Blood Transfusion
Adults
Basic Information 
Overview and Goal(s)
• Overview: a transfusion is the administration of blood and/or partial blood constituents from one horse (donor) to another (recipient) in which the recipient has a clinical disease that necessitates these components as therapy to prolong life.
There is usually a history of prior disease or trauma that results in a reduction in the functional circulating erythrocyte mass.
• The underlying type of the anemia should be determined as hypovolemic (eg, hemorrhagic) or euvolemic (hemolytic or erythropoietic failure).
• For hemorrhagic anemia, the cause should be determined as either internal or external hemorrhage.
• In the case of hemolysis, the anemia should be classified as extravascular or intravascular.
• Goal of therapy: to increase the delivery of oxygen (DO2) to the tissues to treat/prevent global and local tissue hypoxia.
Global and local tissue hypoxia causes ineffective cellular metabolism, cell dysfunction, and cell death (apoptosis and necrosis).
Indications
• There are no age or sex predispositions for the need for blood transfusions in adult horses.
This is in contrast to neonatal isoerythrolysis (see “Neonatal Isoerythrolysis” in Section I), where only foals with the ability to ingest and absorb colostral anti-erythrocyte antibodies from their mare may develop hemolysis requiring blood component therapy.• Risk factors for the need of whole blood transfusion include surgical procedures, notably procedures that involve the paranasal sinuses.
• Disease conditions such as guttural pouch mycosis (where fatal hemorrhage from the internal carotid artery can occur) may also increase the likelihood for transfusion.
• Traumatic events such as limb lacerations, long bone fractures (notably femoral), and penetrating chest wounds are also high-risk conditions that may require transfusion.
• Pregnancy, parturition, and dystocia can result in urogenital trauma and hemorrhage.
• Congenital and acquired coagulopathic disorders including disorders of platelets and/or coagulation factors may result in hemorrhage and necessitate transfusion.
• Ingestion of hemolytic toxins including red maple leaf and onion weed may require packed erythrocyte transfusion.
• Endogenous production of hemolytic antibodies (immune mediated hemolytic anemia) in certain diseases (ie, clostridial and streptococcal diseases) may necessitate packed erythrocyte transfusion.
• Bone marrow disorders resulting in significant erythroid hypoplasia/aplasia may necessitate packed erythrocyte transfusion.
Contraindications
Equipment, Anesthesia
• Clippers, prep, nonsterile and sterile gloves
• 3 to 5 mL of lidocaine to block the skin of each horse at the site of catheter insertion
• 14-gauge catheter (one for donor and one for recipient)
• Suture or superglue for temporary catheter placement
• Collection bag (plastic preferred to preserve platelets)
• Anticoagulant (use one-third of recommended amount for autotransfusion)
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