Will You Need a Blood Transfusion After Open Heart Surgery?

Transfusions save lives, but also carry risks
Will You Need a Blood Transfusion After Open Heart Surgery?

Contributor: Faisal Bakaeen, MD

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If you’re having open heart surgery, it’s possible that you’ll need a blood transfusion afterward. Although a transfusion can save your life, patients who don’t need them tend to do better after surgery.

The good news is that doctors are finding new ways to reduce the need for blood transfusions for patients who have open heart surgery. But you still need to prepare for the possibility and learn more about how it may affect your recovery.

Why a blood transfusion becomes necessary

During a major procedure like open heart surgery, it’s common to lose a substantial amount of blood. With blood loss comes anemia, a lack of red blood cells and hemoglobin in the blood.

Since red blood cells deliver oxygen to body tissues, anemia can create life-threatening problems after surgery. A blood transfusion brings new red blood cells into your body, helping to alleviate post-operative anemia.

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Transfusion risks along with benefits 

Although blood transfusions can save lives, doctors must carefully weigh whether the potential benefits of a transfusion outweigh the risks.

A blood transfusion can increase your risk of infection — but not for the reasons you might think. Blood collection agencies screen donations for pathogens such as hepatitis and HIV, and the risk of becoming infected is low.

However, a blood transfusion can weaken your immune system. This makes you more susceptible to infections you might pick up elsewhere.

Other potential complications include:

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  • Transfusion-related acute lung injury, a condition in which the lungs become injured as a result of the transfusion
  • Hemolytic reaction, in which your body attacks the red blood cells of the transfused blood

Both of these conditions are treatable but can make your recovery more difficult.

Techniques that reduce likelihood of transfusions 

Ask your doctor about ways to reduce the chance that you’ll need a blood transfusion. Options to explore include:

  • Minimally invasive surgery. Depending on the kind of surgery you’re having, your doctor may be able to use methods that result in smaller incisions and less blood loss.
  • Blood salvage efforts. Doctors can not only minimize blood loss, but also maximize blood return during surgery. For example, a heart-lung machine cycles blood from your body and returns it during bypass surgery. This also removes some risks of receiving blood from another person.
  • Donate blood before surgery. In some cases, you can donate your own blood prior to surgery. Doctors then can use this blood if you need a transfusion. Your doctor may advise against this, however, as it could make you anemic before surgery. If you go this route, you’ll need to make your donation as far in advance as possible to give yourself time to recover.

Talk to your doctor to prepare yourself

It’s important to understand whether a blood transfusion is likely after your open-heart surgery. You should discuss the possibility and talk about how a transfusion can affect your recovery.

Make sure to talk to your treatment team about how team members make this decision when the time comes. Also, don’t hesitate to ask questions so that you have a good understanding of how it might affect you.

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