Use of Blood Transfusion in Surgery

The golden rule of blood transfusion should be that no transfusion is given unless the benefit of the transfusion outweighs the risks. Before all blood transfusion,therefore,there must be a balance among the risks associated with the transfusion, the indications for transfusion, and the availability and benefit of using alternatives to conventional transfusion. The following is a listing of risks,indications and alternatives to traditional transfusion.

  1. Risks associated with transfusion
  2. Viral infections
  3. Bacterial infections
  4. Compatibility complications
  5. Haemodynamic complications

Indications for transfusion

  1. Transfuse blood intra-operatively for preoperative haemoglobin less than 6.0g/dl
  2. Transfuse blood for blood loss 10% of blood volume or more.

Nota Bella: Avoid”topping-up” anaemic patients prior to surgery.


Alternatives to conventional transfusion

Did You Know?:Autologous donation is frequently used in patients for elective surgery. A pint of blood is removed every 7 days prior to surgery and is re-transfused at the time of surgery. This blood can safely be stored for 21 days. It is important to liaise with the blood donor bank to ensure that the patient gets own blood

  1. Intraoperative haemodilution where a unit is withdrawn and replaced with saline. This can be set aside for re-transfusion as needed.
  2. Another alternative, for level 5 and 6 facilities, is the use of cell savers during surgery as for example during abdominal aortic aneurysm surgery.
  3. Strictly observe all precautions that pertain to blood transfusions.
  4. Do not correct postoperatives anaemia with transfusion, if there is no active bleeding or shock. 

Nota Bene: Transfusion is extensively discussed in Paediatric and Medicine.


Leave a Reply

Your email address will not be published. Required fields are marked *