A Doctor’s Appraisal of Transfusion Risks

UNDER the heading “The dangers of transfusion,” Dr. Salomão A. Chaib wrote in Shopping News of São Paulo, Brazil:

“There is no doubt that the use of blood, in certain cases, is exaggerated and abused. Perhaps better attention, so as to avoid loss of blood, would reduce the number of transfusions.

“ . . . Unquestionably, the transfusion is an important safety factor and oftentimes the only means to save a life in danger. However, it presents certain risks, as all transplants; a transfusion is nothing but a transplant. It may be responsible for transmitting many diseases, such as syphilis, malaria, hepatitis, Chagas’ disease, viruses; the blood may have been contaminated while being drawn and may contain bacteria and provoke infection and sepsis [blood poisoning].

“ . . . Stocked blood loses its platelets and reduces the recipient’s capacity to coagulate the blood. When administered in large quantity, the result will be a stronger bleeding during and after an operation. This forms a vicious circle, the more blood received the more bleeding. . . .

“One must be alert to the fact that persons who have received many transfusions develop antibodies against strange blood and should neither donate nor receive blood, except with caution and under observation, watching for any reaction. . . .

“But the worst accident is the transfusion of incompatible blood. This provokes immediate shock, lack of air, high temperature and tremors. Red blood corpuscles are destroyed, the patient passes blood in the urine, there is kidney damage, and there may be uraemia [disease due to faulty kidney action]. These reactions are difficult to observe in the patient under anesthetic, as they are disguised by the anesthetic; the alert surgeon will notice that the cut tissues begin to bleed profusely, staining and soaking everything, which may be the alarm signal. Fortunately, if treated in time, the body almost always recuperates, if the kidneys are not overly damaged.

“In the United States, with all technical precision, about 8 million blood transfusions are performed every year, with an incidence of 160,000 cases of reaction. In this country [Brazil], the percentage, without any doubt, must be higher.”