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Transfusion-dependent anemia is a form of anemia characterized by the need for continuous blood transfusion. It is a condition that results from various diseases, and is associated with decreased survival rates. [1] [2] Regular transfusion is required to reduce the symptoms of anemia by increasing functional red blood cells and hemoglobin count.
[1] [2] [3] In adults, one unit brings up hemoglobin levels by about 10 g/L (1 g/dL). [4] [5] Repeated transfusions may be required in people receiving cancer chemotherapy or who have hemoglobin disorders. [1] Cross-matching is typically required before the blood is given. [1] It is given by injection into a vein. [6]
Historically, red blood cell transfusion was considered when the hemoglobin level fell below 100g/L or hematocrit fell below 30%. [3] [4] Because each unit of blood given carries risks, a trigger level lower than that, at 70 to 80g/L, is now usually used, as it has been shown to have better patient outcomes.
Transfusion dependent anemia is a form of anemia where ongoing blood transfusion are required. [91] Most people with myelodysplastic syndrome develop this state at some point in time. [92] Beta thalassemia may also result in transfusion dependence. [93] [94] Concerns from repeated blood transfusions include iron overload. [92]
Long-term transfusion therapy (in those with transfusion dependent beta thalassemia) is a treatment used to maintain hemoglobin levels at a target pre-transfusion hemoglobin level of 9–10.5 g/dL (11–12 g/dL in those with concomitant heart disease). [8] To ensure quality blood transfusions, the packed red blood cells should be leucoreduced.
Prior to surgery in people with sickle cell anemia (HbSS) who already have a hemoglobin above 85g/L, or who require a prolonged operation with general anesthetic, or who need high-risk surgery [3] [4] [6] [7] To optimise hemoglobin S levels, for example to prevent a stroke occurring in a child.
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The Surviving Sepsis Campaign recommended packed red blood cells transfusion for hemoglobin levels below 70 g/L if there is no myocardial ischemia, hypoxemia, or acute bleeding. [5] In a 2014 trial, blood transfusions to keep target hemoglobin above 70 or 90 g/L did not make any difference to survival rates; meanwhile, those with a lower ...