What are the indications for blood transfusion?

Dec 12, 2025 Source: Cainiu Health

Dr. Li Feng

Introduction

In general, the indications for blood transfusion mainly include acute blood loss, chronic anemia, coagulation disorders, severe infections, and hematologic diseases. Blood transfusion should be determined based on a comprehensive assessment of the patient's specific condition, strictly adhering to relevant indication criteria to avoid unnecessary or blind transfusions. At the same time, standardized procedures must be followed to ensure the safety and effectiveness of treatment.

Generally, indications for blood transfusion mainly include acute hemorrhage, chronic anemia, coagulation disorders, severe infections, and hematologic diseases. A detailed analysis is as follows:

1. Acute Hemorrhage: Indicated for acute massive blood loss caused by trauma or surgery. When hemoglobin drops below 70 g/L or blood loss exceeds 20% of total blood volume, timely blood transfusion is required to restore blood volume, maintain organ perfusion, and prevent shock.

2. Chronic Anemia: Indicated for severe anemia resulting from chronic conditions such as iron deficiency anemia or megaloblastic anemia. Transfusion may be considered when hemoglobin falls below 60 g/L and is accompanied by significant symptoms such as fatigue, palpitations, and dyspnea, to alleviate discomfort.

3. Coagulation Disorders: Indicated for deficiencies in clotting factors or thrombocytopenia caused by conditions like hemophilia or liver cirrhosis. In cases of severe bleeding—such as visceral hemorrhage or widespread mucocutaneous bleeding—transfusion of platelets or clotting factors is necessary to correct coagulation function.

4. Severe Infections: Indicated for serious infections such as sepsis or severe pneumonia, particularly in patients with profound neutropenia. Transfusion of granulocyte concentrates may enhance the body's ability to fight infection and assist in controlling infectious symptoms.

5. Hematologic Diseases: Indicated for diseases such as leukemia and aplastic anemia, which are often associated with complications including anemia, bleeding, and infection. Red blood cells, platelets, or other blood components should be transfused according to the clinical condition to maintain basic bodily functions.

Blood transfusion decisions should be made based on a comprehensive assessment of the patient’s specific condition. Strict adherence to established transfusion indications is essential to avoid unnecessary transfusions. Additionally, standardized procedures must be followed to ensure the safety and effectiveness of treatment.

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What is the most common complication of blood transfusion?

There is no such thing as "the most common complication of blood transfusion." Common complications of blood transfusion include febrile reactions, allergic reactions, hemolytic reactions, circulatory overload, and transmission of infections. If any discomfort occurs during or after a blood transfusion, medical staff should be informed immediately for prompt management. These complications often appear within 1–2 hours after the transfusion.

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What precautions should be taken during blood transfusion?

In general, key considerations during blood transfusion mainly include strict verification of information, control of transfusion rate, close monitoring for reactions, adherence to standardized procedures, and proper handling of blood products. Prior to transfusion, two medical personnel must jointly verify the patient's name, gender, age, hospital number, blood type, blood bag number, and blood component type to ensure complete consistency of all information and prevent serious adverse reactions due to transfusion errors.

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Is blood transfusion useful for anemia?

Whether blood transfusion is effective for anemia depends on the specific situation. In cases of severe anemia or emergency symptoms, blood transfusion can rapidly alleviate the condition. However, for mild to moderate anemia without significant discomfort, transfusion is not necessary, and treating the underlying cause takes priority. Daily care should focus on targeted management of the cause; individuals with nutritional deficiencies should maintain a balanced diet and supplement the required nutrients.

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Which blood type is prone to hemolysis?

In blood transfusion scenarios, type O red blood cells lack A and B antigens, but the plasma contains anti-A and anti-B antibodies. If a type O patient receives type A, B, or AB blood, the antibodies in the plasma may bind to the antigens on the transfused red blood cells, triggering a hemolytic reaction. Conversely, when type O blood is given by a donor to a non-type O recipient, the antibodies in the donor's plasma may also attack the recipient's red blood cells.