Under what circumstances do patients with aplastic anemia need blood transfusion? What should they pay attention to?

In some cases, patients with aplastic anemia have to resort to blood transfusions to alleviate their condition and save their lives. So under what circumstances does aplastic anemia require blood transfusion?

Indications for blood transfusion in patients with aplastic anemia:

Generally speaking, if the hemoglobin level of patients with aplastic anemia is lower than 60g/L, concentrated red blood cells should be transfused to reduce transfusion reactions; if the hemoglobin level can be maintained at around 80g/L after transfusion, no transfusion is necessary. For young patients with good physical condition, blood transfusion is not necessary if the hemoglobin level can be maintained between 60-70g/L. In principle, blood transfusion should be stopped as long as symptoms of hypoxia no longer occur.

The indication for platelet transfusion is when the patient's platelet count is less than 20×10^9/L and is accompanied by mucosal bleeding. If the platelet count is greater than 20×10^9/L but there is obvious skin and mucosal bleeding, platelet transfusion should also be given. When there is internal bleeding (such as massive gastrointestinal bleeding, renal bleeding, suspected intracranial hemorrhage, extensive fundus bleeding), regardless of the platelet count, there is an indication for platelet transfusion. However, it should be noted that one should not attempt to increase the platelet count by transfusing platelets when the platelet count is not too low and there is no obvious bleeding. The resulting alloimmunization reaction will render the platelet transfusion ineffective or significantly reduce the efficacy during rescue.

Side effects and precautions of blood transfusion in patients with aplastic anemia:

Blood transfusion has many side effects: first of all, blood transfusion can transmit some diseases such as hepatitis. Some statistics show that there is a high chance of blood transfusion causing hepatitis. Patients who have received multiple blood transfusions are prone to fever during the transfusion process, and are prone to allergic reactions due to multiple transfusions of other people's blood.

Transfusing blood too quickly or in excessive amounts can easily lead to heart failure. Long-term massive blood transfusions may lead to hemochromatosis. Blood transfusion itself has an inhibitory effect on bone marrow hematopoietic function, which is not conducive to the recovery of the patient's bone marrow function. Old blood contains very few platelets, and large amounts of transfusion can cause bleeding. Blood maintenance fluid contains sodium citrate, which can easily cause poisoning as the amount of blood transfused increases. Large amounts of blood transfusion can also easily cause the iron in hemoglobin to accumulate in the body and cause iron poisoning. In short, blood transfusion has many complications.