Blood transfusion side effects continue to persist in spite of the many advances in transfusion practice.
Although numerous steps to reduce the risk of blood transfusions have been put in place by the blood collection industry, there is still considerable risk. Blood transfusions has never been safer than in current times.
The doctors who trained me in transfusion alternatives will tell you that the blood transfusion you avoid may save your life.
However, transfusions are not risk free. According to research and numerous scientific studies, a blood transfusion causes some degree of harm to every recipient. This is because of the properties of stored blood. It also is due to the resulting impairments of the immune system function, called immune modulation.
In all, there are over 43 known risks or complications to getting a blood transfusion. When you get up to 10 units transfused, according to the science, you have a 50 - 50 chance of living or dying.
These untoward effects of blood transfusions are considered side effects.
You should know that there is a safer, more effective option.
Not surprisingly, viruses are not the leading causes of illness and death caused by blood transfusions (called transfusion-related morbidity and mortality).
Illness and death from blood transfusions are more often caused by...
Blood transfusions could be likened to chemotherapy. A blood transfusion will only improve outcomes when used in the right patient for the right indication and in the right dose. Many doctors take a carte blanche or blank check approach to giving blood transfusions.
It is still not uncommon to see doctors ordering blood with hemoglobin levels of 10 in small rural hospitals. Yet in the more progressive hospitals like Sloan Kettering, they trigger or the value where a blood transfusion is automatically ordered is closer to 6.
In the gold standard of blood transfusion free care, actually no blood is given. Patients with Hemoglobin's as low as 1.2 have been successfully treated.
Note: In my experience as a Nurse Case Manager, the lowest count for a patent was a hemoglobin of 2.9. In over 600 patients treated by the doctors I worked with, not one died. Many got out of the hospital faster than those who got blood. Statistically by 1/2 to 3 days faster.
This begs the question, Why?
Why do some give blood liberally and others conservatively. Considering the blood transfusion side effects, wouldn't doctors want to avoid them? Why do more doctors not buy into the blood transfusion avoidance since the outcomes are so much better.
Even JAMA said every hospital should have a Bloodless Program. Numerous studies show that bloodless medicine is associated with positive outcomes, including financial ones.
In an era of hospitals losing money, this is a business model that can make them barrels or pardon the pun, numerous units of profits.
Understanding Health Care Politics will answer the question in part.
Secondly, there is a lot of money to be made in blood and selling blood products. Follow the money and see where it leads. An economic term called actuarial analysis is used to in effect say that the risk and down side of a transfusion are far outweighed by the up side.
However, there are no high level studies that show that a blood transfusion saves lives. Actually, all of the high level studies say the opposite. From any to the more blood that is transfused, the higher the risk of death or getting sick.
The plastic bags used to store blood were found to leach carcinogenic chemicals into blood. Even though the common opinion was that blood transfusions were safe. Then came Hepatitis C. Even though the blood was considered safe, thousands were infected.
Then cam AIDs. In Canada alone, over 50 thousand people got AIDS from contaminated blood. Every year, only a few get AIDS today. It is considered clinically insignificant. That is unless you are one of the ones who got a tainted transfusion.
Perhaps even worse, if you got a transfusion that you did not need, such as Jonathan White, a 6 year old who got a table spoon full of blood and AID's at the same time.
Why? Because the family was told that he needed the transfusion to save his life. A table spoon of blood is an insignificant amount.
If these blood transfusion side effects can result in such damage and yet the blood supply was considered safe, then what will the future hold for the current so called safe blood.
Goodnough LT. Risks of blood transfusion. [Review] [124 refs]. Critical Care Medicine 2003;31:S678-S686.
Note: Dr Goodnough was one of the most published and vocal doctors promoting blood transfusions at one time. As he continued his research and practice, he changed camps. He is now one of the most prolific writers on the subject of treating patients with out blood transfusions.
Transfusion-related acute lung injury: definition and review. Crit Care Med 2005
Transfusion Safety in the Hospital: Transfusion 2003
At the least, find a cooperative doctor. At the best, find an experienced doctor and a hospital where Bloodless Medicine and Surgery is practiced. It is also called Advanced Transfusion Practice at John's Hopkins Hospital.
NoBlood.org has a list of the hospitals where you can find experienced doctors and nurses who can provide, according to Time Magazine, Bloodless Medicine and Surgery, The Gold Standard of Health Care.
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