Blood group and blood transfusion indications

Posted by Doctor Pediatrician - Pediatric Center - Vinmec Times City International Hospital

In humans, blood types are divided into many types and each type has its own characteristics. Accordingly, if the blood type is incompatible, it can disrupt the structure of blood vessels, endangering the life of the person receiving the blood transfusion.

In the human body, the AB0 blood group system is the most important blood group system in blood transfusion practice, there are 4 main blood groups: A, B, AB, O
The grouping depends on a protein on the red blood cell membrane Also called antibodies. Each person will have a blood type in the above 4 types. Specifically:
Blood group A: Red blood cells have the A antigen on the red blood cell membrane. Blood group B: Red blood cells have B antigens on the red blood cell membranes. Blood group AB: Red blood cells have A and B antigens on the red blood cell membrane. Blood group O: Red blood cells have no A antigens, no B antigens on the red blood cell membrane.

In addition, red blood cells also have Rh blood group system, people have Rhesus antigen on the red blood cell membrane called Rh (+). A person who does not have the Rhesus antigen on the red blood cell membrane is called Rh(-).
This is also an important blood group in blood transfusion. Vietnam 80-85% carry the Rh(+) group.

A blood transfusion is an operation to receive blood or blood products including red blood cells, platelets and plasma from another person to be stored in a plastic bag and given through a line with a needle attached to a vein in your arm. receiver. Accordingly, the specific purposes of blood transfusion are as follows:
To restore circulating volume in cases of acute blood loss, blood replacement. Boosting Hemoglobin to ensure oxygen transport needs Anti-bleeding, hemostasis: Transfusion of platelets, clotting factors. Immune enhancement: Transfusion of white blood cells, immunoglobulins, source cells. Depending on the purpose of blood transfusion, doctors have appropriate indications for blood recipients.

2.1. Whole blood transfusion Transfusion when bleeding acutely, blood loss due to many other reasons such as surgery, accident Shock hypovolemic accompanied by anemia. Blood transfusion Currently, whole blood transfusion is used less often than other methods.
2.2. Red blood cell transfusion Transfusion of red blood cells is whole blood with plasma removed. Hematocrit about 70%, hemoglobin reaches 220 g/l. The red blood cell mass also contains many white blood cells and no clotting factors.
Red blood cell transfusion is indicated in cases of anemia that does not require volume restoration (chronic anemia such as Thalassemia), anemia in heart disease, high blood pressure.

2.3. Transfusion of leukopenia and leukopenia is a whole blood plasma reduction and leukocyte reduction by centrifugation or leukocyte filtration. Accordingly, this method is indicated in patients with reduced red blood cell mass who have had multiple blood transfusions or organ transplants to reduce HLA allogeneic reactions and reduce the risk of CMV infection.
2.4. Washed RBC Transfusion Washed erythrocytes are whole blood from which plasma has been removed, washed 3 times with sterile 0.9/% saline. Accordingly, transfusion of washed red blood cells is indicated in autoimmune hemolysis, in patients with anti-globulin antibodies, in patients with repeated blood transfusions, or in transfusion reactions.

Indications for blood transfusion must ensure the correct and reasonable principles, need to be carefully considered before each case where the decision to transfuse blood and blood products is required. Transfusion of blood only when absolutely necessary, the lack of any component will supplement that component, minimizing the need for whole blood transfusion.
In the event that a patient has a reaction to a blood transfusion, medication will be prescribed before further transfusions or will be given another blood product to help prevent a reaction.

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