What You Need to Know About Blood Transfusion for Anemia

Generally, the threshold for needing a blood transfusion is a hemoglobin level below 7 to 8 grams per deciliter (g/dL) or lower. Hemoglobin is a protein in red blood cells, and low hemoglobin levels, as measured with a blood test, suggest anemia. Healthy hemoglobin levels are between 11 and 18 g/dL.

Recently, health experts have started to question if the 7 to 8 g/dL hemoglobin level for transfusion is correct, suggesting that people with a hemoglobin level of up to 9 g/dL may benefit from a transfusion as well.

A 2017 report in the journal Blood Transfusion recommends a more individualized assessment of a person with anemia, considering hemoglobin levels, other health indicators, and the person’s ability to access repeat blood transfusion procedures.

Sometimes a blood transfusion is done with what is known as “whole blood.” This contains red blood cells and other parts of blood like:

• white blood cells
• plasma
• platelets

Often a transfusion contains one or more of these components, depending on the recipient’s need. For someone with a low red blood cell count, getting an infusion of healthy blood, or primarily just red blood cells, can improve the body’s ability to carry oxygenated blood and support optimal health.

During your blood transfusion, you’ll be seated or lying down. A nurse will clean the part of your arm where the IV port will be inserted.

After you’re hooked up to the IV, the donated blood will slowly flow into your blood vessel through the IV line. Once you’ve received the prescribed amount, the IV line will be removed, and the insertion site will be bandaged. The entire process can take anywhere from 1 to 4 hours.

You’ll be monitored for any reactions throughout the procedure.

Before you leave for home, a nurse will check your temperature, blood pressure, and other vital signs. If everything seems OK, you’ll be discharged.

Once home, you can usually return to your typical activities. But it’s important to inform your healthcare team of any symptoms like:

• difficulty breathing
• fever
• swelling at the injection site

You’ll need follow-up blood tests to measure your red blood cell count and other markers. Your healthcare team will explain the timeline for future blood tests and follow-up appointments.

Blood transfusions are generally safe, but adverse reactions may occur. Some of the more common risks and complications include:

• Allergic reaction to the donated blood: This may occur during the transfusion or within the first 24 hours.
• Fever: It usually goes away on its own.
• Hemolytic reaction: This is a destruction of the donated red blood cells by the recipient’s immune system.
• Transfusion overload: This occurs when too much blood is given. It causes symptoms like shortness of breath.

It’s also possible that a blood-borne virus like HIV or hepatitis can be transferred during a blood transfusion. it’s important to know that careful and strict screening of donated blood reduces the risk and keeps the number of transfusion-based infections very low in the United States.

The National Heart, Lung, and Blood Institute suggests that mild cases of anemia may require no treatment at all. Also, if anemia is a side effect from medication taken or received to treat another condition, a healthcare professional changing that medication or its dosage may be enough to restore a healthy red blood cell count.

Sometimes anemia is related to autoimmune diseases or irregularites like iron, vitamin B12, and folate deficiencies. These three nutrients are key building blocks of red blood cells.

For deficiencies in these crucial nutrients, supplements — taken orally or by injection — may be enough to restore healthy red blood cell production. Your doctor may also recommend eating a balanced diet to receive recommended amounts of iron, B12, or folate.

A bone marrow transplant may be necessary to treat certain types of anemia, such as aplastic anemia, which occurs when the body stops making enough of certain cells, including red blood cells.

Barring any negative reactions to the transfusion, the outlook for many people with anemia is good, but it depends on what’s causing your anemia.

People with anemia that low iron levels or other nutrient deficiencies causes tend to do well with transfusions and regular supplementation.

Likewise, if your anemia results from substantial blood loss, a transfusion may be enough to balance your red blood cell count.

For some people with anemia, especially older adults and others with multiple health challenges, blood transfusions may not be enough.

How much blood will I receive during a transfusion?

Usually, one unit of blood — about a pint, is administered in one transfusion. This unit contains about 200 milliliters (mL) of red blood cells, as well as plasma and other substances. Receiving too much blood may be harmful.

Does insurance cover blood transfusions?

If you’ve received a confirmed diagnosis of anemia, most health insurance providers will cover all or part of the costs of blood transfusions. Check with your insurance provider for more details.

When will I need my next blood transfusion?

The type of anemia you have and whether you live with other health conditions will determine whether you’re likely to need another transfusion.

People with certain types of bone marrow disorders (bone marrow is where red blood cells are mainly produced) may need a blood transfusion every few weeks. Others may need one every few months.

A blood transfusion is a common treatment for anemia. The frequency of transfusions depends largely on the cause of anemia and how an individual reacts to the procedure.

Though there are some risks and potential complications associated with blood transfusions, they’re generally safe and effective in restoring vital oxygen-rich red blood cell levels.