Contraindications to blood transfusion

Adequate blood flow in the human body is a prerequisite for ensuring the normal functioning of the body, but once phenomena such as heavy bleeding occur, artificial blood transfusion is required. But blood transfusion is not a trivial matter. Different blood types have different contents of various cells in the blood. It is very dangerous to transfuse blood rashly. It is necessary to ensure that the conditions of the blood donor and the blood recipient are consistent, which means that blood transfusion has strict contraindications. So, what are the contraindications to blood transfusion?

Indications

1. Acute massive blood loss

The volume of blood and type of blood products to be replaced are determined based on the amount and rate of blood loss and the patient's general condition. The blood transfusion guidelines formulated by the National Health and Family Planning Commission (formerly the Ministry of Health) recommend: if hemoglobin (Hb) is >100g/L, no blood transfusion is required; if Hb is <70g/L, blood transfusion should be considered; when Hb is between 70 and 100g/L, blood transfusion should be considered based on factors such as the patient's degree of anemia, increased metabolic rate, cardiopulmonary compensatory function, and age.

2. .Chronic anemia

Patients with chronic anemia have a long course of illness, and most have established compensatory mechanisms and are able to tolerate lower levels of hemoglobin. Therefore, the treatment of patients with chronic anemia should seek out the cause and treat it accordingly. Blood transfusion can be considered for those with symptoms of hypoxia. Its indications are: ① those with hemoglobin <60g/L and obvious symptoms of hypoxia; ② patients with severe anemia who need surgery or pregnant women who are about to give birth.

3. .Coagulation disorders

Coagulation disorders are mainly caused by decreased platelet count, platelet dysfunction and abnormal coagulation factors. In clinical practice, appropriate blood component transfusions are generally given based on laboratory test results such as platelet count, prothrombin time (PT), and activated partial prothrombin time (APTT). For example, fibrinogen supplementation or cryoprecipitate can be used for fibrinogen deficiency; fresh frozen plasma infusion and cryoprecipitate infusion can prevent and treat bleeding caused by abnormal coagulation function.

4. .Severe infection

For severe sepsis and refractory infections after chemotherapy, transfusion of concentrated white blood cells may be considered when conventional treatment is ineffective. During infusion, attention should be paid to the adverse reactions caused by white blood cell transfusion.

5. Hypoproteinemia

Albumin infusion can treat hypoproteinemia caused by chronic blood loss, burns, severe sepsis, etc.

Contraindications

① In the case of matching failure, due to HLA incompatibility of white blood cells and platelets, or allergic reaction to a certain component in the donor's plasma.

② Various immune diseases, where anti-erythrocyte antibodies or complement in plasma can damage red blood cells and cause hemolysis;

⑧In patients with uremia, hyperkalemia and acidosis, the destruction of stored red blood cells leads to increased potassium concentration and lactic acid content in plasma.