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Blood Transfusion Consent: An Important Decision to Protect Your Health

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Anesthesia - Intensive Care Department
A06-034
TS BS.
Nguyễn Tất Nghiêm
Khoa Gây mê - Hồi sức
View detail
Tìm hiểu về tầm quan trọng của việc ký đồng thuận truyền máu chu phẫu. Nắm rõ lợi ích, nguy cơ và cách đưa ra quyết định sáng suốt để bảo vệ sức khỏe của bạn.

Blood transfusion is an important medical procedure that can be life-saving for patients in emergency situations or during surgeries with a high risk of major blood loss. However, like any medical intervention, blood transfusion also carries certain risks. Understanding the procedure, its benefits and risks, and making an informed consent decision are the rights and responsibilities of every patient and their family members.

1. At-Risk Groups

The following patients are generally at higher risk of requiring blood transfusion and should pay particular attention to the consent process:

  • Patients who may require blood transfusion during major surgery, particularly cardiac, liver, kidney, or aortic surgery—procedures involving highly vascular organs or structures with a high risk of major blood loss [3, 4].
  • Patients with severe trauma, acute gastrointestinal bleeding, or other conditions causing acute blood loss [4].
  • Patients with chronic anemia or coagulation disorders who require transfusion support to maintain their health [4].

2. Benefits of Blood Transfusion

Timely and appropriate blood transfusion provides several essential benefits and can be life-saving:

  • Saving lives in cases of acute blood loss: When the body loses a large amount of blood due to trauma or surgery, blood transfusion helps restore circulating blood volume, maintain stable blood pressure, and ensure adequate oxygen delivery to vital organs such as the brain, heart, and kidneys [4].
  • Improving anemia: Red blood cell transfusion improves oxygen-carrying capacity and rapidly relieves symptoms associated with anemia, such as fatigue, shortness of breath, dizziness, and pallor [4].
  • Stabilizing hemodynamics and coagulation: Blood products such as fresh frozen plasma (FFP) or platelets can replace deficient clotting factors, helping control bleeding, prevent serious complications, and support recovery [4].

3. Risks and Complications of Blood Transfusion

Although significant advances have been made in improving blood transfusion safety, potential risks and complications remain, ranging from mild to severe [2, 3].

3.1. Acute Reactions Occurring Within 24 Hours After Transfusion

  • Febrile non-hemolytic transfusion reaction (FNHTR): This is the most common reaction, characterized by fever and chills [2, 3].
  • Allergic reactions: These may present as urticaria, itching, or erythematous rash. In rare cases, they may progress to life-threatening anaphylaxis [2, 3].
  • Acute hemolytic transfusion reaction (AHTR): Although very rare, this reaction is extremely serious and is commonly associated with ABO-incompatible transfusion. Symptoms may include fever, chills, back pain, hematuria, acute kidney injury, coagulation disorders, and a high risk of death [2, 3].
  • Transfusion-related acute lung injury (TRALI): One of the leading causes of transfusion-related mortality, TRALI presents with respiratory distress and non-cardiogenic pulmonary edema within 6 hours after transfusion [2, 3].
  • Transfusion-associated circulatory overload (TACO): This occurs when blood is transfused too rapidly or in excessive amounts, particularly in patients with a history of cardiovascular or kidney disease. It may cause shortness of breath, cardiogenic pulmonary edema, and hypertension [2, 3].

3.2. Delayed Complications Occurring After 24 Hours to Several Days or Weeks

  • Infections: The risk is very low due to modern screening tests, but infections such as hepatitis B, hepatitis C, HIV, or bacterial sepsis may still occur [2, 3].
  • Delayed hemolytic transfusion reaction (DHTR): This occurs when the body produces antibodies against transfused red blood cells several days after transfusion [2, 3].
  • Iron overload: This is commonly seen in patients who require repeated blood transfusions and may cause damage to organs such as the heart, liver, and endocrine glands [2, 3].
  • Alloimmunization: The body produces antibodies against antigens on transfused blood cells, which may make subsequent blood transfusions more difficult [2, 3].

Obtaining consent before blood transfusion is an essential step in ensuring the patient's rights and safety.

  • Ensuring patient autonomy: Every patient has the right to receive adequate information and make decisions regarding any treatment provided to them [1].
  • Sharing information and understanding risks and benefits: The consent process ensures that patients receive clear explanations from their doctors about the purpose, benefits, risks, and available alternatives, and have the opportunity to ask questions and clarify any concerns [1].
  • Legal and ethical basis: Informed consent is an important legal and ethical requirement in healthcare, protecting both patients and healthcare professionals from avoidable disputes [1].

4.2. Information That Should Be Provided

Before signing the consent form, the patient or their family member should receive the following detailed information [1]:

  • The specific purpose of the blood transfusion.
  • The expected benefits of blood transfusion.
  • Potential risks and complications, including rare but serious complications.
  • Alternative treatment options or the possibility of not receiving a blood transfusion, where applicable, along with the risks and benefits of each option.
  • The validity period of the consent form.

4.3. The Role of Patients and Family Members

  • Actively and carefully listen to the information provided by the doctor.
  • Ask questions to clarify any concerns before signing the consent form and do not hesitate to request further explanation.
  • Inform the doctor about any history of allergies, previous transfusion reactions, or underlying medical conditions.

5. Always Consult With Your Anesthesiologist and Intensivist

During surgery, particularly procedures with a high risk of major blood loss, the anesthesiologist and intensivist is directly responsible for determining whether a blood transfusion is indicated. They will explain in detail the need for blood transfusion, the blood products expected to be used, and the associated risks, helping patients and their family members make an informed decision.

6. Medical Review and References

  • Medical Review:
    • Medical consultation: PhD, MD Nguyen Tat Nghiem, University Medical Center Ho Chi Minh City
    • Updated: November 6, 2025
  • References:
    • [1] Murphy, M. F., Harris, A., & Neuberger, J. (2021). Consent for blood transfusion: summary of recommendations from the Advisory Committee for the Safety of Blood, Tissues and Organs (SaBTO). Clin Med (Lond), 21(3), 201–203. https://pmc.ncbi.nlm.nih.gov/articles/PMC8140698/. Accessed: November 6, 2025.
    • [2] Khan, A. I., Goldin, J., & Gupta, G. (2025). Noninfectious Complications of Blood Transfusion. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK574536/. Accessed: November 6, 2025.
    • [3] Buerger, C. S., & Jain, H. (2025). Infectious Complications of Blood Transfusion. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK585035/. Accessed: November 6, 2025.
    • [4] Lotterman, S., & Sharma, S. (2025). Blood Transfusion. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK499824/. Accessed: November 6, 2025.

The information above is for reference purposes only and is not intended as medical advice. Please contact your doctor for detailed medical consultation.

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