Talk:Blood transfusion

Confusing Blood Transfusion Safety Section

I am confused as to whether all the bullets listed under Blood Transfusion Safety sections are conditions that the a recipient may or may NOT get as a result of a transfusion. Is this section saying that donated blood is screened for all these conditions, or is it saying it that the blood supply is NOT screened for these? (I don't know this topic very well).

Also, maybe this section should be merged into the Risks section? 75.6.228.54 05:54, 21 October 2007 (UTC)

Mixed Comments

Please consider addinf a section on or cross-reference to the religious concerns and objections to transfusion.

I don't see an article on, or discussion here, of blood exchanges, the procedure in which we replace a patient's blood (at a logarithmic return on new blood). Should we add content to this article to cover it? If so, should we change the name of the article to "Blood transfusion and exchange", or provide a redirect from "Blood exchange"? (New contributor to wikipedia.)--Ojophoyimbo 2006-01-03@21h44m UTC

Needs references to cover the content, added tag.--FloNight 14:08, 27 November 2005 (UTC)

• From page with unreferenced tag: This template should only be placed on a talk page or at the bottom of an article, preferably in the empty 'References' section.--FloNight 18:03, 27 November 2005 (UTC)

If you put it here, hardly anyone will see it. Just visit Category:Articles lacking sources and you'll see that there are hardly any talk pages listed there. - Karl Stas 22:09, 27 November 2005 (UTC)

"The time required to donate blood is different from the Blood Donation article. Please select a time in common, I would recommend thirty minutes" --JoshNahum 15:12, 4 Jul 2005 (UTC)

"7th century"? Is that a typo for "17th century"?

I wondered the same thing when I read that line. --AaronW 23:34, 17 Jun 2004 (UTC)

It certainly was! - Nunh-huh 23:36, 17 Jun 2004 (UTC)

Took "probably" out of this sentence, since "it's likely" already says that. "it's likely that the transfusion probably caused his death."

donors with high risk sexual behaviour

Can we have a definition of this? Or rather, examples of what different countries/medical agencies define as high risk. Is it prostitution, promiscuity, homosexuality, ...? --Joy [shallot] 11:56, 12 August 2005 (UTC)

Procedure

Why does the procedure section only cover the donation of the blood and not the actual operation in which a patient recieves it?

Because that is more straightforward. I'll see if I can write a line or two. JFW | T@lk 23:41, 15 November 2005 (UTC)

At the risk of publishing original research I could not find a reference for giving Lasix with blood in patients with heart failure. JFW | T@lk 23:55, 15 November 2005 (UTC)

the procedure section states that transfusions normally require four hours. i am trying to find a reference for this statement, which would explain why four hours is required and why it may be dangerous to infuse multiple units within four or less hours. any suggestions are appreciated. thanks.

There are a couple reasons why transfusions are usually done one at a time and slowly. First, if there are multiple units hung and the recipient has a reaction, it's impossible to tell which of the units caused it. Secondly, if a hemolytic transfusion reaction occurs it is best to have a minimal amount actually transfused. Third, circulatory overload (too much fluid) can cause problems, and a slow transfusion allows the body to move excess fluid to interstitial spaces and out of circulation. Lastly, blood for transfusion, especially type O negative red cells and platelets of any type, is often in short supply, so generally only the smallest amount needed is used. If the patient is stable on less, further units are generally not ordered. In trauma situations or other critical need scenarios, these concerns are generally waived based on the actual needs of the patient.

150.148.0.27 18:36, 25 October 2007 (UTC)

"Type of organ donation"

The only source for this that I can find so far, is in a defense of transfusions by for Witnesses by the AJRWB: http://www.ajwrb.org/science/meal.shtml . As such, this may be a subtle attempt at making a religious statement as opposed to impartial, unbiased, pure knowledge. If anyone can find a non-religious medical source for this, it would be appreciated. -- Avi 19:40, 22 February 2006 (UTC)

The article attributes that claim to 'cardiovascular surgeon Denton Cooley'. I don't know what Cooley's personal beliefs are, but he looks to have good medical credentials. I couldn't verify that particular quote, and I'm always wary of short quotes out of context, but I wouldn't be terribly surprised if a medical professional said such a thing.

That said, supposing for the sake of argument that he and a dozen other doctors have said such a thing, the way a fact is presented can still make it POV. I don't see that this factoid is particularly useful or notable in any but this particular religious context. If it's going to be brought up, that context should be made clear. It would be appropriate in a section on the JWs' stance on transfusions (maybe this article should have such a section?) but not context-free in the intro paragraph of the article. --Calair 23:16, 22 February 2006 (UTC)

the procedure section states that blood transfusions normally take four hours. i am trying to find a reference for this statement, which would explain why four hours is needed and why it may be dangerous to administer multiple units within four or less hours. does anyone have a suggestion? thanks

Complications of transfusion

Can an informed persion exand this area? Snowman 10:47, 27 March 2006 (UTC)

OK, I've done my best. Thoughts? MastCell 21:51, 10 August 2006 (UTC)

Photopherisis

I am assuming that photophoresis (sic) is distinct from photopheresis [1] which is to do with blood transfusion and apherisis. Am I right? Cutler 09:12, 2 June 2006 (UTC)

Tranfusion-related immunosuppression

Added a request for citation on the statement about transfusions suppressing the immune system and leading to increased complications after surgery. I know there have been a few papers describing an increased risk of mortality with more liberal transfusion strategies, and a citation would be useful - I'll look into it as well. Will also expand the "Risks" category with some hard numbers once I have a chance. I've also added a section listing the specific infectious agents for which donated blood is screened in the U.S. (with citation). MastCell 18:08, 10 August 2006 (UTC)

This is probably a good one: Hill G, Frawley W, Griffith K, Forestner J, Minei J (2003). "Allogeneic blood transfusion increases the risk of postoperative bacterial infection: a meta-analysis". J Trauma. 54 (5): 908–14. PMID 12777903.{{cite journal}}: CS1 maint: multiple names: authors list (link) --WS 23:37, 11 August 2006 (UTC)

Talking about risks, this is also interesting: PMID 15339855 difference in risks and indications in poor and rich countries. --WS 23:54, 11 August 2006 (UTC)

Those are both good references... feel free to add a section on transfusion-related immune suppression, or I will get around to it sooner or later. The question is always - did they get sick because they got transfused, or were the transfused pts sicker to start with (hence the transfusions)? I assume the reference addresses that issue; I'll take a look. MastCell 00:31, 12 August 2006 (UTC)

Related topics

I've managed to swell the page to an ungodly size. Thoughts on splitting off "History of blood transfusion" and "Exchange transfusion" (which is not yet covered on this page)? MastCell 22:45, 11 August 2006 (UTC)

Exchange transfusion is briefly mentioned on HDN and Rh disease pages. Snowman 09:42, 12 August 2006 (UTC)

In the section titled leukoreduction it says that stray white blood cells are removed from the donated blood.Does this mean that all white blood cells in the donor's blood are removed or just certain white blood cells. If stray white blood cells stand for only a certain type of white blood cells could somebody please clarify this by explaining the type of white blood cells that should be removed. If all white blood cells are removed from the donor's blood could somebody please remove the term "stray". —The preceding unsigned comment was added by 88.110.207.144 (talk • contribs).

Indications

A section about the indications for blood transfusion is still missing. PMID 15460551 could be of some help if someone wants to write it. --WS 23:44, 11 August 2006 (UTC)

Merge ?

Why not merge Blood transfusion and Transfusion reactions? Snowman 08:35, 14 August 2006 (UTC)

Since there's not much difference right now, you certainly could. However, I can imagine a transfusion reaction page which is much more than the current list, including sections on each individual reaction, etc. They are different enough topics that each could more than stand on its own. If you'd like, you can put a merge template up on this and the reaction page and probably get more comments! InvictaHOG 11:22, 14 August 2006 (UTC)

Yes, the two pages could become very different with more development; however, there is a lot of duplication at the present time.
No merged needed. Snowman 12:07, 14 August 2006 (UTC)

After I edited the blood transfusion page, there ended up being more info on transfusion reaction there than on the "Transfusion reaction" page, so I copied most of the info and expanded it slightly. Perhaps this was a mistake. Agree that the transfusion reaction page could definitely be expanded and reorganized, or the info could be removed from the "Blood transfusion" page and replaced with a "main article" link. Probably better to keep 2 separate pages since they are both fairly involved subjects; those are my 2 cents. MastCell 15:46, 14 August 2006 (UTC)

External links

Hello - Johanneum, your external link has been added back in the appropriate section. The part that was removed was the line saying "See also: external links below" in the text of the article. This is generally not done; people can peruse the external links when they get down there, or they can be used as citations for a specific point that the article is making. Please see the Wikipedia policy on external links, under "How to Link". MastCell 21:02, 9 October 2006 (UTC)

Thanks for your reply, I was beginning to wonder. Anyway, the link I recently added is not there. The link is: NoBlood— Blood Management and Avoidance It is possible that this is not acceptable to wiki standards. That is why I have not put it back there but have been waiting for a reason why it is not acceptable. It is always appreciated when one explains why they add or remove the work of another. ( I Am sure I do not always do it myself) At the same time, I have seen many pages that do have: see also, for further info etc in the article. However, it is no big deal! It looks fine the way it is now, I just personaly appreciate it when one explains why they do what they do. Thanks, Johanneum 21:18, 9 October 2006 (UTC)

Ooops... my bad. I thought you had added the "SHOT" link. The reason I'd removed your external link initially was that it seemed to be an advocacy group with a distinct POV that blood transfusions were to be avoided at all costs. Rather than this external link, it would be better to include a section in this article about religious objections to blood transfusion (it's on the to-do list, but I haven't gotten around to it). Feel free to work on it if you're interested. Then, if the NoBlood site illustrates a point in the article, it could be cited. In general, I think we're all a little leery of external links to advocacy groups (unless they're clearly labeled as such), because it can make it appear that Wikipedia has condoned the group's agenda. The WP:EL guideline is a good guide. As far as the "See also", it's often used to link to another internal article on Wikipedia where more information is present, but shouldn't be used to redirect the reader to external links, which are summarized at the bottom of the page. Thanks for your reasoned response. MastCell 21:55, 9 October 2006 (UTC)

Thank you for your very resonable response. I will post below what could be added about religious objections to blood transfusion (JW's). However, the link above is not about, "religious objections". It states right on the home page: "NoBlood is not affiliated with any political or religious organization. It is recognized that Jehovah’s Witnesses likely make up the largest group using this site." [2] For what it is worth :-) Johanneum 12:12, 10 October 2006 (UTC)

Religious Objections

Jehovah's Witnesses believe that the Bible prohibits the consumption, storage and transfusion of blood including in cases of emergency. This has been their view since 1945. Over the years their stance on blood has been a source of controversy, as members have died due to loss of blood.

Jehovah's Witnesses believe that in the Bible blood is sacred to God representing life thus it must not be eaten but pour out (figuratively giving it back to God). They also state that blood was reserved for only one special use, the atonement for sins, leading up to Jesus' shed blood, thus when a Christian abstains from blood, he or she is in effect expressing faith that "only the shed blood of Jesus Christ can truly redeem him and save his life.-Ephesians 1:7" Therefore, they believe that when the New Testament says to “keep abstaining from ...blood” Template:LookupNWT it means that Christians should, 'not take blood into their bodies at all.' —The preceding unsigned comment was added by Johanneum (talk • contribs) .

Perhaps the section could be on "Objections to blood transfusion" (in keeping with the statement about NoBlood) with the recognition that the majority of objections are religiously based. Since you are clearly familiar with the rationale behind JW objections to blood transfusions, why don't you go ahead and start a section on it. The more citations the better, especially when broadly describing a religion's beliefs, as it will make the article more robust and less POV-sounding. MastCell 17:23, 10 October 2006 (UTC)

Sounds good. I have rewrote the first par.to what is below. It is a start for now. Jehovah's Witnesses do not accept tranfusions of whole blood or its four major components namely, red blood cells, white blood cells, platelets (thrombocytes), and whole plasma. They also do not donate or store their own blood for transfusion.Johanneum 12:26, 13 October 2006 (UTC)

National scandals and recovery

Maybe we should include a sentence or two about the Canadian "tainted blood scandal" on this page. In the 1980s, the Canadian Red Cross was responsible for blood donations. However, their screening methods were limited and they were importing blood collected from prisons in the US. This led to thousands of Canadian citizens being infected by HIV and Hepatitis C. After a long enquiry, the Canadian Red Cross was no longer responsible for collecting and testing blood; two newly created agencies took over: the Canadian Blood Services (for most of Canada) and Héma-Québec (in the Quebec province). The two agencies share their knowledge, use similar technologies, and invest actively in R&D for developing new screening technologies. Héma-Québec is currently testing a new screening test for CjD; the test should become fully operational in 2010 and the "donation ban" for people who have stayed in the UK will be lifted. See Royal Commission of Inquiry on the Blood System in Canada for some background info on the scandal. -- Hugo Dufort 01:51, 28 November 2006 (UTC)

A "tainted blood scandal" occurred in Japan too. However, I am not familiar with the incident. -- Hugo Dufort 01:56, 28 November 2006 (UTC)

This probably needs its own page, because HIV isn't the only bug in question and this particular scandal hit quite a few countries. Japan, I believe, is wrestling with a similar problem for Hepatitis C screening failures as of 2008.Somedumbyankee (talk) 06:26, 13 March 2008 (UTC)

Chagas/Leichmania in the blood system

Can some mention be made of the new testing policies being put in place for Trypanosoma and Leishmania? I know there were several Chagas infections in the past decade which have been traced back to transfusions and transplants.Rusty 22:01, 18 March 2007 (UTC)

I can only speak for US policy, but the official guidance and typical practice is to defer donors who have been in areas endemic for Leishmaniasis for a year. Since Iraq is a main area of concern this is largely transparent since it's also a malarial risk area and the donors would be deferred for a year anyway (though plasmapheresis donors are affected since malaria is irrelevant to acellular components). A screening test for T. cruzi (Chagas) has been implemented in many US blood centers, but isn't required.Somedumbyankee (talk) 06:26, 13 March 2008 (UTC)

Intravenous route

It's not strictl true that a transfusion can only be carried out via the intravenous route. Endosteal transfusion (i.e. into the medullary cavity of bone) is theoretically possible, and peritoneal transfusion is occasionally practiced in neonates of some animal species. The water and plasma salts are absorbed easily across the peritoneum by diffusion; the protein and even the cellular fraction by active uptake (pinocytosis). 86.133.243.110 15:10, 15 June 2007 (UTC)

Stored blood loses Nitric Oxide?

http://www.economist.com/science/displaystory.cfm?story_id=9941992 Any idea how to add the findings of that study to the article? --204.4.131.140 09:05, 12 October 2007 (UTC)

Here's a second source if anyone needs it.

http://www.time.com/time/magazine/article/0,9171,1670523,00.html Ixistant 18:37, 3 November 2007 (UTC)

This is specific to packed Red Blood Cells (maybe also Whole Blood) and might be better explained on the specific pages. This page is very busy as it is. Not sure if NO metabolism has its own page. Definitely deserves a mention or a link, though.Somedumbyankee (talk) 06:26, 13 March 2008 (UTC)

Wikipedia Scaremongering Strikes Again

Just reading your wonderfull article, very detailed, however, once again wikipedia has demonstrated the tactic of scaremongering in terms of risk assessment for medical conditions. Specifically on the transferred diseases thru blood transfusion section, noone happens to mention that thanks to screening, the chance of picking up a transmitte disease through blood is about 0.25%. Ask your local doctor or hospital, blood is screened so thoroughly that only about 15% of donated blood is given final approval for transmission to another patient. - 203.51.43.121 (talk) 00:30, 2 December 2009 (UTC)

Uh... where are you getting those numbers? The risk of transfusion-transmitted infection (TTI) is about the same risk of getting struck by lightning in most developed countries. There are millions of transfusions each year in the US, and the number of reported transfusion-associated infections is in the tens, many of which are unlikely to be actual TTI's, so 0.25 is way too high (maybe 0.0000025%). The 15% figure is also bizarre. Of people that volunteer to donate (which is a lot less than 15% of the population), most (~85-90%) donation attempts result in transfusable components. The most common reason that an attempt fails is that the donor does not have a high enough iron level, disease-related failed donations account for maybe 1% of failed donation attempts, mostly due to near-paranoid exclusion of any group that might be at high risk rather than test results. Again, these are US numbers, and I'd assume that most developed countries are similar. In Zimbabwe, maybe not. SDY (talk) 16:26, 3 December 2009 (UTC)

Studies related to efficacy of modern blood use

There is information related to the history of the use of blood transfusion in the article, but little related to modern research of blood transfusion practice. Of course the individual studies them self would be too numerous to mention. Perhaps some of the more recent ones could be mentioned. There are numerous news articles related to an expert panel convened earlier this year that found 40 to 60% of blood transfusion are given in scenario's in which the transfusion either adds no benefits or adds additional risks beyond infection, while adding no benefit. I have provided a couple links in case anyone would like to look at it. I personally believe it is beneficial to include such information as many are under the presumption that, aside to the rare infection, that the procedure is benign at worst. http://www.englewoodhospital.com/medservices.cfm?pageid=850&bc=0,27,831 http://www.medpagetoday.com/HospitalBasedMedicine/Hospitalists/13869 —Preceding unsigned comment added by 204.9.160.90 (talk) 21:43, 11 December 2009 (UTC)

Pope Innocent VIII

What is the point of having the experience of Pope Innocent VIII as the opening statement in the history section? Men had been drinking blood for thousands of years prior to Pope Innocent VIII. Innocent VIII did not experience a blood transfusion. He was fed blood. I propose deleting this material as though it is part of the history of transfusing blood.--Marvin Shilmer (talk) 20:05, 19 January 2010 (UTC)

Copyright problem removed

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medico-legal issues related to transfusion

there is no mention of laws related to blood transfusions, blood banks etc. if any one can help?