Blood transfusion in patient undergoing kidney transplant

What is the different feature of leucodepleted blood? Blood transfusion in a patient undergoing a kidney transplant.

Introduction:

Blood in addition is required by the patient’s body to compensate for the loss that occurs during surgery. It is advised to transfuse leucodepleted blood to avoid the complications that can occur due to more number of white blood corpuscles.

Leucocytes mean white blood cells which are a major component of blood. It constitutes 55% of the total blood component. 

The leucocytes when present in the blood which is being transfused, increases the risk for the recipient to undergo rejection of the transplanted organ.

More the leukocytes, the more the chance of graft rejection. The HLA that the recipient receives from the donor is foreign. This leads to the formation of anti-HLA antibodies in the host. This further leads to the rejection of the graft.

About leucodepleted blood.

  • Blood contains components like plasma, red blood cells or RBC, white blood cells or WBC which are also called leukocytes, and platelets in general. 
  • But blood to be transfused should not carry WBC in it to a larger extent. 
  • So, there are several medical procedures to remove the leukocytes from the blood that is donated for transfusion.
  • Leucodepleted blood hence means blood in which leukocytes are very low in concentration.
  • This type of blood imposes less risk of creating an adverse effect on the receiver’s body.
  • Leucodepleted blood, therefore, is given to the patient who needs immediate transfusion due to blood loss or in major transplantation surgeries where there is blood loss.
  • The chances of getting viral infections and bacterial infections are low.

What is a blood transfusion?

  • It is a process by which blood is administered to the patient’s body intravenously. Blood is stored in the blood banks as and when donated. Most preferably blood is collected from the donor just before the requirement. 
  • Blood can then be altered as per the patient’s requirement such as leukocyte depletion being an example.
  • The patient is connected by the sterile equipment to the blood pack. Blood is infused slowly into the vein of the patient.
  • For transfusion, proper matching of the donor and recipient is done. This is an important step.

Blood transfusion in kidney transplant.

Due to severe blood loss, blood is administered to the patient as per requirement by matching the blood group of the donor. Fresh frozen plasma is administered too. 

Reasons for blood transfusion in kidney transplant:

  • To avoid any hypovolemia complications in the patient.
  • To avoid hypovolemic shock.
  • To avoid hypotension and cardiac arrest.
  • To avoid anaemia.
  • To keep the patient stable.

Criteria for selection of the blood donor:

  • The patient can be a family member or a blood relative.
  • The blood group should match.
  • The donor should not have cancer or sexually transmitted disease.
  • The donor should be non-alcoholic, healthy, and willing to donate blood.

Complications of blood transfusion:

  • Skin rashes may appear.
  • The newly transplanted kidney may not get accepted by the body.
  • Anti HLA antibodies can cause other complications.
  • The patient may undergo shock.
  • If the equipment is not sterile it leads to infection and contamination.
  • The patient may get CMV, AIDS, and such deadly infections if the sterility is not maintained.

The patient requires a blood transfusion after a kidney transplant.

  • The patient who undergoes transplants about 50% of them requires a blood transfusion.
  • The requirement is due to bone marrow suppression as medications are given for various other reasons.
  • Also, graft functioning is faster when blood is given from external sources.
  • Anaemia is prevented and by which further deficiency of the blood components is prevented.

 

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