II. Definitions

  1. Autologous Blood Transfusion (Autotransfusion)
    1. Blood Product transfusion in which the recipient is also the donor, and receives their own Blood Products
    2. Recipient may donate their blood in preparation for major surgery in which large blood loss is expected
    3. Hemothorax may also be drained, filtered and re-transfused (e.g. Hemovac or Cell Saver)
  2. Red Blood Cell Transfusion
    1. Donor erythrocytes (Red Blood Cells) are processed, filtered, tested and reinfused into a recipient

III. Preparations

  1. Packed Red Blood Cells are derived from whole blood by removing 250 ml plasma
  2. Remaining product contains 200-250 ml per unit pRBC
  3. Most centers filter Leukocytes before storage
    1. Decreases Febrile Nonhemolytic Transfusion Reaction risk
    2. CMV-safe

IV. Precautions

  1. Transfused Red Blood Cell lifespan is 50-60 days at best (significantly shorter than the 120 lifespan of a native RBC)
    1. Without Iron Replacement and intact RBC synthetic function, expect Hemoglobin to drop again within weeks
  2. Treat the underlying cause of chronic Anemia in hemodynamically stable, relatively asymptomatic patients
    1. Erythropoietin is preferred in Anemia due to Chronic Renal Failure, Chemotherapy
    2. Iron Replacement is preferred in chronic Iron Deficiency Anemia (e.g. chronic Menorrhagia)

V. Indications

  1. Acute Sickle Cell Crisis (CVA Prevention)
  2. Massive acute blood loss >1500 ml (30% of Blood Volume)
  3. Hemorrhagic Shock
  4. Hemoglobin <7.0 g/dl and no serious comorbidity (and no ongoing bleeding)
  5. Hemoglobin <9.0 g/dl with serious comorbidity (e.g. cardiovascular disease, active bleeding)
  6. Symptomatic Anemia
    1. Severe Fatigue, weakness, or Dizziness
    2. Dyspnea
    3. Altered Level of Consciousness
    4. Angina
    5. Congestive Heart Failure
  7. Hospitalized patient criteria (per American Association of Blood Banks)
    1. Hemoglobin <7 mg/dl if hemodynamically stable (even if critically ill)
    2. Hemoglobin <8 mg/dl if orthopedic surgery, cardiac surgery or preexisting Coronary Artery Disease
    3. Unclear threshold for Acute Coronary Syndrome, severe Thrombocytopenia, chronic transfusion-dependent Anemia

VI. Dosing

  1. Massive Hemorrhage
    1. See Massive Hemorrhage for protocol
  2. Hemodynamically stable, non-bleeding patient
    1. Transfuse 1 unit pRBC at a time with reassessment of status between units

VII. Labs

  1. Hemoglobin
    1. Expect one unit pRBC to raise Hemoglobin by 1 g/dl
  2. Hematocrit
    1. Expect one unit pRBC to raise Hematocrit by 3%

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Related Studies

Ontology: Blood Transfusion (C0005841)

Definition (NCI_NCI-GLOSS) The infusion of components of blood or whole blood into the bloodstream. The blood may be donated from another person, or it may have been taken from the person earlier and stored until needed.
Definition (NCI) The injection of whole blood or a blood component directly into the bloodstream.
Definition (MSH) The introduction of whole blood or blood component directly into the blood stream. (Dorland, 27th ed)
Definition (CSP) introduction of whole blood or blood component directly into the blood stream.
Concepts Therapeutic or Preventive Procedure (T061)
MSH D001803
SnomedCT 233557002, 151000002, 266806005, 180209006, 116859006
CPT 36430
LNC LP32812-7, LP34333-2, MTHU020992, LA9940-3, LA21147-6
English Blood Transfusions, Transfusions, Blood, Transfusion, Blood, Transfusion, blood transfusion (treatment), blood transfusion, Transfusion of Blood Products, blood transfusions, Transfusion of blood, Blood transfusion (& cell) (procedure), Cell -blood-transfusion, Blood transfusion (procedure), Blood transfusion (& cell), Transfusion - blood, Blood cell transfusion, blood transfusion (___ ml), Transfusions, Blood--Transfusion, transfusion, Blood Transfusion(s), Blood transfusion, BT - Blood transfusion, Transfusion (Blood), Blood Component Transfusion, Blood Transfusion, Transfusion, blood NOS
Dutch bloedtransfusie, Bloedtransfusie
German Vollbluttransfusion, Bluttransfusion, Blutübertragung
Portuguese Transfusão de sangue, Transfusão Sanguínea, Transfusão de Sangue
Spanish Transfusión sanguínea, Transfusión Sanguínea
Swedish Blodtransfusion
Japanese ユケツ, 輸血
Czech krevní transfúze, Krevní transfuze, transfuze krve
Finnish Verensiirto
French Transfusion de sang, Transfusion sanguine
Italian Trasfusioni di sangue, Trasfusione di sangue
Polish Przetaczanie krwi, Transfuzja krwi
Hungarian Vérátömlesztés
Norwegian Blodoverføring, Blodoverføringer, Blodtransfusjon, Blodtransfusjoner

Ontology: Blood Transfusion, Autologous (C0005842)

Definition (NCI) Infusion of previously obtained autologous blood or blood products back to the same individual.
Definition (MSH) Reinfusion of blood or blood products derived from the patient's own circulation. (Dorland, 27th ed)
Definition (CSP) reinfusion of blood or blood products derived from the patient's own circulation.
Definition (NIC) Collecting and reinfusing blood that has been lost intraoperatively or postoperatively from clean wounds
Definition (ALT) Collecting a client/patient's intraoperative and/or postoperative blood, taken from a clean wound(s) and/or vein, and reinfusing it into his or her body. Service is billed per treatment.
Concepts Therapeutic or Preventive Procedure (T061)
MSH D001804
SnomedCT 3320000
English Autologous Blood Transfusion, Autologous Blood Transfusions, Autotransfusion, Autotransfusions, Blood Transfusion, Autologous, Blood Transfusions, Autologous, Transfusion, Autologous Blood, Transfusions, Autologous Blood, autotransfusion, Autotransfusion Procedure, TRANSFUSION AUTOL BLOOD, BLOOD TRANSFUSIONS AUTOL, AUTOL BLOOD TRANSFUSIONS, TRANSFUSIONS AUTOL BLOOD, BLOOD TRANSFUSION AUTOL, AUTOL BLOOD TRANSFUSION, ABT - Autologous blood transfn, ABT - Autologous blood transfusion, autologous blood transfusion, autotransfusions, autotransfusion (treatment), Blood--Transfusion, Autologous, Autologous blood transfusion, Abt - autologous blood transfusion, Autotransfusion (procedure), Autotransfusion, NOS, Intravenous autotransfusion each treatment, IV autotransfusion ea.Tx
Dutch autoloogbloedtransfusie, autotransfusie, Autotransfusie, Bloedtransfusie, autologe
German autogene Bluttransfusion, Autotransfusion, Bluttransfusion, autologe
Italian Trasfusione di sangue autologo, Autotrasfusione, Trasfusioni di sangue autologhe, Trasfusione di sangue autologa
Portuguese Transfusão de sangue autólogo, Autotransfusão, Transfusão de Sangue Autóloga
Spanish Transfusión sanguínea autóloga, autotransfusión (procedimiento), autotransfusión, Autotransfusión, Transfusión de Sangre Autóloga
Swedish Autotransfusion
Japanese ジコケツユケツ, 自家輸血, 自己血輸血, 返血(自己血輸血), 返血法(自己血輸血), 自家輸血法, 自己輸血, 自己輸血法, 輸血-自家, 輸血-自己血
Czech autotransfúze, krevní transfúze autologní, Autotransfuze, Autologní krevní transfuze, transfuze krve autologní
Finnish Autologinen verensiirto
French Transfusion de sang autologue, Autotransfusion, Transfusion sanguine autologue
Polish Autotransfuzja, Przetaczanie krwi własnej
Hungarian Autológ vér transzfúzió, Autotranszfúzió
Norwegian Autolog blodtransfusjon, Autologe blodtransfusjoner, Autolog blodoverføring, Autotransfusjon, Blodtransfusjon, autolog, Autolog blodoverføringer, Blodoverføring, autolog

Ontology: Red Blood Cell Transfusion (C0086252)

Definition (MSH) The transfer of erythrocytes from a donor to a recipient or reinfusion to the donor.
Concepts Therapeutic or Preventive Procedure (T061)
MSH D017707
SnomedCT 116863004
English Erythrocyte Transfusion, Erythrocyte Transfusions, Transfusion, Erythrocyte, Transfusions, Erythrocyte, Red Blood Cell Transfusions, Transfusion, Red Blood Cell, Transfusions, Red Blood Cell, blood cells red transfusions, transfusion of red blood cells, transfusion erythrocyte, blood cells red transfusion, red blood cell transfusion, Red Blood Cell Transfusion, Erythrocytes--Transfusion, Red blood cells administration by intravascular infusion, Transfusion of red blood cells (procedure), Transfusion of red blood cells
Swedish Erytrocyttransfusion
Czech erytrocyty - transfúze, transfuze erytrocytů
Finnish Punasolusiirto
Japanese 赤血球輸血, 輸血-赤血球
French Transfusion d'érythrocytes, Transfusion d'hématies, Transfusion érythrocytaire, Transfusion de globules rouges
Polish Transfuzja czerwonych krwinek, Przetaczanie erytrocytów
Norwegian Transfusjoner av røde blodceller, Blodoverføring, røde blodceller, Blodoverføringer, røde blodceller, Erytrocyttransfusjon, Transfusjon av røde blodceller
Spanish administración de glóbulos rojos mediante infusión intravascular, transfusión de eritrocitos (procedimiento), transfusión de eritrocitos, transfusión de glóbulos rojos, Transfusión de Eritrocitos, Transfusión de Glóbulos Rojos
German Erythrozytentransfusion, Red Blood Cell Transfusion, Tranfusion, Erythrozyten-
Italian Trasfusione di eritrociti
Dutch Erytrocytentransfusie, Transfusie, erytrocyten-
Portuguese Transfusão de Eritrócitos, Transfusão de Hemácias

Ontology: Transfusion of packed red blood cells (C0199962)

Definition (NCI) The intravenous administration of red blood cells (whole blood without the plasma) into an individual.
Definition (NCI_CDISC) The intravenous administration of red blood cells (whole blood without the plasma) into an individual.
Concepts Therapeutic or Preventive Procedure (T061)
SnomedCT 71493000, 180207008
English IV blood transfuse packed cell, packed red blood cell transfusion, Packed red blood cell transfusion, blood cell packed red transfusion, blood cells packed red transfusion, prbc transfusion, Transfusion of packed red blood cells, Red Blood Cell Transfusion, Transfusion of PRBC, Intravenous blood transfusion of packed cells, Intravenous blood transfusion of packed cells (procedure), Transfusion of packed red blood cells (procedure), Packed Red Blood Cell Transfusion, PRBC Transfusion
Italian Trasfusione di emazie concentrate
Japanese 濃厚赤血球輸血, ノウコウセッケッキュウユケツ
Czech Transfuze erymasy
Hungarian Vörösvértest-massza transzfúzió
Spanish transfusión de PRBC, transfusión de eritrocitos centrifugados, transfusión de glóbulos rojos centrifugados (procedimiento), transfusión de glóbulos rojos centrifugados, transfusión intravenosa de concentrado de eritrocitos (procedimiento), transfusión intravenosa de concentrado de eritrocitos, transfusión intravenosa de eritrocitos desplasmatizados, Transfusión de concentrado de hematíes
Portuguese Transfusão de concentrado de eritrócitos
Dutch rode bloedceltransfusie
French Transfusion de concentré de globules rouges
German Transfusion mit Erythrozytenkonzentrat

Ontology: Packed red blood cells (C2316467)

Concepts Pharmacologic Substance (T121)
SnomedCT 431069006
LNC LP15236-0
English Packed red blood cells (product), Packed red blood cells, Packed red blood cells (PRC's), Packed red blood cells (PRBC's), Packed erythrocytes
Spanish concentrado de eritrocitos, concentrado de eritrocitos (producto), concentrado de glóbulos rojos