Blood Transfusions and Associated Risks
Blood transfusions are not without risk, such as acute transfusion
reactions, ranging from mild to life-threatening, such as mild
urticaria, acute haemolytic reactions, transfusion-associated
circulatory overload and transfusion-related acute lung
injury35. In several cases, the risk is greater when
transfusing blood products versus management without transfusion.
Engoren et al. found that even after comorbidities, age and
additional confounding variables were accounted for, the 5-year
mortality rate had increased by 70% in patients that received a blood
transfusion compared to those who did not36.
Similarly, research including 10,289 patients receiving blood
transfusions demonstrated, after controlling factors such as
demographics and comorbidities, a reduction, not only in immediate, but
in long-term survival37. Furthermore, when haematocrit
is low, theoretically a patient would benefit most from a blood
transfusion, however, this was found not to be the case and a low
haematocrit is associated with a higher complication and mortality
rate38. It is imperative that clinicians are able to
optimise patient care, especially for Witness patients, at all stages of
treatment in order to avoid poorer outcomes.