Thalassemia Patients in the UK

Hi to all of you !
I moved to Portsmouth, UK last week and I even had my first transfusion.
The thing that really bothers me is that I am a student here in a University and I have to be treated in Portsmouth , where there are no thalassemia patients.
However, I got in touch with a haematologist here in the local hospital and we arranged a blood transfusion for me .

I want to ask all of you who have regular blood transfusion:

Do they transfuse you cold blood or they warm it before they start transfuse it. I was used to get my blood with the normal temperature of a human body.. In Portsmouth they gave me this blood right directly from the fridge.

I still do not know what is better, pleasee tell me !

Thank you !

Welcome to the UK!  I hope you will like it here.

I am a beta thalassaemic and the approach usually adopted when I had blood is for it to be given to me cold usually starting slowly so there are no reactions. 

It is usually better I have been told for this approach because for some reason this causes problems with the blood.

I hope this answers your question Rozitika.

Hi Rozitka
It will be better if our members would tell us about their transfusion expierence. But from what i know is that blood should be warmed before transfuion in order to avoid some reactions as a result of the cold temperture of blood. You can also read in the following links where they also advise warm blood transfusion

Cold blood In ultra-emergent situations, blood stored at 4º C may be tranfused prior to reaching body temperature at 37º C; warming a unit of blood from 4 to 37º C requires 30 kcal/L of energy, consumed as glucose; cold blood slows metabolism, exacerbates lactic acidosis, ↓ available calcium, ↑ hemoglobin's affinity for O2 and causes K+ leakage, a major concern in cold hemoglobinuria

http://medical-dictionary.thefreedictionary.com/transfusion+reaction

Hypothermia
Red blood cells are stored at 4oC and do not warm up much beyond 10oC if they are transfused rapidly.

Symptoms: Many of the arrhythmias attributed to hypocalcemia and hypomagnesemia may be accentuated by hypothermia.

Consequences: Hypothermia may impair drug metabolism, impair platelet function and coagulation. Tissue oxygen delivery is reduced, while oxygen consumption increases due to shivering. At body temperatures of 25 to 30o C, cardiac output decreases and ventricular irritability increases. Patients may develop ventricular fibrillation.

Lab Data: None.

Treatment: Warming fluids and inspired gases, increasing ambient temperature and applying warming blankets directly to the patient are also effective treatments.

Prevention: Infants and elderly patients are at greatest risk of hypothermia, particularly during massive transfusion of blood components. Other situations where cold blood may induce arrhythmias include exchange transfusions and transfusion of multiple units through central IV lines. In all of these cases, blood should be warmed to 37oC with an electronic in-line-warming device.

http://www.clinlabnavigator.com/transfusion/transfusionreactions.html

Hope this helps and good luck with your studies in London

manal

Very useful info, Manal.
In my Unit blood is taken out of fridge some time before it is transfused so it warms up naturally.

You are welcomed Lena

I remember that two years ago, our thal association bought this machine that warms the blood because many children at this time suffered from sudden drop in circulation due to the cold blood

manal

From http://www.guideline.gov/summary/summary.aspx?doc_id=12787&nbr=6589&ss=6&xl=999

Administration of a Blood Transfusion

    * A transfusion of red blood cells should commence within six hours of removal of the unit from a refrigerator. The transfusion of a unit of red blood cells should be completed within six hours from the start.
    * If a red blood cell product has been at room temperature for two hours, it must not be returned to a refrigerator for storage but it must either be transfused (see above) or discarded and returned to the blood bank for writeoff (according to the local practice).
    * Before starting a transfusion check the patient's vital signs (i.e., blood pressure, pulse and temperature).
    * Transfusion of red blood cells may usually be commenced immediately after the product has been taken out of refrigerator.
    * If the patient has significant cold agglutinins [Note: Antibodies], red blood cell products should be warmed during transfusion with an approved commercial blood warmer. The temperature must not exceed +37 degrees C due to the risk of haemolysis.

Some warming of the blood may be indicated in many thals due to the possible problems involving cold antibodies. The cited website is very good. There is another excellent site called ClinLab Navigator that explains most tests and also has a great section on transfusions. This can be found at
http://www.clinlabnavigator.com/transfusion/bloodadmin.html  The links on the left cover all areas related to transfusions. The page on blood administration is excellent and can serve as guidelines for what should be done during transfusions. Please everyone, pay special attention to the requirements for "Confirming Patient And Donor Identity". Following these procedures can literally save your life.

Hi Rozitka
The hospital where my son transfuses uses a blood warmer sometimes, but most of the time they wait for an hour or so if the blood is very cold.

maha

My son also receives blood which is warmed for a period of time, say 1 hour to prevent certain reactions.
Souly

 Hi all! we also have it warmed before transfusing the blood, when we were still having our bt my sis and I.