Is the pre-transfusion Hb level the right indicator for transfuiosn?

 Hi

I want to know what your doctors say about the pre-transfusion  Hb evels being the correct indicator for scheduling your next transfusion?

I was pointed out recently that even though the pre-transfusion Hb level is quite high, it might not be the right indicator. Sometimes other parameters indicate that your bone marrow is being overworked, which is not good, and the high Hb levels that is showing is due to the floating RBCs  of the healthy donor.

I am not sure if such extensive tests are done in India when one gives blood samples for typing and cross matching. But at Duke Medical Center, USA, they do do extensive tests before a transfusion.

So eventhough , after 5 weeks your Hb level is at 9 or 9.5, it might not be an indication that you could wait for some time.

If anyone has any knowledge about this, I would very much like to know.

shikha

All I know is that when my HB was 10g/dl, my doctor would appoint me to come after one week. Anything below 10; they would transfuse.

Hi Shikha,

My son gets 2 units every four weeks.  The longest he's gone between transfussions has been 5 weeks.
His doctor goes by his hb.  If it's 9 or above they extend a week. When he was little he used to get 1 unit every 4 weeks.  With him I've also always had the indicator that he usually gets tired right around the time he's due for his next transfussion. By now he himself can tell when he's due for blood.

I hope this helps answer your question,

Take care,
Lily

I’m given a HB and X-Match test before a transfusion.  This needs to be done 7 to 4 days before my pre-booked appointment date.

I’m transfused every three weeks not matter what my level of haemoglobin may be, unless it’s lower then 10.  I’m transfused 3 units of blood which is approximately (700-900 mls). 

If my haemoglobin is below 10.  Then my next transfusion will be booked in two weeks and I will be transfused every 2 weeks until my HB goes up to 10 (that’s 10 pre-transfusion)

When I was pregnant I was transfused every 2 weeks and my HB had to be above 11 (pre-transfusion).

I am unable to cope with a HB less then 9.  I get yellowing skin, throbbing back, sore joints and very fatigued.  I also have a lot of responsibility with work and family so I don’t like to feel like I am run down all the time.  So my Doctor and Nurses have a personal guideline which is set for me.  Other patients may have different ways they are managed.

Hi

As I had asked if the pre transfusion level is the correct indicator for the next transfusion?

Well, as per a leading Hemmatologist at Duke medical Center, the reticulocyte count should not be too high either. It should be lower, preferabley under 300. Otherwise it means that the bone marrow is over active, and producing more of own blood cells which are weak compared to the cells that one gets through transfusion,  from outside.  That means the bone marrow is overworking, although the Hb level could be 9-9.5
So although the Hb is high, one might need transfusion because of the higher Reticulocyte count.

I was wondering if anyone was told this fact?

shikha mitra

Dear Shikha,
                This is Shantanu. Wanted to know how your daughter ( RJ) is keeping? Is she still in US? I've lost your contact no. Mine is 9450600382. Please call me as soon as you can.
Regards.
Shantanu