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• Ages and Stages
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What is a transfusion?

Human blood can be used to make more than 30 different products. Putting some or all of these blood products into someone’s body is called a transfusion. The blood product is usually given through a small needle placed into a vein.

Why would a child need a transfusion?

Your child may need a blood (or blood product) transfusion during a major surgery or to treat a medical condition.  A transfusion can help a person recover from a serious illness, surgery or injury. Sometimes, people need more than one transfusion because they are missing important parts of their blood.

What are the parts of blood and what do they do?

Red blood cells carry oxygen to all tissues in the body so that they stay alive and work well. Anemia is when your child does not have enough red blood cells. If your child has had a lot of bleeding, or is not making enough red blood cells, he may need a red blood cell transfusion. This helps prevent more damage.

Platelets are cells that help prevent and stop bleeding.

Plasma is the yellow liquid around the red blood cells and platelets.

• Plasma helps blood clot (become thick). It can be used with platelets to prevent or stop bleeding or to replace the plasma in children with certain severe diseases.
• Other products can be made from plasma and can be used to treat special bleeding problems, such as hemophilia.
• Plasma is also used to make a product called intravenous immunoglobulin (IVIG).This helps the body fight infection and is used to treat many medical conditions.

Other blood products are used in very specific cases. If your child needs them, your doctor will discuss them with you in detail.

Where does donated blood come from?

Canadian Blood Services and Héma-Québec collect blood from volunteer donors. Before it is used, blood is tested and divided into separate parts or units. If your child needs a transfusion he will get only the part that he needs.

Are there risks to having a blood transfusion?

There are some problems that can happen from a blood transfusion. Here are some examples:

• Allergic reactions, including rashes and hives. They are usually mild and easily treated. More serious allergic reactions are rare.
• A fever usually means the body is reacting to white blood cells or plasma proteins from the donor’s blood. The fever is usually not severe and can be easily treated. If your child has had a high fever in the past after or during a transfusion, you should talk to the doctor.
• Transfusion-related acute lung injury (TRALI) is a rare but serious problem that affects the lungs. It starts with shortness of breath and low oxygen levels in the blood and lungs. This reaction starts quickly, either during the transfusion or within 6 hours of completing the transfusion.

Can my child get a contagious disease from a transfusion?

Although blood can never be 100% safe, blood donors are carefully screened and their blood is tested. The risk of infection from a transfusion is very low.

• The risk of HIV infection has been reduced to 1 in every 8-12 million transfusions in Canada.
• The risk of hepatitis B infection from a transfusion is 1 in 1.1 to 1.7 million transfusions in Canada. The risk of getting hepatitis C is even smaller now that a new test can find the virus right in the blood (less than 1 in 5-7 million units).

For products made from plasma (such as albumin and immunoglobulin), there are extra steps taken to get rid of any of the viruses that may remain after testing.

If you have questions, it’s a good idea to discuss them with your child’s doctor.

Does my child have to receive blood from an unknown person?

That is what usually happens and is generally very safe. Sometimes one of the following is also an option:

• Autologous blood donation means that the patient donates her own blood before surgery. This has been done safely with children, elderly people, pregnant women and even people with heart disease. This is not an option for everyone, especially very small children and with many medical conditions. Talk with your child’s doctor to find out if this is possible.
• Sometimes, parents can do a directed donation of blood to be used only for their child. Ask your doctor about this but often there are reasons why it is not the best choice. There may be other alternatives, such as the use of saline or nonplasma-derived clotting factor concentrates made with new DNA technology, or other manufactured products. There are also procedures, such as blood salvaging, which may be an option for your child in certain situations. It is important to discuss the details with your child’s doctor.

How do I decide about a transfusion?

As long as it isn’t an emergency situation, your doctor or another help professional will explain why a transfusion is needed, what components of blood are needed, and all the risks and benefits. This is called informed process. You will be asked to sign an informed consent form. Your doctor can tell you if it’s possible to use your child’s blood or your blood. However, in many medical circumstances this is not possible.

Should a blood transfusion record be kept?

Yes. A record will be kept in the hospital, but before you leave, make sure you receive something in writing that says your child received blood or blood products. This is important medical information that should be kept with your child’s health information.

Reviewed by the following CPS Committees:
Infectious Diseases and Immunization Committee

Last updated: February 2012