Transfusionsmeditsiin

Transfusionsmeditsiin, or transfusion medicine, is a medical specialty focused on the safe and effective use of blood and blood components. It encompasses donor recruitment and screening, collection, processing, testing, storage, compatibility testing, and the clinical use of transfusions. The field integrates laboratory immunohematology with clinical care and is guided by national regulations and quality standards. Karl Landsteiner's work on ABO blood groups laid the scientific basis for transfusion medicine.

In most health systems, transfusion medicine is a service area within pathology, hematology, or internal medicine. Blood centers or blood banks coordinate donation, testing for infectious agents, component preparation, storage, and distribution to hospitals. Crossmatching and compatibility testing help reduce the risk of immune reactions.

Blood components include red blood cells, platelets, plasma, and cryoprecipitate, as well as granulocytes in select cases. Indications vary: red cells for symptomatic anemia or ongoing bleeding; platelets for thrombocytopenia or platelet dysfunction; plasma and factor concentrates for coagulation deficits. Perioperative and trauma settings are major use areas.

Safety is a central concern. Donor screening and infectious disease testing reduce transmission risk; leukoreduction, irradiation, and pathogen reduction in some contexts improve safety. Protocols oversee product labeling, storage, and traceability to prevent transfusion errors.

Adverse transfusion reactions occur, including allergic and febrile reactions, acute hemolytic reactions, transfusion-related acute lung injury (TRALI), and transfusion-associated circulatory overload (TACO). Prompt recognition and treatment are essential; physicians weigh benefits against risks before transfusion.

Contemporary transfusion medicine emphasizes patient blood management, restrictive transfusion strategies, and alternatives such as iron therapy, erythropoiesis-stimulating agents, antifibrinolytics, and autologous transfusion. The field continues to adopt pathogen reduction, improved donor recruitment, and data-driven quality improvement.