Talk:Blood transfusion

Confusing Blood Transfusion Safety Section
I am confused as to whether all the bullets listed under Blood Transfusion Safety sections are conditions that the a recipient may or may NOT get as a result of a transfusion. Is this section saying that donated blood is screened for all these conditions, or is it saying it that the blood supply is NOT screened for these? (I don't know this topic very well).

Also, maybe this section should be merged into the Risks section? 75.6.228.54 05:54, 21 October 2007 (UTC)

Mixed Comments
Please consider addinf a section on or cross-reference to the religious concerns and objections to transfusion.

I don't see an article on, or discussion here, of blood exchanges, the procedure in which we replace a patient's blood (at a logarithmic return on new blood). Should we add content to this article to cover it? If so, should we change the name of the article to "Blood transfusion and exchange", or provide a redirect from "Blood exchange"? (New contributor to wikipedia.)--Ojophoyimbo 2006-01-03@21h44m UTC

Needs references to cover the content, added tag.--FloNight 14:08, 27 November 2005 (UTC)
 * From page with unreferenced tag: This template should only be placed on a talk page or at the bottom of an article, preferably in the empty 'References' section.--FloNight 18:03, 27 November 2005 (UTC)


 * If you put it here, hardly anyone will see it. Just visit Category:Articles lacking sources and you'll see that there are hardly any talk pages listed there. - Karl Stas 22:09, 27 November 2005 (UTC)

"The time required to donate blood is different from the Blood Donation article. Please select a time in common, I would recommend thirty minutes" --JoshNahum 15:12, 4 Jul 2005 (UTC)

"7th century"? Is that a typo for "17th century"?


 * I wondered the same thing when I read that line. --AaronW 23:34, 17 Jun 2004 (UTC)


 * It certainly was! - Nunh-huh 23:36, 17 Jun 2004 (UTC)

Took "probably" out of this sentence, since "it's likely" already says that. "it's likely that the transfusion probably caused his death."

donors with high risk sexual behaviour
Can we have a definition of this? Or rather, examples of what different countries/medical agencies define as high risk. Is it prostitution, promiscuity, homosexuality, ...? --Joy &#91;shallot&#93;   11:56, 12 August 2005 (UTC)

Procedure
Why does the procedure section only cover the donation of the blood and not the actual operation in which a patient recieves it?


 * Because that is more straightforward. I'll see if I can write a line or two. JFW | T@lk  23:41, 15 November 2005 (UTC)


 * At the risk of publishing original research I could not find a reference for giving Lasix with blood in patients with heart failure. JFW | T@lk  23:55, 15 November 2005 (UTC)

the procedure section states that transfusions normally require four hours. i am trying to find a reference for this statement, which would explain why four hours is required and why it may be dangerous to infuse multiple units within four or less hours. any suggestions are appreciated. thanks.


 * There are a couple reasons why transfusions are usually done one at a time and slowly. First, if there are multiple units hung and the recipient has a reaction, it's impossible to tell which of the units caused it.  Secondly, if a hemolytic transfusion reaction occurs it is best to have a minimal amount actually transfused.  Third, circulatory overload (too much fluid) can cause problems, and a slow transfusion allows the body to move excess fluid to interstitial spaces and out of circulation.  Lastly, blood for transfusion, especially type O negative red cells and platelets of any type, is often in short supply, so generally only the smallest amount needed is used.  If the patient is stable on less, further units are generally not ordered.  In trauma situations or other critical need scenarios, these concerns are generally waived based on the actual needs of the patient.

150.148.0.27 18:36, 25 October 2007 (UTC)

"Type of organ donation"
The only source for this that I can find so far, is in a defense of transfusions by for Witnesses by the AJRWB: http://www.ajwrb.org/science/meal.shtml. As such, this may be a subtle attempt at making a religious statement as opposed to impartial, unbiased, pure knowledge. If anyone can find a non-religious medical source for this, it would be appreciated. -- Avi 19:40, 22 February 2006 (UTC)


 * The article attributes that claim to 'cardiovascular surgeon Denton Cooley'. I don't know what Cooley's personal beliefs are, but he looks to have good medical credentials. I couldn't verify that particular quote, and I'm always wary of short quotes out of context, but I wouldn't be terribly surprised if a medical professional said such a thing.


 * That said, supposing for the sake of argument that he and a dozen other doctors have said such a thing, the way a fact is presented can still make it POV. I don't see that this factoid is particularly useful or notable in any but this particular religious context. If it's going to be brought up, that context should be made clear. It would be appropriate in a section on the JWs' stance on transfusions (maybe this article should have such a section?) but not context-free in the intro paragraph of the article. --Calair 23:16, 22 February 2006 (UTC)

the procedure section states that blood transfusions normally take four hours. i am trying to find a reference for this statement, which would explain why four hours is needed and why it may be dangerous to administer multiple units within four or less hours. does anyone have a suggestion? thanks

Complications of transfusion
Can an informed persion exand this area? Snowman 10:47, 27 March 2006 (UTC)
 * OK, I've done my best. Thoughts? MastCell 21:51, 10 August 2006 (UTC)

Photopherisis
I am assuming that photophoresis (sic) is distinct from photopheresis which is to do with blood transfusion and apherisis. Am I right? Cutler 09:12, 2 June 2006 (UTC)

Tranfusion-related immunosuppression
Added a request for citation on the statement about transfusions suppressing the immune system and leading to increased complications after surgery. I know there have been a few papers describing an increased risk of mortality with more liberal transfusion strategies, and a citation would be useful - I'll look into it as well. Will also expand the "Risks" category with some hard numbers once I have a chance. I've also added a section listing the specific infectious agents for which donated blood is screened in the U.S. (with citation). MastCell 18:08, 10 August 2006 (UTC)


 * This is probably a good one: --WS 23:37, 11 August 2006 (UTC)

Talking about risks, this is also interesting: difference in risks and indications in poor and rich countries. --WS 23:54, 11 August 2006 (UTC)


 * Those are both good references... feel free to add a section on transfusion-related immune suppression, or I will get around to it sooner or later. The question is always - did they get sick because they got transfused, or were the transfused pts sicker to start with (hence the transfusions)? I assume the reference addresses that issue; I'll take a look. MastCell 00:31, 12 August 2006 (UTC)

Related topics
I've managed to swell the page to an ungodly size. Thoughts on splitting off "History of blood transfusion" and "Exchange transfusion" (which is not yet covered on this page)? MastCell 22:45, 11 August 2006 (UTC)
 * Exchange transfusion is briefly mentioned on HDN and Rh disease pages. Snowman 09:42, 12 August 2006 (UTC)

In the section titled leukoreduction it says that stray white blood cells are removed from the donated blood.Does this mean that all white blood cells in the donor's blood are removed or just certain white blood cells. If stray white blood cells stand for only a certain type of white blood cells could somebody please clarify this by explaining the type of white blood cells that should be removed. If all white blood cells are removed from the donor's blood could somebody please remove the term "stray". —The preceding unsigned comment was added by 88.110.207.144 (talk • contribs).

Indications
A section about the indications for blood transfusion is still missing. could be of some help if someone wants to write it. --WS 23:44, 11 August 2006 (UTC)

Merge ?
Why not merge Blood transfusion and Transfusion reactions? Snowman 08:35, 14 August 2006 (UTC)
 * Since there's not much difference right now, you certainly could. However, I can imagine a transfusion reaction page which is much more than the current list, including sections on each individual reaction, etc. They are different enough topics that each could more than stand on its own. If you'd like, you can put a merge template up on this and the reaction page and probably get more comments! InvictaHOG 11:22, 14 August 2006 (UTC)
 * Yes, the two pages could become very different with more development; however, there is a lot of duplication at the present time. No merged needed.  Snowman 12:07, 14 August 2006 (UTC)
 * After I edited the blood transfusion page, there ended up being more info on transfusion reaction there than on the "Transfusion reaction" page, so I copied most of the info and expanded it slightly. Perhaps this was a mistake. Agree that the transfusion reaction page could definitely be expanded and reorganized, or the info could be removed from the "Blood transfusion" page and replaced with a "main article" link. Probably better to keep 2 separate pages since they are both fairly involved subjects; those are my 2 cents. MastCell 15:46, 14 August 2006 (UTC)

I am attempting to merge all subsections (ie transfusion reaction, crossmatch, etc that are stub-like) into this page to make flow better

Shaolin md (talk) 21:17, 16 March 2011 (UTC)

Religious Objections
Jehovah's Witnesses believe that the Bible prohibits the consumption, storage and transfusion of blood including in cases of emergency. This has been their view since 1945. Over the years their stance on blood has been a source of controversy, as members have died due to loss of blood.

Jehovah's Witnesses believe that in the Bible blood is sacred to God representing life thus it must not be eaten but pour out (figuratively giving it back to God). They also state that blood was reserved for only one special use, the atonement for sins, leading up to Jesus' shed blood, thus when a Christian abstains from blood, he or she is in effect expressing faith that "only the shed blood of Jesus Christ can truly redeem him and save his life.-Ephesians 1:7" Therefore, they believe that when the New Testament says to “keep abstaining from ...blood” [Acts, Ch. 15, Verse 29] it means that Christians should, 'not take blood into their bodies at all.' —The preceding unsigned comment was added by Johanneum (talk • contribs).


 * Perhaps the section could be on "Objections to blood transfusion" (in keeping with the statement about NoBlood) with the recognition that the majority of objections are religiously based. Since you are clearly familiar with the rationale behind JW objections to blood transfusions, why don't you go ahead and start a section on it. The more citations the better, especially when broadly describing a religion's beliefs, as it will make the article more robust and less POV-sounding. MastCell 17:23, 10 October 2006 (UTC)

Sounds good. I have rewrote the first par.to what is below. It is a start for now. Jehovah's Witnesses do not accept tranfusions of whole blood or its four major components namely, red blood cells, white blood cells, platelets (thrombocytes), and whole plasma. They also do not donate or store their own blood for transfusion.Johanneum 12:26, 13 October 2006 (UTC)

National scandals and recovery
Maybe we should include a sentence or two about the Canadian "tainted blood scandal" on this page. In the 1980s, the Canadian Red Cross was responsible for blood donations. However, their screening methods were limited and they were importing blood collected from prisons in the US. This led to thousands of Canadian citizens being infected by HIV and Hepatitis C. After a long enquiry, the Canadian Red Cross was no longer responsible for collecting and testing blood; two newly created agencies took over: the Canadian Blood Services (for most of Canada) and Héma-Québec (in the Quebec province). The two agencies share their knowledge, use similar technologies, and invest actively in R&D for developing new screening technologies. Héma-Québec is currently testing a new screening test for CjD; the test should become fully operational in 2010 and the "donation ban" for people who have stayed in the UK will be lifted. See Royal Commission of Inquiry on the Blood System in Canada for some background info on the scandal. -- Hugo Dufort 01:51, 28 November 2006 (UTC)

A "tainted blood scandal" occurred in Japan too. However, I am not familiar with the incident. -- Hugo Dufort 01:56, 28 November 2006 (UTC)


 * This probably needs its own page, because HIV isn't the only bug in question and this particular scandal hit quite a few countries. Japan, I believe, is wrestling with a similar problem for Hepatitis C screening failures as of 2008.Somedumbyankee (talk) 06:26, 13 March 2008 (UTC)

Chagas/Leichmania in the blood system
Can some mention be made of the new testing policies being put in place for Trypanosoma and Leishmania? I know there were several Chagas infections in the past decade which have been traced back to transfusions and transplants.Rusty 22:01, 18 March 2007 (UTC)


 * I can only speak for US policy, but the official guidance and typical practice is to defer donors who have been in areas endemic for Leishmaniasis for a year. Since Iraq is a main area of concern this is largely transparent since it's also a malarial risk area and the donors would be deferred for a year anyway (though plasmapheresis donors are affected since malaria is irrelevant to acellular components).  A screening test for T. cruzi (Chagas) has been implemented in many US blood centers, but isn't required.Somedumbyankee (talk) 06:26, 13 March 2008 (UTC)

Intravenous route
It's not strictl true that a transfusion can only be carried out via the intravenous route. Endosteal transfusion (i.e. into the medullary cavity of bone) is theoretically possible, and peritoneal transfusion is occasionally practiced in neonates of some animal species. The water and plasma salts are absorbed easily across the peritoneum by diffusion; the protein and even the cellular fraction by active uptake (pinocytosis). 86.133.243.110 15:10, 15 June 2007 (UTC)

Stored blood loses Nitric Oxide?
http://www.economist.com/science/displaystory.cfm?story_id=9941992 Any idea how to add the findings of that study to the article? --204.4.131.140 09:05, 12 October 2007 (UTC)
 * Here's a second source if anyone needs it.

http://www.time.com/time/magazine/article/0,9171,1670523,00.html Ixistant 18:37, 3 November 2007 (UTC)


 * This is specific to packed Red Blood Cells (maybe also Whole Blood) and might be better explained on the specific pages. This page is very busy as it is.  Not sure if NO metabolism has its own page.  Definitely deserves a mention or a link, though.Somedumbyankee (talk) 06:26, 13 March 2008 (UTC)

Wikipedia Scaremongering Strikes Again
Just reading your wonderfull article, very detailed, however, once again wikipedia has demonstrated the tactic of scaremongering in terms of risk assessment for medical conditions. Specifically on the transferred diseases thru blood transfusion section, noone happens to mention that thanks to screening, the chance of picking up a transmitte disease through blood is about 0.25%. Ask your local doctor or hospital, blood is screened so thoroughly that only about 15% of donated blood is given final approval for transmission to another patient. - 203.51.43.121 (talk) 00:30, 2 December 2009 (UTC)


 * Uh... where are you getting those numbers? The risk of transfusion-transmitted infection (TTI) is about the same risk of getting struck by lightning in most developed countries.  There are millions of transfusions each year in the US, and the number of reported transfusion-associated infections is in the tens, many of which are unlikely to be actual TTI's, so 0.25 is way too high (maybe 0.0000025%).  The 15% figure is also bizarre.  Of people that volunteer to donate (which is a lot less than 15% of the population), most (~85-90%) donation attempts result in transfusable components.  The most common reason that an attempt fails is that the donor does not have a high enough iron level, disease-related failed donations account for maybe 1% of failed donation attempts, mostly due to near-paranoid exclusion of any group that might be at high risk rather than test results.  Again, these are US numbers, and I'd assume that most developed countries are similar.  In Zimbabwe, maybe not.  SDY (talk) 16:26, 3 December 2009 (UTC)

Studies related to efficacy of modern blood use
There is information related to the history of the use of blood transfusion in the article, but little related to modern research of blood transfusion practice. Of course the individual studies them self would be too numerous to mention. Perhaps some of the more recent ones could be mentioned. There are numerous news articles related to an expert panel convened earlier this year that found 40 to 60% of blood transfusion are given in scenario's in which the transfusion either adds no benefits or adds additional risks beyond infection, while adding no benefit. I have provided a couple links in case anyone would like to look at it. I personally believe it is beneficial to include such information as many are under the presumption that, aside to the rare infection, that the procedure is benign at worst. http://www.englewoodhospital.com/medservices.cfm?pageid=850&bc=0,27,831 http://www.medpagetoday.com/HospitalBasedMedicine/Hospitalists/13869 —Preceding unsigned comment added by 204.9.160.90 (talk) 21:43, 11 December 2009 (UTC)

This is a good point - I've added some content (with references) regarding transfusion inefficacy, specifically regarding RBC storage lesion. Unknown quality/efficacy levels of stored RBC product has been bolstering arguments for using the so-called "restrictive protocol" of avoiding transfusions wherever possible, even if it delays patient recovery. Interprof (talk) 02:43, 25 September 2011 (UTC)

Pope Innocent VIII
What is the point of having the experience of Pope Innocent VIII as the opening statement in the history section? Men had been drinking blood for thousands of years prior to Pope Innocent VIII. Innocent VIII did not experience a blood transfusion. He was fed blood. I propose deleting this material as though it is part of the history of transfusing blood.--Marvin Shilmer (talk) 20:05, 19 January 2010 (UTC)
 * Given the misleading notion that drinking blood is somehow comparable to the subject known today as blood transfusion, and given the fact that reputable historians have debunked the supposed incident of Pope Innocent VIII receiving a transfusion as fable, unless there is an objection otherwise, I’m deleting the information. (See Lindeboom, The Story of a Blood Transfusion to a Pope, Journal of the History of Medicine, October 1954, pp. 455-459; and Gottlieb, History of the First Blood Transfusion but a Fable Agreed Upon: The Transfusion of Blood to a Pope, Transfusion Medicine Reviews, Vol. 5, No. 3, July 1991, pp. 228-235.) -- Marvin Shilmer (talk)

Copyright problem removed
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medico-legal issues related to transfusion
there is no mention of laws related to blood transfusions, blood banks etc. if any one can help? —Preceding unsigned comment added by 117.199.93.231 (talk) 13:37, 13 July 2010 (UTC)

TRALI
From the description itself this seems to be associated with antibodies towards WBC HLA antigen. why is this placed under the heading Non-immunological reactions? AndreiAA —Preceding unsigned comment added by 78.133.29.242 (talk) 08:06, 17 April 2011 (UTC)

moved to the correct section, also citations provided where citation needed tags were there Jimmy joe joeseph (talk) 08:14, 30 May 2011 (UTC)

Volume information
I've removed a section added to the page regarding volume of a "unit" of blood. This is a complicated issue, and it's not very consistent. 450-500 mls are typically collected from a donor in the US, apparently 470 is the UK's standard collection, but this is a unit of whole blood, which is not often used for transfuson. Of that 450-500 mls, the hematocrit of the donor determines what percent is red blood cells. These are typically processed into what are called packed red blood cells, which are 225-350 mls of RBCs with some residual plasma (pure RBCs wouldn't flow). Some of the cites used to support the "450 mls is it" are a bit misleading, one is talking about "how much of a liter of blood is RBCs" rather than a transfusable volume.

This document has a lot of information that might be useful: Circular of Information. It is, however, the US standards. European standards are grossly similar, but not identical. Blood collection and transfusion in China, for example, is quite different, though there are some basic similarities. My understanding is that 200 mls collected was previously typical in China, though that's changing. SDY (talk) 01:20, 24 August 2011 (UTC)


 * Could you write a section on this? If someone says "I had 20 units of blood". I wish to be able to use wikipedia to translate that into volume (m³). Electron9 (talk) 01:25, 24 August 2011 (UTC)


 * I'll second Electron9's request. This is exactly why I came to this page, and then to the talk page to request it.  Including the above in an only slightly edited form would be useful and improve the article.  --Keithonearth (talk) 19:05, 30 April 2012 (UTC)
 * Great, so we now have an article where "unit" of blood is referenced 30 times but nowhere is it shown what a unit of blood actually is. This is the reason wikipedia is going down the toilet. Good work guys. 2A00:23C8:C93:ED01:345B:2CEA:FDB1:1423 (talk) 20:40, 8 July 2022 (UTC)

Primates
Can people get transfustions from non human Primates and is that successful? — Preceding unsigned comment added by Jokem (talk • contribs) 19:29, 9 November 2011 (UTC)

No. Jimmy joe joeseph (talk) 02:45, 28 February 2012 (UTC)

Listen to the experts?
This section of the article reeks of bias. Blood transfusion has saved millions of lives. I suggest that this section either be moved under a new title (perhaps called "criticisms") or be removed entirely. I'm not doing this myself because I'm not sure who put it there in the first place. But seriously, what's next, a section under the polio vaccine page suggesting that it's a plot by communists to take over our children? People need to get real. — Preceding unsigned comment added by 24.253.56.32 (talk) 23:24, 8 April 2012 (UTC)

completeness
The issue about the researcher who used blood from somebody who had malaria and tuberculosis offers an opportunity to discuss the history of blood born diseases affecting blood banks. Need to expand on this. 108.45.122.74 (talk) 12:26, 26 October 2012 (UTC)

Typical wikipedia omits basic facts
So how much is a unit of blood? — Preceding unsigned comment added by 88.106.68.190 (talk) 16:50, 24 August 2013 (UTC)


 * Thankfully a quick look on Google reveals it's ~450 ml. We need a good source to add it to the article though. JFW &#124; T@lk  13:12, 14 October 2013 (UTC)

harles Drew was the first man to use plasma — Preceding unsigned comment added by 66.229.184.247 (talk) 02:34, 10 January 2014 (UTC)

Restrictive transfusion strategies
... are safer in terms of risk of infection and cardiovascular complications 10.1016/j.amjmed.2013.09.017 JFW &#124; T@lk  13:12, 14 October 2013 (UTC)

"Early efforts to transfuse human blood" Needs Cleanup
The first sentence should probably be deleted, or at least moved. The paragraph starts out "The science of blood transfusion dates to the first decade of the 20th century...", and then jumps to a discussion of blood transfusion in the early *nineteenth* century.kmarple1 (talk) 06:59, 9 January 2014 (UTC)

Storage
10.1111/bjh.12747 Br J Haem - prolonged storage of blood may cause harm. JFW &#124; T@lk  19:57, 27 January 2014 (UTC)


 * ... but not necessarily. 10.1182/blood-2015-09-670950 JFW &#124; T@lk  21:01, 28 January 2016 (UTC)

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Compatibility of ABO and Rh system
Receivers with Rhesus minus blood can't receive Rhesus plus blood. The AB- receiver row wrongly describes the possible matches. And the table in the Role of ABO antigens in transfusion medicine section in ABO blood group system page shows that AB+ receivers can receive blood from all blood types, so I made a small adjustment to correct it yesterday. But for whatever reasons, it was reverted. Can anyone explain that? --171.248.123.170 (talk) 04:13, 18 November 2016 (UTC)

wording clarification
First sentence in the subsection 'Infection' is:

"The use of greater amount of red blood cells is associated with a high risk of infections."

Does this mean number of red blood cells? If not, what does it mean, please?

The next sentence also needs clarification:

"In those who were given red blood only with significant anemia infection rates were 12% while in those who were given red blood at milder levels of anemia infection rates were 17%." I take it that this sentence is introducing the concept of patients with significant anemia versus those with milder anemia? If so, how does this relate to the previous sentence's topic, i.e. number/amount of red blood cells?

any help appreciated

-- Ty rS  13:38, 29 March 2017 (UTC)

Can CMV and other viruses be 100% removed or not?
Wikipedia says: "Leukoreduced blood products are LESS likely to cause HLA alloimmunization (development of antibodies against specific blood types), febrile non-hemolytic transfusion reaction, CMV = cytomegalovirus infection, and platelet-transfusion refractoriness".

The source is quite old and I was not able to access it as it requires a subscription. 91.155.24.127 (talk) 14:55, 14 April 2017 (UTC)
 * if you have a new data, please add it.--Bolzanobozen (talk) 15:17, 27 August 2017 (UTC)

NEJM
10.1056/NEJMra1612789 JFW &#124; T@lk  09:10, 28 September 2017 (UTC)

First transfusion
Dr Agote realize the first blood transfusion, he did it before the rector of the university, the dean of the medical school and the mayor of the city of Buenos Aires in November, 1914 and not only published the results, he wrote to all the countries at WWI explaining how to do it. Only when WWI finished, Albert Hustin says that he had done the same thing before, but in science the first is who published first and Hustin only has his word about the date that he supposedly did it, so you are confirming a rumor without evidence. — Preceding unsigned comment added by 186.22.67.17 (talk) 21:05, 13 February 2019 (UTC)

OPS link in infobox is wrong
can it just be deleted if it is wrong and I don't know the correct one?EncycloABC (talk) 17:01, 16 December 2019 (UTC)

Blood unit redirects here
The unit disambiguation page points to blood unit which uselessly redirects here. There needs to be a section explaining this, even if the only thing it says is "it's complicated". For what it's worth, when I had a phlebotomy today, they measured one unit of whole blood as 16 ounces avoirdupois, on a scale. 207.180.169.36 (talk) 04:47, 23 January 2021 (UTC)

Use of enzymes to change blood type to O
In 2007, it was reported in Nature Biotechnology that scientists had found a way to strip blood type enzymes and make blood into type O. They were planning to get regulatory approval for this procedure...whatever became of this? Is it worth mentioning in the article? -- Beland (talk) 20:17, 11 April 2021 (UTC)