the transfusion. It’s painless and doesn’t feel uncomfortable at all. Afterwards I normally feel a little tired and have a longer sleep that night but then I feel fine the following day and have more energy. - Claire At the start of my diagnosis I was given 1 bag of blood each week. I was tired just from the illness itself, so attending hospital two or three times a week was difficult. However I knew the blood and platelet transfusions were saving my life. It was just a process I had to go through, and was so much easier once I had my PICC line. - Paula When I first got diagnosed and needed blood and platelet transfusions once or twice a week it involved lots of waiting around. My hospital would take my blood and I would wait about an hour for the results. They would then order my blood products to arrive a couple of hours later. The actual transfusion involved having a cannula into my vein and then platelets would take 30 minutes and one unit of blood would take 90 minutes to transfuse. Sometimes I would need 2 units so I would take lots of snacks and a box set to watch and settle in. I always got a comfortable recliner as I would be there the longest. The transfusion itself was painless and after a set of observations I was free to go. The whole process was much nicer when I had my PICC line which I could have my blood taken from for testing and used instead of a cannula. It made such a positive difference to the whole experience. - Laura Blood Products In the UK, once blood has been collected from volunteer donors, it is split into its component parts: red blood cells, white blood cells, platelets and plasma. Therefore, a patient can be given just the part that they need. What kinds of blood transfusions will I need? Most patients with aplastic anaemia who need treatment will require transfusions of red blood cells and platelets. (White blood cell transfusions are not routinely used, as these cells only live for a few days.) When you will need transfusions and how often will depend on lots of different factors. Red blood cell transfusions One unit of transfused red blood cells typically raises the haemoglobin level by about 10 g/L. How many cell transfusions you might need depends on lots of factors. If you have many red cell transfusions given over many months, this can lead to a build up of iron in the body, which can build up in various organs, but mainly the liver, heart and the endocrine organs. To stop this causing problems, your medical team may recommend you have iron-chelating (neutralising) medicines. Red cell transfusions may need to be given cautiously, and sometimes with diuretics (water medicine), to ensure there is no build-up of fluid in the lungs. This may be especially true for people over the age of 70. Platelet transfusions Platelets are the blood cells that help your blood to clot and stop you from bleeding. Platelets are shorter-lived cells. A single unit of transfused platelets should raise the platelet count by 10-40 x 109/L for about two to five days. Response to platelet transfusions is much more variable from one patient to another. Sometimes patients develop antibodies to platelets and special donors have to be found by the transfusion service. The threshold for platelet transfusions can differ and be dependent on bleeding symptoms or problems, or special circumstances such as needing surgery or treatment with Anti-Thymocyte Globulin (ATG). Some patients may need Human Leukocyte Antigen (HLA) matched platelets, which have to be a special order, and require advance notice and on occasions, more time. When will I need a platelet transfusion? A platelet transfusion will be given either to treat bleeding, or to prevent bleeding. Platelets will usually be given to prevent you from bleeding if your platelet count is very low (below 10 x 109/L, or, if you are showing signs of a fever, below 20 x 10^9/L.) You are also likely to be given a platelet transfusion if you are actively bleeding, depending on how bad the bleeding is and where in your body you are bleeding. Some people will not get the benefits from a platelet transfusion (their blood tests will not show an increase in platelet numbers after a transfusion). There could be many potential reasons for this, for example a fever, drugs you are on, or antibodies could have developed as a result of having transfusions before. If this happens, your medical team will carry out appropriate tests to investigate this. Would you like this information in print? If you're in the UK, you can order this information as a free printed booklet from our shop. You can also download it as a pdf here View this as a printable PDF Manage Cookie Preferences