Who needs a transfusion
Transfusion is considered when anaemia causes symptoms or when the haemoglobin is low enough that the body cannot compensate, especially when there is heart disease, active bleeding or surgery. It is also part of emergency care for severe bleeding, haemolytic crises and some cases of sickle cell disease or thalassemia.
The decision is not based on a number alone. Symptoms, speed of the fall, cardiovascular status, ongoing blood loss and the underlying diagnosis all matter. A stable patient without symptoms may not need transfusion at the same threshold as a patient with chest pain or breathlessness.
Related: Haematology → · Dr. Sachita Baniya profile → · All conditions →
Safety, reactions and consent
Blood is crossmatched and screened for major infections before transfusion. Consent includes a discussion of benefits, alternatives and the small risks of allergic reactions, fever, fluid overload, lung injury and infection. Most reactions are mild and treatable, but staff monitor during and after the transfusion.
Directed donation from a relative is not automatically safer than screened volunteer blood and is not routinely recommended. If you have had a previous reaction or a complex antibody history, tell the treating team so that special matching can be arranged.
| Situation | Typical approach |
|---|---|
| Symptomatic anaemia with stable bleeding | Transfuse to relieve symptoms, treat the cause |
| Thalassemia major | Regular transfusion to maintain growth and suppress ineffective marrow |
| Sickle cell crisis with severe anaemia or acute chest syndrome | Urgent transfusion or exchange in hospital |
| Aplastic anaemia or MDS | Transfusion support while definitive treatment is planned |
Iron overload and long-term support
Repeated transfusion adds iron that the body cannot excrete. Over years, iron can accumulate in the heart, liver and endocrine organs. Monitoring includes ferritin and sometimes liver and cardiac iron assessment, with iron chelation when needed.
Long-term transfusion care also addresses alloimmunisation, vein access, vaccination, fertility and bone health. The aim is not only a safe transfusion today but a sustainable plan that protects organs over time.
Access and booking
Dr. Baniya consults at Kathmandu Neurology Clinic & Cognitive Center, Durbar Marg, and also practises at Kathmandu Cancer Center (KCC) Nepal, Civil Service Hospital, Kathmandu, and Advanced Care Hospital. Appointments are arranged at the Durbar Marg clinic or through the respective hospital or cancer centre. Bring all blood counts, blood film, marrow, flow cytometry and molecular reports.