blood transfusion

blood transfusion, transfer of blood from one person to another, or from one animal to another of the same species. Transfusions are performed to replace a substantial loss of blood and as supportive treatment in certain diseases and blood disorders. When whole blood is not needed, or when it is not available, plasma, the fluid of the blood without the blood cells, can be given. Alternately, such components of the blood as red cells, white cells, or platelets may be given for particular deficiencies. Blood substitutes, which are under development, are expected ultimately to ease the chronic short supply of blood and to alleviate certain storage and compatibility problems.

In whole-blood transfusions, the blood of the donor must be compatible with that of the recipient. Blood is incompatible when certain factors in red blood cells and plasma differ in donor and recipient; when that occurs, agglutinins (i.e., antibodies) in the recipient's blood will clump with the red blood cells of the donor's blood. The most frequent blood transfusion reactions are caused by substances of the ABO blood group system and the Rh factor system. In the ABO system, group AB individuals are known as universal recipients, because they can accept A, B, AB, or O donor blood. Persons with O blood are sometimes called universal donors, since their red cells are unlikely to be agglutinated by the blood of any other group. In the Rh factor system, agglutinins are not produced spontaneously in an individual but only in response to previous exposure to Rh antigens, as in some earlier transfusion. Transfusion reactions involving incompatibility eventually cause hemolysis, or disruption of donor cells. The resulting liberation of hemoglobin into the circulatory system, causing jaundice and kidney damage, can be lethal.

In addition to providing for the compatibility of blood groups in transfusion, it is necessary to determine that the donor's blood is free of organisms that might cause syphilis, malaria, serum hepatitis, or HIV, the virus believed to cause AIDS. Allergic reactions to transfusions may occur in cases where allergic antibodies have been transmitted from the donor's blood, possibly because of some type of food recently ingested by the donor. These problems have increased the popularity of autologous transfusions, transfusions using a person's own blood, which has been donated ahead of time. See blood bank.

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