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Does transferring blood between two people also transfer all the white blood cells?
Why can't AIDS victims with low t-cell count just get blood transfusions till they have more t-cells? Why can't someone who's over a cold give blood to someone with a cold to cure them? I know this is silly, but I really want to know why this won't work.
Not really no. Most blood transfusions we think about are red blood cells or platelets, which don't have the immune function you're asking for. That's a good thing. Usually, if there are white blood cells in the transfused blood, the host's immune system will recognize them as foreign and destroy them. Remember, your cells all look like foreign invaders to my cells; blood transfusions of red blood cells are carefully matched to limit negative reactions. There is also a process called transfusion-associated graft versus host disease in which the donor white blood cells will attack the host cells; this mainly occurs in immune-compromised individuals, but GvHD is definitely something to avoid. Blood transfusions are usually filtered and irradiated to remove, among other things, white blood cells.
That being said, people are beginning to use white blood cells as treatment. A new therapy being studied heavily for all sorts of diseases, from cancer to HIV, is to take the hosts own white blood cells and grow them up in the lab to select for the strongest and most effective cells. The researchers then wipe out the individual's immune system and give them a dose of their own, super-powered white blood cells, hoping that works.
Sometimes it kind of does. They've also been trying a new system, similar to what you propose, using bone marrow. They had a huge success with an HIV-positive individual now referred to as "the Berlin patient." They gave him a marrow transfusion which would produce HIV-immune white blood cells and replaced his immune system. He was and is effectively cured of HIV/AIDS.
Usually the infection is caused by bacteria. The blood may get infected when an IV line or shot is given through an infected area of skin or if an IV catheter (tube) is left in too long. There are always bacteria on the skin and on the surfaces of most objects. This is why healthcare providers clean the skin to kill bacteria before they give a shot or IV. They also use gloves and sterilized instruments and equipment to prevent spread of bacteria and viruses.
You have a higher risk of getting a blood infection if you have:
- Long-term illness, such as diabetes, heart disease, or lung problems
- An open wound (from injury, surgery, or a severe burn)
You are also at higher risk if you are taking medicines such as steroids or anticancer drugs. These medicines can make it harder for your body to fight infection. You may get a blood infection if an infection from another part of your body spreads to the injection site.
Where does blood for a blood transfusion come from?
Typically, the blood comes from an anonymous person who has donated it for use as hospitals see fit. A blood bank holds the blood until needed for a transfusion.
In some cases, though, people donate blood to directly benefit a friend or loved one. You may also have the chance to bank your own blood for a scheduled surgery.
How does a blood transfusion work?
The donated blood or blood components are stored in special medical bags until they are needed. Your healthcare provider connects the needed bag of blood to an intravenous line made of tubing. A needle at the end of the tubing is inserted into one of your veins and the blood or blood components begins to be delivered into your circulatory system.
What can I expect during the transfusion?
Before your transfusion, your nurse will:
- Check your blood pressure, pulse and temperature.
- Make sure the donor blood type is a match for your blood type.
- Make sure that the supplied blood is the product ordered by your doctor and is labeled with your name.
During your transfusion, your nurse will:
- Recheck your blood pressure and pulse after 15 minutes.
- Recheck your blood pressure and pulse at the end of the transfusion.
How long does a blood transfusion take?
How long a blood transfusion takes depends on many factors, including how much blood and/or blood component you need. Most transfusions take between one and three hours. Talk to your healthcare provider for more specifics about your needs.
Almost all of the blood used for blood transfusions is donated by volunteers.
For details on the donation process, see Donating Blood.
Safety of donated blood
The process of blood donation and the handling of donated blood in the United States is regulated by the U.S. Food and Drug Administration (FDA). The FDA enforces five layers of overlapping safeguards to protect the blood supply against disease.
- Donor screening. To donate blood, you must answer a series of questions about your current health, health history, any travel to countries where certain diseases are common, and behavior that increases your risk for getting certain diseases, such as drug use or unprotected sex. Your temperature, your blood pressure, and the volume of red blood cells in a blood sample ( hematocrit ) are checked. You may not be allowed to donate blood if any of these screening steps suggests a problem, such as potential exposure to an infectious disease or anemia .
- Deferred-donor lists. Organizations that collect blood must keep lists of people who are permanently prevented from giving blood. Potential donors must be checked against this list so that blood is not collected from them. The deferred-donor list includes people who have had certain types of cancer, had viral hepatitis after age 11, or are at high risk for HIV infection.
- Blood testing. After donation, every unit of blood is tested for certain diseases, such as hepatitis B and C, HIV, West Nile virus, syphilis, and HTLV-I/II viruses. If any disease is detected, the blood is thrown away.
- Quarantine. Donated blood is kept isolated from other blood and cannot be used for any purpose until it passes all required tests.
- Quality assurance. Blood centers must keep careful records of every unit of donated blood. If a problem arises involving a donated unit of blood, the blood center must notify the FDA and work with them to correct the problem.
Donating blood for your own use
If you are going to have surgery and expect to need a blood transfusion, you may want to consider donating or banking your own blood before the surgery (autologous donation).
For more information on this option, see:
Scientific Committee on Transfusion Medicine
Dana V. Devine, PhD ('22)
Cassandra Josephson, MD ('24)
Rick Kapur, MD ('24)
John Manis, MD ('23)
France Pirenne, MD, PhD ('23)
Patricia A. Shi, MD ('24)
Moritz Stolla, MD ('24)
Sean Stowell, MD ('22)
The Scientific Committee on Transfusion Medicine is focused on basic and clinical research that lie at the intersection of classical transfusion medicine and the hematologic diseases within hematology. Specifically, the Committee focuses on the collection, storage, transfusion, testing, ex vivo production, and apheresis of blood components, with an emphasis on mechanistic discoveries that elucidate the function of these products and their effects on disease pathophysiology.
Areas of biological and mechanistic interest include:
- Blood component therapy- mechanisms, management, and safety:
Blood component therapy encompasses the processing, storage, transfusion, and clinical consequences of whole blood or its derivatives, e.g. red blood cells, platelets, and plasma. The Committee supports development, evaluation, and improvement of component therapies for treatment of patients with malignant and non-malignant clinical conditions, including hypo-proliferative cytopenias, acquired and congenital bleeding disorders, hemolytic anemias, hemoglobinopathies, resuscitation of the injured, and blood component support for solid organ transplantation. Conditions in which transfusion recipients have mounted immune responses to transfused blood products or cells also represent specific areas of importance. These conditions include hemolytic transfusion reactions, hemolytic disease of the newborn, neonatal alloimmune thrombocytopenia, drug-induced thrombocytopenia, platelet transfusion refractoriness, and transfusion-related acute lung injury due to neutrophil-specific alloantibodies. Topics covering pathophysiology of hematologic diseases are considered in scope when an aspect of blood transfusion is being studied. Infectious and non-infectious complications of transfusion that are relevant to hematology patients will be included as new developments occur.
Potential overlap and overlap resolution with other Scientific Committees: The Scientific Committee on Transfusion Medicine differs from closely-related committees (e.g. Stem Cells and Regenerative Medicine, Transplantation Biology) in that the cell source is typically peripheral blood, placental blood, or a cell that is readily mobilized and released into peripheral blood using pharmacological agents. This typically includes blood cells with no or limited proliferative potential in vivo, as well as various circulating stem cells. The Scientific Committee on Transfusion Medicine does not focus on the production of induced pluripotent stem cells or embryonic stem cells, with the exception of ex vivo generation and expansion of blood cells for transfusion. Unlike the Transplantation Biology Committee, the Scientific Committee on Transfusion Medicine emphasizes the clinical laboratory manipulation and storage of cellular products for subsequent therapeutic purposes, rather than the process and biology of stem cell transplantation itself.
Areas of specific overlap ripe for collaboration include:
- Scientific Committee on Iron and Heme: Iron status of blood donors intentional or accidental infusion of free hemoglobin
- Scientific Committee on Red Cell Biology: efforts to grow red cells in culture erythroid regulators red cell membrane proteins in health and disease
- Scientific Committee on Blood Disorders in Childhood: Pediatric transfusion therapy
- Scientific Committee on Stem Cells and Regenerative Medicine: Hematopoietic stem cell collection, expansion and modification tissue banking
- Scientific Committee on Platelets: Platelet collection and transfusion therapy thrombopoietic growth factors, production of platelets in culture, platelet substitutes
- Scientific Committee on Hemostasis: Recombinant coagulation factors platelet transfusion therapy, the emerging role of red blood cells in hemostasis
- Scientific Committee on Hematopoiesis: Hematopoietic stem cell collection and modification ex vivo generation and expansion of blood cells for transfusion therapy
- Scientific Committee on Transplantation Biology: Hematopoietic stem cell collection and modification treatment of graft rejection by therapeutic apheresis and extracorporeal phototherapy alloimmunization to blood groups and histocompatibility antigens
Thus, appropriate joint sessions at the ASH annual meeting may include:
What happens during a blood transfusion?
During the procedure, you will be given blood from one or more people who donated it. In some cases, you may be given blood that was taken from you before. Or you may be given blood from a family member or friend.
A healthcare provider will clean the area where the IV will go. He or she will insert an IV into one of your veins, most likely in your arm. The whole blood or blood parts will be sent through this line. The whole process may take 1 to 4 hours.
A healthcare provider will watch you for any signs of negative reactions. These are most likely in the first 15 minutes. Tell the healthcare provider right away if you start having symptoms.
You should be able to eat, drink, and go to the bathroom with help during the procedure. Your healthcare provider will let you know about what else to expect.
The irradiation process kills the donor’s T-lymphocytes which are the main cause of TA-GvHD. Unless the T-lymphocytes are destroyed, they will graft themselves in the recipient’s tissues. If the person’s own immune system is incapable of mounting an immune response to them, the T-lymphocytes get the upper hand and attack the recipient’s body as if it were a foreign invader.
Between 4 and 30 days after transfusion, the resulting cascading immune response causes fever, rash, diarrhea, hepatitis, and reduced levels of red blood cells, white blood cells, and platelets (pancytopenia). Experts describe attempts to treat TA-GvHD as “difficult to futile.” The disease is fatal about 90% of the time, and death occurs due to an infection the patient can’t fight off or hemorrhaging caused by the pancytopenia.
Could a blood transfusion transmit Lyme disease?
Researchers now know that the tick-borne disease Babesia can be transmitted unknowingly through blood transfusions. But what about transfusion-associated Lyme disease? The risk is unlikely, but it is a concern worth considering, writes Pavia and Plummer. 
Studies have found Borrelia burgdorferi in the blood of patients with early Lyme disease using culture tests.
“Borrelia are likely to be found circulating in the blood sporadically or they may persist for a time period ranging from 2 to 5 weeks and in some cases beyond this time frame,” writes Pavia, citing a 2001 study by Wormser and colleagues. 
It is unlikely that an individual will donate blood if they have had a tick bite, erythema migrans (EM) rash or were ill, the author writes. But there could be donors who are unaware they have Lyme disease. They may not have seen a tick bite or EM rash and may be asymptomatic and not exhibiting any symptoms of the disease. This, in turn, would pose a theoretical risk.
After all, researchers have shown that it is possible to transmit B. burgdorferi spirochete in mice.
“B. burgdorferi can be transferred from spirochetemic donor mice to naive recipients during an experimental blood transfusion that closely mimicked typical human blood transfusion procedures,” according to a study by Gabitzsch. 
Investigators, however, do not know if transmission can occur if the blood is stored under blood-storage conditions.
Furthermore, another Borrelia species, B. recurrentis has been shown to cause transfusion-associated relapsing fever, the authors point out. And these microorganisms share several common elements.
It is also possible to transmit via transfusion the tick-borne pathogen Borrelia miyamotoi.
“Borrelia miyamotoi, was able to survive and infect mice after being kept under standard storage conditions with human blood or most of its component parts, suggesting that transmission by blood transfusion of this pathogen was possible,” explains Thorp. 
Additional studies are needed to determine the risks and reassess the blood bank criteria.
“It is necessary to consider determining what the optimal criteria and policies should be, such as the appropriate use of approved diagnostic methods, for monitoring blood products for possible contamination with the Lyme disease spirochete, especially in geographic areas in which B. burgdorferi infection and other related tick-borne diseases are endemic,” Pavia writes.
Does a blood transfusion cure disease? - Biology
Hematology, Blood Transfusion and Disorders
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