• Reference Number: HEY-922/2021
• Departments: Renal Service
• Last Updated: 28 February 2021

Introduction

This leaflet has been produced to give you general information about blood transfusion.  Most of your questions should be answered by this leaflet. It is not intended to replace the discussion between you and the healthcare team, but may act as a starting point for discussion.  If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team.

What is a blood transfusion?

Blood transfusion is given to treat low red blood cell count, also called anaemia.  Kidney failure is an important cause of anaemia.  If the blood count is too low, despite giving you iron replacement and the erythropoietin (EPO) hormone e.g. Aranesp, you may need a transfusion.  This is given during a haemodialysis session.  Some patients may not be suitable for iron and the hormone injection so a blood transfusion may be the only treatment to improve your anaemia.

Why do I need a blood transfusion?

You may have symptoms of anaemia which can include tiredness, dizziness, shortage of breath, cold hands or feet, chest pain and lack of concentration. Six in every ten patients with end stage renal failure or chronic kidney disease (CKD) are anaemic.  If the anaemia is not improved then the body may not have enough oxygen.

Can there be any complications or risks?

The risk that a blood transfusion will cause severe harm is very low.

One of the most important checks for a safe transfusion is to make sure you get the right blood and therefore it is important that you are correctly identified at each stage of the transfusion, including when blood samples are taken before the transfusion.  Wearing an identification band with your correct details is essential.  You will be asked to state your full name and date of birth and this will be checked against your identification band.

It is alright to remind the healthcare professional to ask you for this information. If you have a card that states that you need to have blood of a specific type, please show it as soon as possible to your healthcare professional.

There is a small risk of rare infections (please note the blood before transfusion is screened for some infections like hepatitis, however, it is not possible to screen the blood for all possible infections).

You can refuse to have the transfusion.  If a blood transfusion is recommended, it is important you understand the implications to your health of refusing the transfusion.  If you are refusing on religious grounds then speak to your doctor as there may be other options.

What will happen?

The blood will be administered through the dialysis machine whilst you dialyse. You will be monitored by your dialysis nurse before, during and after the transfusion.  Most people do not feel anything unusual during a blood transfusion.

What are the signs of a transfusion reaction?

Transfusion reactions describe a rare group of complications following treatment with blood.

The majority of reactions happen during or immediately after the transfusion, however, transfusion reactions can occur within 24 hours of treatment with blood and delayed transfusion reactions can occur 24 hours after treatment with blood.

The reactions are usually very mild in nature and may cause a few minor problems.  Any unusual or unexpected symptoms occurring within 14 days of your transfusion with blood should be reported to your doctor or nurse.

The signs and symptoms of possible reactions include:

• A high temperature (especially above 38.5°C)
• Increased heart rate
• Shivering or cold chills (rigors)
• Breathing problems
• Blood in your urine
• Itchy skin rash or nettle rash (hives/urticaria)
• New swelling or worsened swelling of the legs
• Jaundice (yellow colour of the white of your eyes)
• Passing very dark urine

Severe reactions to blood transfusions are extremely rare but in the event of an emergency once you are home, please contact your doctor or dial 999.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Dialysis Unit (01482) 608748 or 608753.

If you need urgent advice out of hours please contact or attend the Emergency Department.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.