Introduction: Transfusion Medicine
Transfusion medicine is changing rapidly in response to new developments. Considerable changes in approaches to transfusion, together with the use of alternative agents, have become apparent over the past decade. Blood transfusion can be lifesaving, but this is a scarce and costly resource. There is increased focus on appropriate transfusion practice to ensure quality of service provision, and tr
Transfusion medicine is changing rapidly in response to new developments. Considerable changes in approaches to transfusion, together with the use of alternative agents, have become apparent over the past decade. Blood transfusion can be lifesaving, but this is a scarce and costly resource. There is increased focus on appropriate transfusion practice to ensure quality of service provision, and transfusion has been proposed as a quality indicator in surgical care. Blood transfusion usage remains high, particularly in trauma, obstetrics, critical care and cardiovascular surgery.
Anaesthesiologists are frequently involved in transfusion decisions, the administration of blood and blood components and as part of the team managing any major haemorrhage. However, the use of allogeneic blood components has serious implications and warrants careful consideration. As a consequence, there has recently been an expansion of interest in safeguarding and checklists, blood conservation, preservation techniques, coagulation profiling and the use of haemostatic agents. Appropriate use of blood components in patient care is of utmost importance.
Several recent publications related to transfusion practice examined aspects of patient safety, outcomes and individualised care, including: use of restrictive transfusion protocols; adjuvant therapies; substitution of blood components with pooled factor concentrates; and use of POC testing to target specific component use.
It is essential that our practice of blood transfusion is safe and based on current, scientific, evidence-based knowledge. A multidisciplinary approach that aims to benefit patients by the reduction in inappropriate transfusions is paramount. This working party aimed to formalise guidance on the clinical indications and risks of transfusion, blood conservation and the transfusion process.
South African Society of Anaesthesiologists (SASA) Guidelines for Patient Blood Management 2020. Confirmed as current version on the SASA website as of November 2024.