Counseling Patients
Sample script for obtaining informed consent for transfusion:
As part of your medical treatment, you need to receive a transfusion of a blood product. These products come from healthy volunteers from the general population who choose to donate blood for patients such as yourself. Blood donors and blood products are carefully screened and tested to minimize the risk of transmitting an infectious disease or problem. Careful testing is performed to match your blood with the donor blood you may receive (compatibility testing). It is impossible to eliminate all risks. Reactions such as allergy, chills, or fever may occur as well as rare unexpected and/or fatal reactions. However, not receiving a transfusion when needed also can carry a great risk of serious injury or death.
It is anticipated that you will need __________ transfusions over _________ period of time. There are alternatives to transfusion. Do you have any questions? Can you restate what I have told you?
Infectious Risks of Transfusion
| Virus | Estimated Risk per Unit transfused | Parasites | Estimated Risk per Unit transfused |
|---|---|---|---|
| HIV-1 & -2 | 1: 1,900,000 | Malaria | 1: 4,000,000 |
| HBV | 1: 205,000 | Trypanosoma cruzi (Chagas Disease) | Unknown |
| HCV | 1: 1,600,000 | ||
| HAV | 1: 1,000,000 | RBCs | 1: 500,000 have bacteria |
| HTLV-1& -II | 1: 2,500,000 | Platelets | 1: 75,000 have bacteria |
Non-Infectious Risks of Transfusion
| Risk | |
|---|---|
| Urticarial (mild allergic) Reaction | 1% – 3% |
| Febrile non-hemolytic Transfusion Reaction | 0.1-1% with leukoreduction |
| Transfusion-related Acute Lung Injury (TRALI) | 1:5,000 – 1:190,000 |
| Anaphylaxis | 1:20,000 – 1:50,000 |
| Acute hemolytic transfusion reaction due to ABO incompatibility | 1:80,000 |
| Acute hemolytic transfusion reaction – Fatal | 1:2,000,000 – 1: 3,000,000 |
Blood Product Supplier
The New York Blood Center supplies the majority of blood products used at SUNY Downstate Medical Center (SUNY). These products are collected from healthy volunteers who have been interviewed by an extensive questionnaire that lists the donor’s medical history, medication history and travel history before donating along with a limited physical assessment.
How much testing is involved?
(Testing performed by the New York Blood Center)
- ABO & Rh type
- Antibody Screen
- HTLV I & II
- HIV I & II
- Hepatitis B & C
- Syphilis
- Chagas Disease
- West Nile Virus
| Blood Type | How Rare is your Blood Type? | Can receive which type of RBCs? |
|---|---|---|
| O positive | 39% of the population | O+, O- |
| A positive | 31% of the population | O+, A+, O-, A- |
| B positive | 9% of the population | O+, B+, O-, B- |
| AB positive | 3% of the population | O+, A+, B+, AB+, O-, A-, B-, AB- |
| O negative | 9% of the population | O- |
| A negative | 6% of the population | O-, A- |
| B negative | 2% of the population | O-, B- |
| AB negative | 1% of the population | O-, A-, B-, AB- |