What is a blood transfusion for children?

During a blood transfusion, your child receives donated blood through one of his or her blood vessels. A needle is put into a vein, often in the arm. The needle is attached to a thin, flexible tube called a catheter. This is called an intravenous line, or IV. Blood is sent into the vein through this IV line.

Blood has several parts.

• Plasma. This is the liquid part of the blood. It’s made of water, proteins, clotting factors, hormones, and other substances.

• Red blood cells. Floating in the plasma are many red blood cells (RBCs). These large cells contain hemoglobin. Hemoglobin lets RBCs carry oxygen from the lungs to the rest of the body. The whole body needs oxygen, so it’s important to have enough RBCs.

• White blood cells. Blood also contains white blood cells. These help the body fight infection.

• Platelets. Smaller cells called platelets help the blood clot. Proteins called clotting factors also help blood clot.

Whole blood refers to blood with all these parts. Most of the time, a blood transfusion is done with only part of the blood. Your child might be given one or more of these blood parts based on his or her needs.

When a person has a blood transfusion, it’s important to be given the right blood. Blood comes in 4 main types: A, B, AB, and O. These types refer to molecules called antigens on the surfaces of blood cells. Antigens are substances that can cause a person’s immune system to react.

Rh factor is another type of antigen. Blood is either Rh positive or Rh negative. Each person’s blood is 1 of 8 specific types: A+, A−, B+, B−, AB+, AB−, O+, and O−.

If a person gets the wrong type of blood, his or her immune system will react to it. This is a serious condition that can cause severe symptoms such as fever, muscles aches, and trouble breathing. It can sometimes be fatal.

People with O− blood don't have A, B, or Rh molecules on their blood cells. These people can donate blood to anyone, and are known as universal donors.

People who are AB+ have all 3 molecules (A, B, and Rh) on their blood cells and can safely receive blood from anyone.

Other blood types can donate and give to only their matching blood types.

Why might my child need a blood transfusion?

Your child might need a blood transfusion if he or she has had a problem such as:

• A serious injury that’s caused major blood loss

• Surgery that’s caused a lot of blood loss

• A liver problem that makes the body unable to create certain blood parts

• A bleeding disorder such as hemophilia

• An illness that causes reduced or poor-quality RBCs (anemia)

• Kidney failure, which causes problems with blood cell production

• Treatment for cancer (chemotherapy) that slows down the body’s production of blood cells

Different health problems may need different types of blood transfusions. For example, after surgery your child may need just RBCs. Your child’s healthcare provider can tell you why your child needs a blood transfusion, and which type is best for him or her.

What are the risks of blood transfusions for a child?

All procedures have some risks. The risks of blood transfusions include:

An allergic reaction. This can be mild or severe. Mild symptoms can include itching or rash. Severe symptoms can include trouble breathing, chest pain, or nausea. These symptoms may start soon after a blood transfusion or within the next 24 hours.

Fever. This can happen within a day of the blood transfusion. It’s usually temporary.

Destruction of red blood cells by the body (hemolytic reaction). A hemolytic reaction happens when the body attacks the donated RBCs. This happens if a person gets a blood type that his or her blood isn’t compatible with. Donated blood goes through a very careful matching process, so this reaction is very rare. If it does happen, it can cause chills, fever, kidney damage, and other serious symptoms. Symptoms can happen during the blood transfusion or in the next several hours. A delayed hemolytic reaction can also happen. This can happen even if your child received the right blood type. This may take days or weeks to happen. It may not cause any symptoms, but it can cause your child’s RBC count to be lower.

Too much blood in the body (transfusion overload). Transfusion overload may happen if a person get more blood than needed. It can cause shortness of breath and other symptoms. The symptoms usually happen within a few hours to a day. It’s more common in people with heart problems. Taking diuretic medicine after a blood transfusion may prevent this problem.

Too much iron in the body (iron overload). This can happen in people who need to have many blood transfusions over time for an ongoing medical condition.

Viruses being transmitted. The viruses can include HIV or hepatitis. Blood goes through a very careful screening before blood transfusions. The risk of a virus being passed on is extremely low.

Graft versus host disease. This is a condition where the new, donated blood cells attack cells in the body. It’s a serious but rare condition. It only happens in people with very weak immune systems. Symptoms such as fever and rash may start within a month of the blood transfusion.

Your child’s risks may vary according to his or her general health, the type of blood transfusion, and whether your child has had a blood transfusion before. Talk to the healthcare provider about which risks may apply to your child.

How do I get my child ready for a blood transfusion?

You likely won’t need to do much to get your child ready for a blood transfusion. Your child’s healthcare provider will let you know if your child needs to prepare in any way.

Make sure to tell the healthcare provider if your child has ever had a bad reaction to a blood transfusion. Your child may be given a medicine to help prevent an allergic reaction.

Most hospitals require a consent form before a blood transfusion. This needs to be signed by a legal guardian.

Your child’s blood will be tested before the blood transfusion to find out what type it is. This is to make sure that your child gets the right kind of donor blood. Your child’s finger may be pricked to get a few drops of blood. Or your child may have blood taken from a vein in his or her arm.

What happens during a blood transfusion for a child?

During the procedure, your child will be given blood from a one or more people who donated it. In some cases, your child may be given blood that was taken from him or her before. Or your child may be given blood by a family member or friend.

A healthcare provider will clean the area where the IV will go. He or she will insert an IV into one of your child’s veins, most likely in the arm. The whole blood or blood parts will be sent through this line. The whole process may take 1 to 4 hours.

A healthcare provider will watch your child for any signs of negative reactions. These are most likely in the first 15 minutes. Tell your child to let the healthcare provider know right away if he or she starts having symptoms.

Your child should be able to eat, drink, and go to the bathroom with help during the procedure. The healthcare provider will let you know about what else to expect.

What happens after a blood transfusion for a child?

After the blood transfusion, your child’s vital signs will be checked. These include their temperature and blood pressure.

Your child may be able to go home soon after the blood transfusion. They should be able to go back to their normal activities and eat a normal diet. Your child’s healthcare provider may give you additional instructions.

The area on the arm where your child had the IV may be sore for a few hours. Tell your child’s healthcare provider right away if your child has fever, trouble breathing, or swelling at the IV site.

Next steps

Before you agree to the test or the procedure for your child make sure you know:

• The name of the test or procedure

• The reason your child is having the test or procedure

• What results to expect and what they mean

• The risks and benefits of the test or procedure

• When and where your child is to have the test or procedure

• Who will do the procedure and what that person’s qualifications are

• What would happen if your child did not have the test or procedure

• Any alternative tests or procedures to think about

• When and how will you get the results

• Who to call after the test or procedure if you have questions or your child has problems

• How much will you have to pay for the test or procedure