Transfusion medicine reviews
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In summary, it is impossible to reconcile the contradictory results of the studies of the association between previous blood transfusion and subsequent development of NHL (Figs 1 and 2). Most of the studies were of high quality, and the authors discussed the possible sources of bias that might have generated a spurious association or concealed a true relationship. Although recall bias, detection bias, and allogeneic blood transfusions given because of the onset of NHL could be responsible for the reported positive associations, these explanations were considered by the investigators, and they seem unlikely. ⋯ The available studies are observational, and they cannot determine whether any increase in risk, observed in association with allogeneic blood transfusion, is due to the transfusion itself or to other factors occurring in association with the transfusion. In conclusion, allogeneic blood transfusion from healthy donors may be associated with a small increase in the risk of development of NHL after the transfusion. This hypothesis is biologically plausible and is
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Informed consent for transfusions presumes that the patient has been "informed," meaning they have been given sufficient information to make an intelligent choice, and that they "consent," meaning that the patient is competent and free to consent. Although this may be oral or written, the latter is preferable for documentation and legal proof. This may either be as a chart note, or form. ⋯ If this process is performed by the physician talking to his/her patient, then, the patient is likely to be informed about, and consent to, elective transfusions. Once obtained and documented, that consent should be presumed to be valid with a course of therapy for transfusions. If some event significantly changes some aspects of the information on which the patient relied in consenting and now should be aware of, then, the patient should again give consent for transfusion, after being informed of this new information.