About your blood

Red blood cells carry oxygen around your body. These red blood cells contain an iron-rich protein called haemoglobin. 

When your haemoglobin becomes low, your body does not receive enough oxygen. This can cause you to feel short of breath or tired.

Low haemoglobin is often called anaemia. It is usually caused by low iron levels, bleeding or medical conditions that stop your body making enough red blood cells.

Treatment for anaemia caused by blood loss

We can increase your haemoglobin with a blood transfusion of red blood cells from a blood donor. There is currently no other way to improve the oxygenation of blood in the body.

However, there are other medications and treatments that we can use to help minimise blood loss and its effects. Their use depends on the type of surgery you have and your current medical condition.

Your medical team will discuss these other medications and treatments with you.

Pregnancy

If you are pregnant and plan to refuse a blood transfusion, it is important that you let us know as soon as possible.

We will then offer you an appointment to see a consultant anaesthetist during your pregnancy. 

They will discuss your options with you, and make sure your wishes are clearly recorded ahead of time.

Other medications and treatments

For pregnant women only

Cell salvage

If your baby is due to be born by caesarean section, we can collect any blood that you lose and return it to you. To do this, we use a 'cell salvage' machine. 

It collects your blood, washes and filters it, and returns it to your blood circulation.

This can reduce your need for a blood transfusion afterwards. However, it does not replace the need for a blood transfusion if you experience significant heavy bleeding.

For all patients

Tranexamic acid

We often use this medication to help prevent and treat blood loss. We can give it to patients by tablet or intravenously (through a vein, using a drip). It helps to stop reduction in blood clotting at the site of bleeding.

The side effects of tranexamic acid can include:

  • nausea and vomiting
  • diarrhoea.

Iron

If you have a low iron level, this may contribute to giving you anaemia (low red blood cells). 

We can give patients iron by tablet or intravenously (through a vein, using a drip). 

Lifestyle tip: you can help to raise your own iron levels by having plenty of iron-rich foods in your diet.  These foods include:
  • pulses
  • meat
  • leafy green vegetables
  • nuts
  • dried fruit.

Erythropoietin

Erythropoietin is a natural hormone produced by your kidneys. It helps your body to produce more red blood cells, and we can use it to treat anaemia for some (not all) patients.

We usually give it by injection, 1 to 3 times a week.

Side effects include:

  • high blood pressure
  • skin reactions
  • headaches
  • bone pain
  • flu-like symptoms.

rFVIIa (Recombinant Factor VIIa)

rFVIIa (brand name NovoSeven) is a medication developed to promote blood clotting and reduce severe bleeding. We can also use it to treat severe bleeding after childbirth (postpartum haemorrhage), if other treatments have not been able to stop the bleeding.

rFVIIa is not derived from human plasma. The manufacturing process uses small amounts of mouse, cow and hamster proteins.

rFVlla has serious side effects, which can include:

  • blood clots
  • heart attack
  • stroke.

Other options

You can talk to your medical team about the use of:

  • surgical adhesives
  • tissue sealants.

They will discuss with you whether either of these are suitable for use during your treatment or surgery.

More information

Kingston Hospital on Ferinject iron infusion during pregnancy

NHS information on anaemia

NHS information on iron in your diet

Contact information

Blood transfusion department
Wednesday to Friday, 8am to 6pm

Telephone:

020 8934 5268

Email: krft.transfusion@nhs.net