Blood Transfusions for Beta Thalassemia

Medically Reviewed by Hansa D. Bhargava, MD on November 18, 2019

Blood transfusions could be a regular thing if you or your child has a blood disorder called beta thalassemia. The disease causes a drop in the amount of red blood cells you have. A transfusion gives you healthy red blood cells from a donor to make up for the ones you don't have.

Regular transfusions can help prevent beta thalassemia complications like:

  • Weak bones
  • Enlarged spleen
  • Slow growth
  • Heart problems

If you're the parent of a child with beta thalassemia, it's important to find support for the emotions you may feel as you help your child manage the disease. Reach out to your family and friends for the backing you need. If you find you're feeling stressed or anxious, ask your doctor how to find a mental health professional who can help.

Do I or My Child Need Transfusions?

Beta thalassemia lowers your hemoglobin -- a protein that helps red blood cells carry oxygen to your organs and tissues -- and causes a drop in your red blood cell count.

The type of beta thalassemia you or your child has will help your doctor decide if you need blood transfusions.

If you have the mildest form, beta thalassemia minor, you likely won't need transfusions or any other treatment.

For a type called beta thalassemia intermedia, you may need transfusions at certain times, like when you're sick or before you have surgery.

If you have the most severe form, beta thalassemia major, you'll need regular transfusions.

Your doctor will decide whether to start you or your child on blood transfusions based on your symptoms and hemoglobin level. You'll often get transfusions when your blood hemoglobin level drops below 7 grams per deciliter (g/dL).

Your baby will likely need regular transfusions if they have low hemoglobin and is very tired, doesn't sleep well, or is developing more slowly than usual.

Even if your child has higher hemoglobin levels, they may need transfusions if they have symptoms like:

  • An enlarged spleen
  • Tiredness and trouble breathing from anemia
  • Bone fractures
  • Bony growths on the face or other areas
  • Slowed growth

What Happens Before the Transfusion?

The blood you get has to be the right match or you could have a dangerous reaction to it. Blood comes in several types: A, B, AB, or O, which are either positive or negative. Blood types get their names based on which proteins are on the surface of the blood cells.

If you get the wrong type of blood, your immune system -- your body's defense against germs -- could see it as dangerous and attack it. Some immune reactions can be serious. That's why before your transfusion, your medical team will match you with the right blood type.

Another test checks your blood for other antibodies that could make your immune system react to the donated blood. Your medical team will carefully match you to your donor's blood based on these antibodies.

What Happens During a Transfusion?

You or your child will get blood transfusions once every 2 to 4 weeks. You'll visit a hospital or doctor's office for the transfusions.

A doctor or nurse will put an IV into a vein in your arm with a needle. They'll keep tabs on your heart rate, blood pressure, and other vital signs during the transfusion.

They'll also check to make sure you don't have a reaction. The whole transfusion takes between 1 and 4 hours.

What Are the Risks?

Getting a blood transfusion is safe, but there are a few possible risks involved.

Infections. Health care professionals screen the blood used in transfusions carefully to prevent infections like HIV and hepatitis. The risk of getting HIV from a blood transfusion today is less than 1 in 1 million. The risk of hepatitis B is slightly higher, but you'll get a hepatitis B vaccine to protect you before you start transfusions.

Allergic reactions. Sometimes the immune system reacts to the transfusion. This can start right away or a few days later. Some reactions are more serious than others.

An allergic reaction is the most common type. It happens when your immune system sees proteins or other substances in the blood you receive as foreign and attacks them. Mild cases cause symptoms like hives and itching, which you can treat with an antihistamine.

Severe allergic reactions are rare, but they can cause serious symptoms like a fast heartbeat and fainting. Taking epinephrine or steroids should stop the reaction.

Febrile reaction. This happens when your body reacts to white blood cells in the donated blood. You'll run a fever and you may have symptoms like headache, nausea, and chills. If you've had a febrile reaction in the past, your doctor can give you blood without the white blood cells next time.

Transfusion-related acute lung injury (TRALI). It's a rare but serious reaction to plasma -- the fluid part of the donated blood. It causes fluid to fill the lungs. It can happen during a transfusion or up to 6 hours later.

The main symptom from TRALI is trouble breathing. You're more likely to have this reaction if you had a recent operation, injury, or illness. To prevent TRALI, your doctor can give you blood that has had most of the plasma removed.

Acute hemolytic reaction. It's the most serious type of reaction, but it's very rare. It happens if you get the wrong type of blood. Your immune system attacks the donated red blood cells, causing them to break open and release dangerous substances into your body.

The symptoms include chills, fever, low back pain, and nausea. If this happens, your doctor will stop the transfusion right away.

Delayed hemolytic reaction. This is when your body attacks the new blood cells over a period of days or weeks. The red blood cells slowly break apart. If you have this reaction, your doctor will give you special blood tests before your next transfusion to prevent it.

Iron overload. The blood cells that you get in a transfusion have iron. Over time, iron can build up in your body to the point where it overloads organs like your heart and liver.

If this happens, you may need chelation therapy. It's a treatment that uses pills or shots of medicine that bind to extra iron and remove it from your body.

WebMD Medical Reference



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American Red Cross: "Facts About Blood and Blood Types."

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Cooley's Anemia Foundation: "Transfusion Issues in Thalassemia."

International Society of Blood Transfusion: "Clinical Transfusion."

Mayo Clinic: "Thalassemia."

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National Heart, Lung, and Blood Institute: "Blood Transfusion."

USCF Benioff Children's Hospital: "Blood Transfusions," "Genetics of Thalassemia,"  "Standard-of-Care Clinical Practice Guidelines."

U.S. National Library of Medicine: "Beta Thalassemia."

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