Discussion Forums > Thalassemia Major

Quantity of blood to be transfused

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Sagar:
Dear All,

I have a question and if somebody can help me out.

I am a thalassemia major, 19yrs Male. My weight is 57kg.

Currently I'm taking 2 units prbc transfusion at a time (approx. 500cc) every 17 days i.e. 8.77cc per kg. But someone told me that you should get transfused with 15 - 20cc per Kg at a time (approx. 855cc) every 21 days.

Request Andy for your expert advice.

Andy Battaglia:
Most patients your age are on a 3 week transfusion schedule. However, if you feel you are getting too tired if you try to stretch it out longer, there is no reason to not have a shorter schedule. It really isn't that big a difference, so it's best to do what works best for you. The one factor that does make a difference physically, is that your heart does have a harder time with larger transfusion volumes. I don't think this is practical for anyone, but ideally, patients would get transfused weekly with smaller volumes, to cause less stress on the heart and to always have a fresh supply of blood.

Dharmesh:
The golden rule to decide quantity of blood to be transfused is your pre bt Hb level.

Thals should maintain pre bt Hb level at 9.5 to 10.5 gms% ( You can maintain higher level if u r not ok with 9.5-10.5 gms%)

if you are able to maintain say 10 gms% before bt with ur current intake of 500ml every 17 days, You should continue else u need to adjust ur blood intake.

Currently u r taking blood 15.50 ml / kg/month aprx. ( 500/17days*30days = 882 ml per month / 57 kgs = 15.48 ml/kg/month)

PS 15-20 CC/month is monthly intake and ur transfusing at that qty.

Hope it made u clear. :)

Ken DS:
Is it better to get more than 2 units? I hear people in Hong Kong only go once a month but get 4 units of blood at a time.

Andy Battaglia:
The fluid volume from transfusions causes stress to the heart. The higher the volume, the more stress on the heart. If it was practical, it would be best to take weekly transfusions. The volume would cause less stress on the heart. But, it isn't practical. I do not like the 4 units at once approach and feel it is done more out of convenience than out of concern for patients.

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