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Blood Transfusions: Should I Bank Blood Before Surgery?
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Blood Transfusions: Should I Bank Blood Before Surgery?
1Get the | 2Compare | 3Your | 4Your | 5Quiz | 6Your Summary |
Get the facts
Your options
- Bank your own blood before surgery.
- Do not bank your own blood before surgery.
Key points to remember
- Getting a disease from a blood transfusion is very rare in the United States. The risk of infection from a blood transfusion is higher in less developed countries.
- If you have had many blood transfusions, your body may have formed antibodies against donated blood. Your body mistakes the new blood as harmful and tries to destroy it. Careful testing helps reduce the risk for these problems.
- There are risks from getting a blood transfusion, some related to errors with the labeling of the blood. The risk of these errors is the same whether you bank your own blood or receive donated blood.
- Your body may not have time to replace the blood you banked before the surgery. This means that you may not be able to stand losing much more blood during surgery before you'd need a transfusion. In some cases, it's possible that you wouldn't have needed a transfusion at all if you had not banked blood before your surgery.
Why might you bank your own blood?
If you are going to have surgery and expect to need a blood transfusion, you may want to bank your own blood a few weeks before the surgery. If you do need a transfusion, doctors can use your own blood.
Many people consider this choice to protect themselves from the risks of disease or mismatched blood that are linked to blood transfusion.
How likely are you to have a reaction to a blood transfusion?
One risk of getting a blood transfusion is a transfusion reaction.
Transfusion reactions occur when the blood you are given does not match your blood type. This matching error is rare. The lab may mislabel a unit of blood. A doctor, nurse, or technician may misread the label before the blood is given to you.
Getting the wrong blood type happens rarely, up to 4 times for every 1 million units of blood transfused.footnote 1 A transfusion reaction may be mild or severe. A severe reaction can be life-threatening.footnote 2
It's possible to have a mild transfusion reaction even if your blood and the blood you are given are matched correctly.
Some people, especially those who have had many blood transfusions, make antibodies against the blood they receive. Their immune system mistakes the new blood as harmful and tries to destroy it. Careful testing helps lower the risk for these problems.
The risk for an error in reading or labeling is the same whether you bank your own blood before surgery or receive a transfusion of donor blood. An error in reading or labeling may also mean that you receive the correct blood type during your surgery but not the blood you banked.
How likely are you to get a disease from a blood transfusion?
Getting a viral infection, such as hepatitis or HIV, from a blood transfusion is very rare in the United States. Guidelines enforced by the U.S. Food and Drug Administration (FDA) guard the collection, testing, storage, and use of blood. The risk of disease from a blood transfusion is higher in less developed countries.
It's possible for blood to become contaminated with bacteria during or after donation. Getting a transfusion with blood that contains bacteria can lead to a bacterial infection that affects your whole body. You face the same risk for bacterial infection whether you bank your own blood before surgery or receive a blood transfusion of donor blood.
What are the risks of banking blood?
Because blood can't be stored very long, you must bank your blood a few weeks before your surgery. This may not allow enough time for your body to make enough new blood to replace what you banked before surgery. You may have less blood than normal at the time of surgery, so your body may not be able to lose much more blood before needing a transfusion. In some cases, it's possible that you would not have needed a transfusion at all if you hadn't banked blood before surgery.
You may not be able to bank enough blood for your surgery. Most people are able to safely bank 2 to 4 units of blood before surgery. If you are having major surgery that may require more blood than this, you may need more than you can safely bank.
Talk with your surgeon about how much blood you might need for your surgery.
Compare your options
Compare
What is usually involved? |
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|---|---|---|
What are the benefits? |
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What are the risks and side effects? |
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- You donate blood a few weeks before your surgery. If you need a transfusion during surgery, you can receive the blood you donated.
- If you have had many transfusions and your body has formed antibodies against donated blood, you are less likely to have a reaction if a transfusion comes from your own blood.
- You may avoid a viral infection from a blood transfusion. Viral infections from blood transfusions are very rare.
- Your body may not have enough time to replace the blood you banked before surgery.
- If there is a labeling or reading error, you may not receive the blood you banked.
- If you need a transfusion, you will receive donor blood from the blood bank.
- Your body will have plenty of blood available at the time of surgery. You may not need a transfusion at all.
- If you have had many transfusions and your body has formed antibodies, you are more likely to have a reaction from donated blood.
- There is a slight chance that you could get a viral infection from the blood you receive. Viral infections from blood transfusions are very rare.
Personal stories about banking blood before surgery
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
I am very concerned about the risk of getting HIV from a blood transfusion. I know the risk is very small, but even that small risk is too great for my comfort. I am banking my own blood before my surgery to reduce this risk even more.
Frank, age 50
After talking with my doctor, I feel much better about the safety of blood transfusions. She pointed out that the main risk is from having a reaction to the blood, and the risk is about the same whether I bank my own blood or not. I'm not going to bank my blood before my surgery.
Margaret, age 47
I had surgery a few years ago and had to have a blood transfusion. I had a pretty bad reaction to the transfusion, and my doctor tells me this is likely to happen again. It has something to do with an uncommon antibody in my blood that makes it react with most other blood. Now I have to have surgery again, and my doctor says I can reduce the risk of having another transfusion reaction by banking my own blood ahead of time. But they also said that they will keep looking for blood that my antibodies won't react with. For now, banking and using my own blood seems safest to me.
Ginger, age 60
I was considering banking my blood before my surgery. I asked my doctor how much blood I was likely to need during the surgery, and he said not very much. In fact, it is possible I will not need a transfusion at all. But he also said that if I chose to bank my blood before the surgery, I might become anemic and need a transfusion I could have avoided if I hadn't banked my blood in the first place. I've decided not to bank my blood before my surgery.
Francisco, age 30
What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to bank blood before surgery
Reasons not to bank blood before surgery
I'm worried about getting a viral infection from a blood transfusion, even though the risk is low.
I'm not worried about getting a viral infection from a blood transfusion.
I have religious or cultural reasons not to receive blood from other people.
I have no objection to receiving blood from other people.
I'm concerned about having a transfusion reaction from donated blood.
I'm not concerned about having a transfusion reaction.
I understand that even if I bank blood, I may not receive it during surgery.
It's not worth it to me to bank blood if there's a chance I'd still get the wrong blood during surgery.
My other important reasons:
My other important reasons:
Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Banking blood
NOT banking blood
What else do you need to make your decision?
Check the facts
Decide what's next
Certainty
1. How sure do you feel right now about your decision?
Your Summary
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
Your decision
Next steps
Which way you're leaning
How sure you are
Your comments
Your knowledge of the facts
Key concepts that you understood
Key concepts that may need review
Getting ready to act
Patient choices
Credits and References
| Author | Healthwise Staff |
|---|---|
| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
| Primary Medical Reviewer | Adam Husney, MD - Family Medicine |
| Primary Medical Reviewer | Martin J. Gabica, MD - Family Medicine |
| Primary Medical Reviewer | Kathleen Romito, MD - Family Medicine |
| Specialist Medical Reviewer | Brian Leber, MDCM, FRCPC - Hematology |
- Coil CJ, Santen SA (2011). Transfusion therapy. In JE Tintinalli, ed., Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7th ed., pp. 1493-1500. New York: McGraw-Hill.
- Galel SA, et al. (2009). Transfusion medicine. In JP Greer et al., eds., Wintrobe's Clinical Hematology, 12th ed., vol. 1, pp. 672-721. Philadelphia: Lippincott Williams and Wilkins.
- McCullough J (2010). Blood procurement and screening. In K Kaushanksy et al., eds., Williams Hematology, 8th ed., pp. 2279-2286. New York: McGraw-Hill.
- Uhl L (2011). Patient blood management: A 68-year-old woman contemplating autologous blood donation before elective surgery. JAMA, 306(17): 1902-1910.
Blood Transfusions: Should I Bank Blood Before Surgery?
- Get the facts
- Compare your options
- What matters most to you?
- Where are you leaning now?
- What else do you need to make your decision?
1. Get the Facts
Your options
- Bank your own blood before surgery.
- Do not bank your own blood before surgery.
Key points to remember
- Getting a disease from a blood transfusion is very rare in the United States. The risk of infection from a blood transfusion is higher in less developed countries.
- If you have had many blood transfusions, your body may have formed antibodies against donated blood. Your body mistakes the new blood as harmful and tries to destroy it. Careful testing helps reduce the risk for these problems.
- There are risks from getting a blood transfusion, some related to errors with the labeling of the blood. The risk of these errors is the same whether you bank your own blood or receive donated blood.
- Your body may not have time to replace the blood you banked before the surgery. This means that you may not be able to stand losing much more blood during surgery before you'd need a transfusion. In some cases, it's possible that you wouldn't have needed a transfusion at all if you had not banked blood before your surgery.
Why might you bank your own blood?
If you are going to have surgery and expect to need a blood transfusion, you may want to bank your own blood a few weeks before the surgery. If you do need a transfusion, doctors can use your own blood.
Many people consider this choice to protect themselves from the risks of disease or mismatched blood that are linked to blood transfusion.
How likely are you to have a reaction to a blood transfusion?
One risk of getting a blood transfusion is a transfusion reaction.
Transfusion reactions occur when the blood you are given does not match your blood type. This matching error is rare. The lab may mislabel a unit of blood. A doctor, nurse, or technician may misread the label before the blood is given to you.
Getting the wrong blood type happens rarely, up to 4 times for every 1 million units of blood transfused.1 A transfusion reaction may be mild or severe. A severe reaction can be life-threatening.2
It's possible to have a mild transfusion reaction even if your blood and the blood you are given are matched correctly.
Some people, especially those who have had many blood transfusions, make antibodies against the blood they receive. Their immune system mistakes the new blood as harmful and tries to destroy it. Careful testing helps lower the risk for these problems.
The risk for an error in reading or labeling is the same whether you bank your own blood before surgery or receive a transfusion of donor blood. An error in reading or labeling may also mean that you receive the correct blood type during your surgery but not the blood you banked.
How likely are you to get a disease from a blood transfusion?
Getting a viral infection, such as hepatitis or HIV, from a blood transfusion is very rare in the United States. Guidelines enforced by the U.S. Food and Drug Administration (FDA) guard the collection, testing, storage, and use of blood. The risk of disease from a blood transfusion is higher in less developed countries.
It's possible for blood to become contaminated with bacteria during or after donation. Getting a transfusion with blood that contains bacteria can lead to a bacterial infection that affects your whole body. You face the same risk for bacterial infection whether you bank your own blood before surgery or receive a blood transfusion of donor blood.
What are the risks of banking blood?
Because blood can't be stored very long, you must bank your blood a few weeks before your surgery. This may not allow enough time for your body to make enough new blood to replace what you banked before surgery. You may have less blood than normal at the time of surgery, so your body may not be able to lose much more blood before needing a transfusion. In some cases, it's possible that you would not have needed a transfusion at all if you hadn't banked blood before surgery.
You may not be able to bank enough blood for your surgery. Most people are able to safely bank 2 to 4 units of blood before surgery. If you are having major surgery that may require more blood than this, you may need more than you can safely bank.
Talk with your surgeon about how much blood you might need for your surgery.
2. Compare your options
| Banking blood | Not banking blood | |
|---|---|---|
| What is usually involved? |
|
|
| What are the benefits? |
|
|
| What are the risks and side effects? |
|
|
Personal stories
Personal stories about banking blood before surgery
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"I am very concerned about the risk of getting HIV from a blood transfusion. I know the risk is very small, but even that small risk is too great for my comfort. I am banking my own blood before my surgery to reduce this risk even more."
— Frank, age 50
"After talking with my doctor, I feel much better about the safety of blood transfusions. She pointed out that the main risk is from having a reaction to the blood, and the risk is about the same whether I bank my own blood or not. I'm not going to bank my blood before my surgery."
— Margaret, age 47
"I had surgery a few years ago and had to have a blood transfusion. I had a pretty bad reaction to the transfusion, and my doctor tells me this is likely to happen again. It has something to do with an uncommon antibody in my blood that makes it react with most other blood. Now I have to have surgery again, and my doctor says I can reduce the risk of having another transfusion reaction by banking my own blood ahead of time. But they also said that they will keep looking for blood that my antibodies won't react with. For now, banking and using my own blood seems safest to me."
— Ginger, age 60
"I was considering banking my blood before my surgery. I asked my doctor how much blood I was likely to need during the surgery, and he said not very much. In fact, it is possible I will not need a transfusion at all. But he also said that if I chose to bank my blood before the surgery, I might become anemic and need a transfusion I could have avoided if I hadn't banked my blood in the first place. I've decided not to bank my blood before my surgery."
— Francisco, age 30
3. What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to bank blood before surgery
Reasons not to bank blood before surgery
I'm worried about getting a viral infection from a blood transfusion, even though the risk is low.
I'm not worried about getting a viral infection from a blood transfusion.
I have religious or cultural reasons not to receive blood from other people.
I have no objection to receiving blood from other people.
I'm concerned about having a transfusion reaction from donated blood.
I'm not concerned about having a transfusion reaction.
I understand that even if I bank blood, I may not receive it during surgery.
It's not worth it to me to bank blood if there's a chance I'd still get the wrong blood during surgery.
My other important reasons:
My other important reasons:
4. Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Banking blood
NOT banking blood
5. What else do you need to make your decision?
Check the facts
1. Are you less likely to have a bad reaction to a transfusion if you use banked blood?
- Yes
- No
- I'm not sure
2. Is it common to get a disease from a blood transfusion in the United States?
- Yes
- No
- I'm not sure
3. Could banking blood make you more likely to need a transfusion during surgery?
- Yes
- No
- I'm not sure
Decide what's next
1. Do you understand the options available to you?
2. Are you clear about which benefits and side effects matter most to you?
3. Do you have enough support and advice from others to make a choice?
Certainty
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
- I'm ready to take action.
- I want to discuss the options with others.
- I want to learn more about my options.
| By | Healthwise Staff |
|---|---|
| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
| Primary Medical Reviewer | Adam Husney, MD - Family Medicine |
| Primary Medical Reviewer | Martin J. Gabica, MD - Family Medicine |
| Primary Medical Reviewer | Kathleen Romito, MD - Family Medicine |
| Specialist Medical Reviewer | Brian Leber, MDCM, FRCPC - Hematology |
- Coil CJ, Santen SA (2011). Transfusion therapy. In JE Tintinalli, ed., Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7th ed., pp. 1493-1500. New York: McGraw-Hill.
- Galel SA, et al. (2009). Transfusion medicine. In JP Greer et al., eds., Wintrobe's Clinical Hematology, 12th ed., vol. 1, pp. 672-721. Philadelphia: Lippincott Williams and Wilkins.
- McCullough J (2010). Blood procurement and screening. In K Kaushanksy et al., eds., Williams Hematology, 8th ed., pp. 2279-2286. New York: McGraw-Hill.
- Uhl L (2011). Patient blood management: A 68-year-old woman contemplating autologous blood donation before elective surgery. JAMA, 306(17): 1902-1910.
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Current as of: October 9, 2017
