Transfusion In Palliative Care

There are relatively few studies related to transfusion therapy in the palliative care and hospice settings, although anemia and its associated symptoms may be evident in these patients. Although bleeding may be an indication for transfusion, the relief of symptoms related to anemia, such as weakness or shortness of breath, are probably more common in this setting.86 Fatigue and mood disturbances are common in patients with advanced cancer.87 Anemia, and related nutritional deficiencies (e.g., iron deficiency), have been shown to be contributory factors to causing fatigue, impaired cognitive function, poor concentration, memory problems, and other related symptoms.87-91 Transfusion, with or without erythropoietin, can be considered for these quality of life issues for patients in the terminal stages of cancer, rather than for any possible prolongation of life when, quality may not be significantly altered.92-94 Transfusions can be administered in the patient's home as well as in conventional care settings; however, home transfusion therapy requires greater commitment and communication between care givers in order to provide safe and efficient transfusion therapy.95-98 Home transfusion therapy, and transfusion in the hospice setting, has been well-received by those patients unable or unwilling to travel to the hospital or infusion unit.99-101 If palliative care initiatives for adult and pediatric patients are to be performed in the home, then transfusion therapy should be given consideration in this setting. Adverse reactions to transfusions should be handled with the same due diligence as in any other conventional care setting in order to guard against and prevent any increased morbidity and mortality.97-101

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