Every few seconds, someone needs a life-saving blood transfusion. Blood transfusions are typically administered without complication. However, when a child will be having a transfusion, it's important for parents to be aware of the way the procedure works and the potential complications that may occur, even if the risks are low.

Blood transfusions are used to replace blood, or any blood component, that has been lost, is missing, or isn't working properly. A blood transfusion lasts anywhere from one to four hours, and the new blood is typically transferred to the recipient through an intravenous line.

Blood transfusions help children with illnesses affecting the blood, such as sickle cell disease, thalassemia, aplastic anemia, and others. Children who have anemia due to disease-modifying treatments, such as chemotherapy for cancer, and children who have lost blood due to an injury or surgery also need transfusions.

Blood is a combination of cells and liquids. The child typically receives parts of the blood like platelets, red blood cells, white blood cells, or plasma. Whole blood transfusions are given, but they are rare. 

The blood component most frequently transfused is red blood cells. These red blood cells shuttle oxygen between organs and tissues. Platelets and plasma can help with blood clotting.

The majority of transfusions are completed without complications. Still, it's important for parents to be aware of potential risks, including a mild or severe allergic reaction caused by the recipient’s immune system’s response to proteins in the transfused blood. Some symptoms could be itching or hives.

A child receiving a blood transfusion may experience fever, chills, or nausea, caused by a reaction between the immune cells in the transfused blood and the immune system of the recipient.

The risk of a more serious complication also exists. For example, if a recipient's blood and a donor's blood do not match, the immune system of the recipient may attack and destroy the red blood cells in the donor blood. This is called a hemolytic transfusion reaction, and these types of reactions can be life-threatening. There is also a very small risk of infectious disease transmission via blood transfusion.

The recipient and the donor must share blood group compatibility. In rare situations, transfusions may be completed on an “emergency release” basis, which means blood that is typically universally compatible with all recipients is transfused before the blood bank laboratory work-up for compatibility is complete.

Blood banks are regulated by the Food and Drug Administration (FDA) and must pass routine inspections in order to operate.

Donated blood is tested for hepatitis B and C, HIV, Human T-lymphotropic virus (HTLV), syphilis, and West Nile virus, as well as others. Some infectious agents, such as malaria, are screened for during donor questioning.

As a result of this testing and the donor questionnaire, the risk of receiving contaminated blood is very low.

"It takes a team-based approach to provide optimal care for children who need blood transfusions," says Jeanne Hendrickson, MD, associate director of Yale Medicine's Transfusion Medicine Program.

At Yale Medicine, pediatric hematologists and oncologists, pediatric intensive care physicians, pediatric emergency department/trauma specialists, pediatric surgeons, anesthesiologists, transfusion medicine physicians, pediatric nursing staff, and many others work together to care for young patients.

"The support of medical technologists in the blood bank, the hematology labs, and the microbiology labs is also critical,” says Dr. Hendrickson. “Each team member plays an important role. It's nice to have all this care under one roof."