Blood Transfusions

Are blood transfusions safe for children?

Because of illness or injury, some children need to receive transfusions of blood and blood products. This procedure can be frightening for parents and their children. Many parents also are concerned about the safety of transfusions. While the blood supply in the United States is considered very safe, parents should know a few things about blood transfusions and the safety of blood products for children.

U.S. blood supply

Stories in the news of people becoming infected with various diseases from contaminated blood may lead parents to fear and question the safety of blood transfusions. While there have been cases of patients receiving contaminated blood, the risk of this actually is very low. In the United States, all blood donors are screened (eg, health history, sexual practice, travel, drug use) and the blood products they donate are carefully checked for a wide variety of infectious agents (germs) that could be spread through transfusions. These include

If a donor is considered to be at significant risk for having a transmissible infection, the donor is not accepted. If a unit of blood is found to be unsafe,it is destroyed. The donor is then contacted and advised not to donate blood in the future.

Blood transfusion options

If your child needs a blood transfusion, you may be able to choose where the blood comes from.

Blood Transfusion Options
Option	Description	Advantages	Disadvantages
Autologous transfusion	A patient donates his or her own blood before surgery to be used if needed.	No risk of disease transmission or allergic reactions.	Not suitable for children younger than 9 or 10 years. Cannot be used for emergency surgery because the donation must be planned in advance. May not be possible for patients with certain medical conditions.
Blood recycling	Blood lost during surgery is collected, cleaned, and returned to the patient.	No risk of disease transmission or allergic reactions.	Cannot be used for emergency surgery because the recycling process must be planned in advance. May not be possible for patients with certain medical conditions.
Directed donation	Patients choose their own blood donors. For example, parents can donate blood to their children.	Patients feel safer by selecting their own donors.	Blood types must be the same or compatible. Still has a risk of disease transmission and allergic reactions. Must be planned in advance. Some hospitals do not allow this type of donation.
Random donor blood	Volunteer blood donors.	Readily available; screened for diseases.	Blood types must be the same or compatible. Small risk of disease transmission and allergic reactions.

Blood alternatives

Some alternatives to human blood and blood products have been developed. For example, children with hemophilia now can be given highly purified clotting factors or factors made without human protein in the laboratory by what are called "recombinant DNA techniques." The recombinant factors are virtually 100% free of germs that can be transferred from a donor to a transfusion recipient.

There also are hormones or growth factors available that cause the body to increase blood cell production. When time permits, treatment with one of these may eliminate the need for a transfusion. Research is being carried out in a number of laboratories on several red blood cell substitutes. Such substitutes would eliminate the need for donors of red blood cells and make transfusions simpler and safer.

Remember

If your child needs to receive blood or blood products, talk with your pediatrician about any concerns or fears you have about the procedure. If necessary, seek out a specialist in transfusion medicine (usually a clinical pathologist affiliated with a hospital blood bank). Learn all you can about your child's condition and make sure you understand the benefits and risks of receiving blood or blood products.