A blood transfusion is one of the treatment options for cold-agglutinin disease (CAD), but is usually used only in severe cases.
CAD is a type of autoimmune hemolytic anemia, in which the body produces autoantibodies called cold agglutinin that mistakenly attack red blood cells in cold temperatures.
What is a blood transfusion?
A blood transfusion is a medical procedure in which healthy blood, or specific blood components, are given to patients through the vein as per their particular need.
In CAD, the transfusion of washed red blood cells from compatible donors serves as a temporary but sometimes necessary treatment.
Before the transfusion
Before a blood transfusion, doctors will perform blood tests to determine the red blood cell count in the patient’s blood. The tests also will determine the levels of autoantibodies in the blood. This will help clinicians confirm the necessity for blood transfusion.
The blood tests are imperative for determining the individual’s blood type and Rh factor, which is a protein found on the surface of red blood cells. This ensures that the corresponding matching donated blood is compatible to that of the patient. A small amount of blood sample is sufficient to determine the patient blood type and Rh factor.
The transfusion process
Blood transfusions usually are administered in outpatient clinics or hospitals in a very carefully monitored setting.
The healthcare provider will assess the patient, and review the medical history, to ensure the person is able to receive the transfusion. The patient’s vital signs, such as heart rate, blood pressure, and temperature, will be monitored through the transfusion process.
For people with CAD, it is vital to warm the blood to body temperature before the transfusion. If this in not done, the cold agglutinin antibodies that are already in the patient’s blood may attack the red blood cells in the donor blood.
Blood transfusion is performed using a narrow tube connected to a needle that is introduced into the patient’s vein. Red blood cell transfusion starts very slowly, and if no adverse events are noted, the rate of transfusion is gradually increased. The entire procedure can take up to four hours.
After the transfusion
A blood transfusion is a safe procedure. However, some reactions and complications may occur. These include:
- Allergic reactions
- Transfusion-related acute lung injury (TRALI), which is characterized by sudden acute respiratory distress following transfusion
- A sudden spike in fever
- Delayed breakdown of red blood cells, called hemolysis
Following blood transfusions, doctors will closely monitor patients for any signs of such complications or any changes in their condition.
Last updated: August 20, 2019
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