An exchange transfusion is a medical procedure that’s done by removing and replacing your blood with blood or plasma from a donor. This is done by using a catheter to transport blood into your body.
An exchange transfusion is typically used to treat life-threatening blood abnormalities, such as blood cell disorders, in both children and adults.
Learn why exchange transfusions are done, how the transfusions are administered, and what to expect from an exchange transfusion.
An exchange transfusion can help reduce or stop the symptoms of conditions like jaundice or blood disorders like sickle cell anemia.
Jaundice happens when too much of a chemical called bilirubin builds up in your body. This can cause yellowing of the skin and the whites of the eyes.
It’s fairly common in newborns during the first few weeks of life, especially in children born before the 38th week of pregnancy.
Sickle cell disease (SCD) is a group of blood conditions that cause red blood cells to stiffen and become crescent-shaped. This shape keeps them from flowing properly through the circulatory system, causing blockages in capillaries.
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Your doctor may also recommend an exchange transfusion to treat other issues related to your blood chemistry, or to fight against toxic symptoms caused by drugs or poisons.
An exchange transfusion is performed in a hospital or clinic. During the procedure, your blood will be removed and replaced with blood or plasma from a donor.
Here’s how the procedure works:
- Your doctor places two small tubes called catheters into a vein in your arm.
- Your blood is withdrawn in cycles. Each cycle takes a few minutes, and the catheters take in about 5–20 milliliters during each cycle.
- As blood is removed during each cycle, a fresh cycle of blood or plasma from a donor is pumped into your body through another catheter.
As with any blood transfusion, there are some possible risks and side effects, including:
- mild allergic reactions
- fever due to infection
- trouble breathing
- electrolyte abnormalities
- chest pains
Your doctor will stop the transfusion right away if you experience one of these side effects or reactions. They’ll then decide whether to continue the transfusion or start again later.
It’s also possible (though rare) for donor blood to be contaminated with:
- hepatitis B or hepatitis C
- variant Creutzfeldt-Jakob disease (the human variant of mad cow disease)
- a virus, such as HIV
Blood banks screen all the blood donated to them carefully to make sure that this doesn’t happen.
You may be at risk of iron overload if you need multiple blood transfusions over a relatively short period of time.
Iron overload means that too much iron has accumulated in your blood. Without treatment, this can cause damage to your heart, liver, and other organs.
In these cases, your doctor will provide chelation therapy to remove the extra iron from your body. Chelation therapy is given either as an oral medication or as an injection.
Lung damage, known as transfusion-related acute lung injury (TRALI), is another rare possible side effect of a blood transfusion.
TRALI usually happens within the first 6 hours of the transfusion if it does occur. Most people will fully recover, though in rare cases it may be fatal.
Before your transfusion, your doctor will give you a simple blood test to confirm your blood type. They’ll just need to prick your finger to get a few drops of blood.
Your blood is then labeled and sent to a lab where a machine will analyze it to determine your blood type. This ensures that the blood you receive for your transfusion matches your own blood type. If donor blood doesn’t match yours, it will make you sick.
In most cases, you don’t need to change your diet before a blood transfusion.
Let your doctor know if you’ve had allergic reactions to blood transfusions in the past.
After your transfusion is completed, your doctor will check your blood pressure, heart rate, and temperature.
Once all these readings are normal, your doctor removes the intravenous lines. Young children getting a transfusion may need to stay in the hospital for a few days to be observed for any side effects.
You may notice some mild bruising around the area where the needles were inserted for a few days after the transfusion.
Your doctor may also recommend follow-up blood tests to monitor your blood.