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Doctors' Answers to "Frequently Asked Questions" - Blood Transfusion

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Blood transfusions and access ports
Question: I require red cell transfusions every three weeks due to severe blood loss (self inflicted by cutting with a razor blade). My HB when I have a transfusion is usually around 4 although it has been as low as 3. It is not possible to get a peripheral line in as my veins are dry at the time of transfusion so I require a cvp line each time. It has been suggested that I have a permanent line inserted. This would have to be an implanted port, as my consultant does not believe that I wouldn't open up an external line and bleed myself that way. What types of implanted ports are available and which would be most suitable in my situation? Would the risk of infection with an implanted port be similar to that of the cvp line? I have been told that the insertion of a cvp line has certain risks including hitting an artery, puncturing a lung, etc. What are the statistics for the occurrence of problems when inserting a cvp line? What problems are likely with repeated blood transfusions?

Answer: Unless you are repeatedly opening your blood vessels, one transfusion should be all that you need. I am not sure that the cause of your anemia has been found. In any case, implanted ports tend to have less infections since there is a skin covering over the area, versus a cvp which exits through the skin. It is the break in the skin that provides the usual port of infection. However, any foreign body in any system of your body is prone to infection . A blood transfusion has several potential risks. First is infection - hepatitis, AIDS virus, bacterial, etc. The risk is low due to screening tests, but is not zero. Second is transfusion reactions. The likelihood of these rises with repeated infections. Again, good testing minimizes these, but they exist. Third, iron overload. This will not occur if blood is lost. However, repeated transfusions with losing iron (usually as lost blood) will cause iron build up in your system leading to potential dysfunction of your heart, liver, pancreas, etc.

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