Your child may need a blood or blood product transfusion during a major surgery or to treat a medical condition. This handout will help you understand the different parts of blood that are often used, along with the benefits and risks of having a transfusion. A doctor or nurse will be happy to discuss your child’s situation and answer your questions.

What is a transfusion? 

Human blood can be used to make more than 30 different products. Putting 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 someone need a transfusion? 

A transfusion can help someone recover from a serious illness, surgery or injury. Sometimes, people need repeated transfusions because they are missing important parts of their blood. 

What do the parts of the blood do?

Red blood cells carry oxygen to all tissues in the body so that they stay alive and work well. If there has been a lot of bleeding, someone may need a red blood cell transfusion. This helps get oxygen to the tissues and prevents more damage. 

Platelets are cells that help prevent and stop bleeding. 

Plasma is the yellow liquid around the red blood cells and platelets. Plasma is used most often to help blood clot (become thick). It may be used with platelets to prevent or stop bleeding. Other products can be made from plasma and some of these can be used to treat special bleeding problems, such as hemophilia. Plasma is also used to make products called immunoglobulin preparations, which help the body fight infection and treat 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 or she will get just the part that is needed. 

Are there risks to having a blood transfusion? 

There are several possible problems that can result from a blood transfusion. 

• Allergic reactions: These include rashes and hives. They are usually mild and easily treated. More serious allergic reactions are rare. 

• Fever reactions: 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 treated easily. If your child has had a bad fever in the past, after or while receiving a transfusion, you should talk to his doctor. 

• Transfusion-related acute lung injury (TRALI): This 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.

What are the chances that my child will get a contagious disease? 

Because blood donors are screened and their blood is tested, blood transfusions are very safe. The risks of getting diseases such as HIV, hepatitis B and hepatitis C are very small. The risk of HIV infection has been reduced to less than 1 in 4 million units in Canada. Hepatitis B and C viruses are also routinely tested for and, according to data from the United States, the risks of these infections are now extremely low. The risk of hepatitis B infection from a transfusion is 1 in 275,000 to 1 in 1 million units. 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 3 million units). Although blood can never be 100% safe, the risk of infection from a transfusion is very low. For products made from plasma (such as albumin and immunoglobulin), additional steps get rid of any of the viruses mentioned above that may remain after testing. 

You may have heard about Creutzfeldt-Jakob disease and variant Creutzfeldt-Jakob disease (vCJD). vCJD is related to mad cow disease, which was first recognized in the United Kingdom. The risk of  transmission of vCJD is extremely low with only 2 reported possible cases in the world. Of these 2 cases, only 1 actually developed symptoms of the disease. If you have questions about this disease or any others, please feel free to discuss them with your child’s doctor. 

Does my child have to receive a stranger’s blood? 

Not necessarily. Here are two options:

• Autologous blood donation: This means that the patient donates his or her own blood before surgery. This has been done safely with children, elderly people, pregnant women and even people with heart disease. But donating one’s own blood is NOT an option for everyone, especially very small children. You will need to talk with your child’s doctor to find out if this is possible. 

• Directed donations: Sometimes, parents can donate blood to be used only for their child.  Ask your doctor about this. 

There may be other alternatives, such as the use of saline or nonplasma-derived clotting factor concentrates made by new DNA technology, or other manufactured products. There are also procedures, such as blood salvaging, that may be an option for your child. It is important to discuss the details with your child’s doctor. 

How do I decide about a transfusion? 

Your doctor or an assistant will explain why a transfusion is needed, along with the risks and benefits, as long as there is enough time. This is called informed process. To use your child’s blood or your blood, you will have to speak with your doctor. You will have to sign an informed consent form. 

Should a blood transfusion record be kept? 

Yes. Before you leave the hospital, 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 medical file for future reference. 

Note to physicians
This information sheet is a tool to help treating physicians obtain informed consent for blood transfusions from patients, parents or guardians. It is adapted from a document developed by the Children’s Hospital of Eastern Ontario. The Canadian Paediatric Society thanks them for sharing their material. The quantitative risk estimates in this document must be updated as new information appears in the literature. Individual institutions may modify this document to better suit local circumstances.

Developed by the CPS Infectious Diseases and Immunization Committee.

Updated: March 2006