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INTRODUCTION

Transfusion encompasses the use of blood components (BCs) to prevent or treat anemia, hemorrhage, and bleeding disorders. Occasionally, BCs may be used to treat infection or relapse of malignant blood diseases after allogeneic hematopoietic transplantation. BCs comprise mainly red blood cell concentrates (RBCCs), platelet concentrates (PCs), and plasma for transfusion use (as opposed to plasma for fractionation into medicinal products such as albumin and immunoglobulin). Alongside transfusion safety, ensuring BC quality, assessing in vivo efficacy, and promoting evidence-based transfusion practices are critical aspects of transfusion medicine.

Blood collection and donor medicine do not fall within the scope of this chapter. Although the processes used are particularly safe, blood donations can cause adverse reactions, among which are fainting reactions and iron deficiency. These risks require preventive approaches and appropriate treatment when needed.

BLOOD COMPONENTS

BC collection and manufacturing processes are described in Table 113-1. Most common BCs are collected as whole blood or directly as components by apheresis. The vast majority of BCs are homologous. Autologous BCs, sometimes collected ahead of planned surgery, are now exceptional as they present little to no evidence-based advantage over homologous BCs. Nevertheless, such donation may still be of benefit in the presence of a rare blood group phenotype.

TABLE 113-1Blood Components: Collection and Manufacturing Processes

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