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Transfusions of Packed Red Blood Cells (PRBCs)

What Are Packed Red Blood Cells?

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Updated June 02, 2013

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Blood Specimens

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What Are Packed Red Blood Cells (PRBCs)?

Packed red blood cells, also known as PRBCs or simply "packed cells", are a type of blood replacement product used for blood transfusions. If a patient needs blood, there are multiple types of blood replacements available. A physician will make the choice of what type of blood replacement will be given.

Packed red blood cells are typically given in situations where the patient has either lost a large amount of blood or has anemia that is causing notable symptoms.

Most people think that when they receive a blood transfusion, they are getting whole blood, because that is what they what donate at a blood drive. The blood one donates, referred to as "whole blood," has both the plasma and the red blood cell components. Plasma is the liquid portion of the blood and is light yellow in color and makes up 55% of the volume of blood. Red blood cells make up 45% of blood, and are the red color that most people think of when they think of blood.

This whole blood is not typically transfused, unless the patient needs a massive amount of blood to counteract tremendous blood loss. Instead, packed red blood cells, which is whole blood minus the plasma portion, is typically given.

Why Red Blood Cells?

Red blood cells are essential to good health and can be lost due to trauma (gunshot wound, car accident), internal bleeding, or health problems such as significant anemia. Red blood cells carry oxygen from the lungs to the tissues of the body. To determine if a blood transfusion should be given, a blood test called a complete blood count (CBC) is done.

A person who needs red blood cells often feels weak, and may feel out of breath with minimal activity. Prior to a needed transfusion, a patient may appear pale and feel fatigued. They may feel dizzy, may feel like their heart is "racing" or have difficulty concentrating.

Packed Red Blood Cell Transfusions

Whole blood is not typically transfused, instead, the component the patient needs is given. The patient may receive plasma, or packed red blood cells, or if there is a need both may be given.

After donated blood is collected, the components are separated in a centrifuge, then a small amount of an anticoagulant is added to keep the packed red blood cells from clotting. The blood is kept in a refrigerator, and is good for approximately 42 days from the date of donation.

PRBCs must be matched to the recipient, meaning that the blood type of the donor and the recipient must be compatible. If the blood is not properly matched, the result can be a life-threatening reaction, so the match is typically double checked by lab staff and nursing staff at the minimum.

Approximately one in seven hospitalized patients needs a transfusion. The chances of needing a transfusion are higher when having surgery, and you may be told prior to the procedure that you will require blood. Some patients prefer to avoid a transfusion when possible, or have religious beliefs that forbid transfusions. For this reason, bloodless surgery, a group of techniques that help patients avoid or minimize the need for blood.

Risks of Blood Transfusion

Safety of the Blood Supply

Extensive testing is done to prevent tainted blood from reaching the blood supply. An initial screening is done to make sure the donor has no medical conditions or high risk behaviors that make blood donation unwise. The donor is also screened for current illnesses, such as having a cold or the flu or having an infection (a risk for spreading infection or colds to the recipient). Once the blood has been collected, it is tested for infectious diseases, including hepatitis and HIV.

The blood supply in the United States is among the safest in the world, however, if you are in a country outside of the US, the level of safety may vary widely. Abroad, you may have difficulty obtaining a blood transfusion (limited supply), the supply may not be considered safe, or testing may not be adequate.

Cost of Blood Transfusion

A transfusion of one unit (one bag) of packed red blood cells ranges from $522 to $1,183. The number of units given in a transfusion can range anywhere from one unit for someone who is anemic, to forty or fifty for a critically ill patient who is hemorrhaging and will die without blood immediately.

While it is true that donors are not compensated for donating their blood, aside from a token gift or a snack, blood is still quite costly. These fees help pay for the staff that runs blood drives and processes the blood, transportation costs, blood bank staff and the nursing staff that gives the blood.

Sources:

Blood Tranfusion Abroad. The Blood Care Foundation. Accessed November 2011. http://www.bloodcare.org.uk/blood_transfusion_abroad.html

New Published Study Finds the Cost of Blood Transfusions is Significantly Under-Estimated, Establishes True Cost at $522 to $1,183 Per Unit. PR Newswire. http://www.prnewswire.com/news-releases/new-published-study-finds-the-cost-of-blood-transfusions-is-significantly-under-estimated-establishes-true-cost-at-522-to-1183-per-unit-89909747.html

56 Facts About Blood. America's Blood Centers. Accessed November 2011. http://www.americasblood.org/go.cfm?do=Page.View&pid=12

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