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Related Concept Videos

Blood Transfusion and Agglutination02:45

Blood Transfusion and Agglutination

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Blood transfusion is a therapeutic measure to restore the blood volume after extensive blood loss due to an accident or a medical procedure. Blood transfusion involves drawing a certain amount of blood from a suitable donor and infusing it into the recipient.
History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...
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Blood Transfusion01:15

Blood Transfusion

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Blood transfusion is a critical medical procedure that saves lives and treats various medical conditions. It involves transferring blood from a donor to a recipient. This process requires a thorough understanding of the ABO blood group system and its associated antigens and antibodies.
Blood Transfusion Overview
A blood transfusion is a medical procedure used to replace blood lost due to injury, surgery, or to treat conditions such as anemia or cancer. During a transfusion, donor blood is...
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Rh Blood Group01:19

Rh Blood Group

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The Rhesus (Rh) antigen is crucial in determining blood groups and ensuring compatibility during blood transfusions.
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Blood Typing01:10

Blood Typing

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Understanding an individual's blood group is a critical component of transfusion medicine. It ensures compatibility in blood transfusions, organ transplants, and even during pregnancy. Determining these blood groups involves the ABO and Rh blood typing systems, utilizing specific antigens and corresponding anti-sera to identify an individual's blood type.
Antigens are protein molecules that reside on the surface of red blood cells (RBCs). The ABO and Rh blood typing systems target...
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The ABO Blood Group01:12

The ABO Blood Group

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The ABO blood group system is a critical element of transfusion medicine, essential for determining blood compatibility in transfusions and organ transplants. It is based on specific antigens, or agglutinogens, present on the surface of red blood cells (RBCs) and corresponding antibodies, or agglutinins, in the blood plasma.
Antigens in the ABO Blood Group System
Antigens are substances that can trigger an immune response, leading to the production of antibodies. In the ABO blood group system,...
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Blood Types02:20

Blood Types

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Human blood is classified into different types based on the presence of antigens on the red blood cell's surface and antibodies in the plasma. Proper identification of blood type is essential for successful blood transfusion. The International Society of Blood Transfusion has identified 38 human blood types based on the surface antigens on the red blood cells. The most common types are ABO, Rh, and MNS blood types.
ABO blood group
ABO antigens are glycoproteins encoded by genes present on...
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Related Experiment Video

Updated: Oct 9, 2025

A Precision Medicine Tool for Measurement and Monitoring of Hemoglobin S in Sickle Cell Disease Patients Receiving Transfusion Therapy
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A Precision Medicine Tool for Measurement and Monitoring of Hemoglobin S in Sickle Cell Disease Patients Receiving Transfusion Therapy

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Transfusion thresholds for guiding red blood cell transfusion.

Jeffrey L Carson1, Simon J Stanworth2,3,4, Jane A Dennis5

  • 1Division of General Internal Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.

The Cochrane Database of Systematic Reviews
|December 21, 2021
PubMed
Summary

A restrictive red blood cell (RBC) transfusion strategy, using lower hemoglobin thresholds (7.0-8.0 g/dL), reduced RBC exposure by 41% without increasing 30-day mortality or other adverse outcomes. Further research is needed for specific patient subgroups.

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Area of Science:

  • Hematology
  • Transfusion Medicine
  • Clinical Research

Background:

  • Optimal hemoglobin thresholds for red blood cell (RBC) transfusions are under investigation.
  • Blood is a scarce resource, and transfusion safety varies globally.
  • A restrictive transfusion policy could become the standard of care if it matches liberal policies in outcomes.

Purpose of the Study:

  • To compare 30-day mortality and other clinical outcomes between restrictive and liberal RBC transfusion thresholds.
  • To evaluate the impact of different hemoglobin concentration triggers for RBC transfusions across all clinical conditions.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs).
  • Searched multiple databases (CENTRAL, MEDLINE, Embase, etc.) up to November 2020.
  • Included RCTs comparing restrictive (lower Hb threshold) vs. liberal (higher Hb threshold) transfusion strategies in adults and children (excluding neonates).
  • Extracted data using Cochrane methods and pooled risk ratios using a random-effects model.

Main Results:

  • 48 trials with 21,433 participants were included across various clinical contexts.
  • Restrictive transfusion strategies reduced RBC transfusion risk by 41% (RR 0.59, 95% CI 0.53-0.66) with high heterogeneity.
  • No significant increase or decrease in 30-day mortality (RR 0.99, 95% CI 0.86-1.15) or other assessed morbidities (cardiac events, MI, stroke, thromboembolism, infection) was observed.
  • Evidence strength was lower for specific subgroups like myocardial infarction and hematological malignancies.

Conclusions:

  • Restrictive transfusion strategies significantly decrease RBC exposure without adversely affecting 30-day mortality or major morbidities.
  • Data remain insufficient to definitively assess safety in specific high-risk subgroups.
  • While hemoglobin concentration is a common marker, it may not be optimal for all patients; further research on optimal thresholds and patient-specific markers is needed.