Explanation regarding Blood Transfusion Therapy
■Blood Transfusion Therapy
The blood is largely divided into cell components (red blood cells, white blood cells and platelets) and plasma components (protein components and clotting factors). Red blood cells carry oxygen throughout the body, white blood cells prevent the invasion of foreign substance such as bacteria and virus, protecting the body. Platelets and clotting factors stop the bleeding, plasma components maintains the nutritive substance and stabilizes the circulation of the blood.
When healthy, the production and elimination of the blood components are well balanced, but when due to sudden bleeding or lack of production of blood, the loose of balance might become fatal. Blood transfusion therapy is used in such a case to replenish deficient blood components for medical care.
■The Necessity of Blood Transfusion (Indicated)
1 Anemia due to injury, surgery, major bleeding due to illness or persistent bleeding.
2 Patient not being able to produce enough blood by him/herself.
Blood transfusion will be necessary if situations are fatal due to any factors such as above.
■The Risks of Not Having Blood Transfusion
Anemia is a condition which lacks in the substance in the blood which carries oxygen (Red blood cell), and if the anemia is severe enough, blood will not be able to carry oxygen to each part of the body. If blood transfusion is not done, there are possibilities of severe and fatal complications such as hemorrhagic shock or heart failure. If bleeding due to the lack of platelets or clotting factors occurs, blood needs to be replenished or else the bleeding will not stop, and more blood will be lost from the body.
■Options for Blood Transfusion
① If treatment is possible by using other medication, that treatment will be proceeded first
Iron pills will be dosed if anemia is due to the lack of iron, and transfusion materials will be dosed if amount of blood loss is not large.
② Autologous Blood Transfusion (Blood transfusion from one’s self)
If there is enough time until the scheduled operation, the body condition is near perfect and the doctor indicates it, the blood of the patient will be collected and preserved before hand, and that blood will be used during the operation.
Autologous blood transfusion is said to be the safest transfusion, since most of the side-effects which will be explained later, can be avoided.
There are necessities of certain circumstances for Autologous blood transfusion, such as the normality of the patient’s blood, perfect full body condition, etc. Since each patient’s requirements are different, please confirm with your doctor regarding the possibilities of Autologous blood transfusion.
Patients with indications of Autologous blood transfusion will be further explained with a separate sheet.
③ Allogeneic Blood Transfusion (Blood Transfusion from blood donors)
As a principle, only necessary substances needed for blood transfusion such as red blood cells products, platelet products, freshly-frozen plasma, etc are provided from the Japanese Red Cross Blood Center.
■Risks and Side-effects of Blood Transfusion
Blood derivatives donated from the Japanese Red Cross Society are inspected thoroughly to prevent side effects. However, it still involves slightest risks as follows.
① Infectious Disease
It is very rare, but there are cases where the patient can get infected by hepatitis virus, aids virus, adult T-cell leukemia virus and other viruses and pathogen such as syphilis, due to the detection limit of tests or the patient’s condition.
② Immunity Reaction
There are cases of light side effects such as chills, fever and hives due to allergic reaction against blood components from others in blood derivatives. And rare cases of fatal side effects may also happen, such as TRALI (transfusion-related acute lung injury) which is accompanied by breathing difficulties, or even anaphylactic shock.
③ After blood transfusion GVHD (Graft-versus-host disease）
The lymphocyte within the blood derivatives recognizes the patient’s body as somebody else’s, and starts to attack it. This critical immunity reaction is called an after blood transfusion GVHD.
As our aim to prevent GVHD after transfusion, we follow the guidelines determined by the Ministry of Health, Labor and Welfare, and the exposure of the radiation to the blood derivatives is proceeded.
■Procedures taken for a safe transfusion therapy
① Examination before Blood Transfusion
Examination of the blood type, irregular antibody examination (existence of antibody against the red blood cell), cross-match test (compatibility with the transfused blood) will be proceeded.
② Examination for Infectious Disease before Transfusion, and Preservation of Specimen
To confirm the presence of infection through blood transfusion, an examination of viral hepatitis B and C, and AIDS virus will be conducted in a 3 month period of before and after blood transfusion. Also, the blood samples collected during the examination will be stored at our hospital for a certain period (for more than a year) for an investigation, in case a side effect ever occurs.
③ Storage of Dosing Records & Usage for Look-back Reviews
In order to handle the situation if ever a virus infection occurs while using the blood derivatives in the future, the usage records will be stored at our hospital for at least 20 years.
Also, the recorded information may be provided based on the law to the authorities concerned, only when it becomes an advantage to the patient.
④ Regarding the Aid System of Infectious Disease through Products of Biological Origin
If ever infectious disease mediated by products of biological origin, such as blood derivatives causes health damage, there are aid systems such as benefits of medical fees.
■For Emergencies
If an emergency or unpredicted side-effect occurs during the blood transfusion treatment, the best treatment will be provided according to the decision made by the doctor in charge.
■Signature or Seal to the Consent Form
Outlines of Autologous blood transfusion have been explained. Please contact the attending doctor if you have any questions. Once you have got full understanding and consent, please sign or place a seal on the separate sheet “Blood Transfusion Therapy Consent Form”