The second Austrian benchmark study confirmed that anaemic patients received transfusions twice as often as non-anaemic patients, and up to four times as many transfusions (unpublished data; personal communication of H.G., P.H. Rehak, A.S., and A.H).
Many transfusions appear to be administered because of an arbitrary 'transfusion trigger' rather than a physiologic need for blood.
When Blumberg was studying antibodies in the blood of a haemophilia patient who had received many transfusions, he discovered that the blood reacted with an antigen in the blood of an Australian Aborigine.
However, the increased odds were not restricted to patients receiving many transfusions, as patients receiving only 1 transfusion had increased odds of an adverse outcome (adjusted OR 2.7, 95% CI: 1.2-5.7).
Because Wiens had received so many transfusions at Parkland, his body had built up an antibody response to more than sixty per cent of donor tissue.
While taking the drugs, he bled profusely from the nose and stomach and required many transfusions.
Because of the universal application of many transfusion interventions, one has to consider carefully the methodologic rigor as to which of these interventions are evaluated.
However, despite growing evidence based on both preclinical and clinical studies to support its efficacy and safety [ 17- 20], fibrinogen concentrate is not yet a standard component of many transfusion protocols.
Many transfusion centers would love to have a single type of blood suitable for everyone, rather than having to keep different types in stock and worrying that severe problems may occur if the wrong type is transfused.
In some patients, this phase lasts for hours, leading to truly massive transfusions of many tens of units of RBCs, along with plasma and platelets to limit dilutional coagulopathy.
