Packed Red Blood Cell (PRBC) Transfusion

What It Is and How It Works

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Packed red blood cells—also called PRBCs, RBCs, and packed cells—are a type of blood replacement product used for blood transfusions. PRBC transfusion is typically given in situations where the patient has either lost a large amount of blood or has anemia and is experiencing notable symptoms.

If a patient needs blood, there are a few types of blood replacements available—PRBCs being just one. A healthcare provider will choose what type of blood replacement is given based on the patient's situation.

This article will explain what PRBCs are, why and how they are used, and important things you should know about getting this type of blood transfusion.

A blood sample tube in a doctor's hand
David Tise / Stockbyte / Getty Images

What Are PRBCs?

Most people think that when they receive a blood transfusion, they are getting the same type of blood they donate at a blood drive, which is known as whole blood. This donated blood includes 55% plasma, 44% red blood cells, and 1% white blood cells platelets.

When you receive a blood transfusion, this whole blood is not what's typically transfused unless you need a massive amount of blood to counteract tremendous blood loss. Instead, packed red blood cells, which is whole blood minus the plasma portion, are typically given.

Approximately 450 mL of blood are collected with each person's donation. From this, about 200 mL of packed blood is attained.

Why Red Blood Cells Are Used for Transfusions

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, feel like their heart is "racing," or have difficulty concentrating.

PRBC Transfusion Procedure

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, and then a small amount of an anticoagulant is added to keep the PBRCs 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 4% of hospitalized patients need a red blood cell 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 is often performed for these patients.

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 an infection 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 U.S., the level of safety may vary widely. Abroad, you may have difficulty obtaining a blood transfusion due to limited supply. Also, the supply may not be considered safe or testing may not be adequate.

What Are the Side Effects of PRBC Blood Transfusion?

The risk of experiencing negative side effects from a blood transfusion is very small. In rare instances when some side effects do occur, you might experience the following:

  • Febrile non-hemolytic transfusion reaction: This is the most common reaction to a transfusion. It causes fever and/or chills immediately upon receiving the transfusion or up to four hours after. It is usually easily treatable.
  • Allergic reaction: An infusion that includes antibodies from a donor may result in a reaction that includes a mild skin irritation or a serious breathing problem.
  • Hemolytic transfusion reaction: Your body starts to destroy the donated blood. This can be immediate or delayed and includes symptoms such as fever, pain, and kidney failure.
  • Transfusion-associated circulatory overload: Symptoms of this reaction include difficulty breathing, cough, and fluid in the lungs. It happens when a recipient cannot effectively process the blood that is transfused.

Cost of PRBC Blood Transfusion

A PRBC transfusion of one unit (one bag) can range from $522 to $1,183. The number of units given in a PRBC transfusion can range anywhere from one unit for someone who is anemic, to 40 or 50 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, the laboratory that processes the blood, transportation costs, blood bank technologists who match and issue the blood, and the nursing staff that gives the blood.

Summary

Packed red blood cells (PRBCs) are the part of blood from a blood donation that is usually transfused into a patient who has lost a large amount of blood or who is being treated for severe anemia. This portion of the blood does not include platelets or plasma.

If you have surgery or experience serious trauma, you may need to receive a PRBC transfusion. Blood donations in the United States are carefully tested, and a transfusion is considered a very safe procedure. In rare instances, you may have problems processing the blood or you may have a reaction to donated blood. These situations are treatable, though.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Additional Reading

By Jennifer Whitlock, RN, MSN, FN
Jennifer Whitlock, RN, MSN, FNP-C, is a board-certified family nurse practitioner. She has experience in primary care and hospital medicine.