Packed Red Blood Cell (PRBC) Transfusion

Packed red blood cells—also called PRBCs, RBCs, and packed cells—are a type of blood replacement product used for blood transfusions. PRBC transfusion is typically given in situations where the patient has either lost a large amount of blood or has anemia that is causing notable symptoms.

If a patient needs blood, there are a few types of blood replacements available—PRBCs being just one. A healthcare provider will choose what type of blood replacement is given based on the patient's situation.

Most people think that when they receive a blood transfusion, they are getting whole blood because that is what they donate at a blood drive. The blood one donates, referred to as whole blood, has both the plasma and the red blood cell components.

Plasma is the liquid portion of the blood and is light yellow in color and makes up 55% of the volume of blood. Red blood cells make up 45% of blood and are the red color that most people think of when they think of blood.

This whole blood is not typically transfused unless the patient needs a massive amount of blood to counteract tremendous blood loss. Instead, packed red blood cells, which is whole blood minus the plasma portion, are typically given.

Why Red Blood Cells Are Used for Transfusions

Red blood cells are essential to good health and can be lost due to trauma (gunshot wound, car accident), internal bleeding, or health problems such as significant anemia. Red blood cells carry oxygen from the lungs to the tissues of the body. To determine if a blood transfusion should be given, a blood test called a complete blood count (CBC) is done.

A person who needs red blood cells often feels weak and may feel out of breath with minimal activity. Prior to a needed transfusion, a patient may appear pale and feel fatigued. They may feel dizzy, may feel like their heart is "racing" or have difficulty concentrating.

PRBC Transfusion Procedure

Whole blood is not typically transfused, instead, the component the patient needs is given. The patient may receive plasma, or packed red blood cells, or if there is a need both may be given.

After donated blood is collected, the components are separated in a centrifuge, then a small amount of an anticoagulant is added to keep the PBRCs from clotting. The blood is kept in a refrigerator and is good for approximately 42 days from the date of donation.

PRBCs must be matched to the recipient, meaning that the blood type of the donor and the recipient must be compatible. If the blood is not properly matched, the result can be a life-threatening reaction, so the match is typically double checked by lab staff and nursing staff at the minimum.

Approximately 1 in 8 hospitalized patients needs a transfusion. The chances of needing a transfusion are higher when having surgery, and you may be told prior to the procedure that you will require blood.

Some patients prefer to avoid a transfusion when possible or have religious beliefs that forbid transfusions. For this reason, bloodless surgery, a group of techniques that help patients avoid or minimize the need for blood is often performed for these patients.

Safety of the Blood Supply

Extensive testing is done to prevent tainted blood from reaching the blood supply. An initial screening is done to make sure the donor has no medical conditions or high-risk behaviors that make blood donation unwise.

The donor is also screened for current illnesses, such as having a cold or the flu or having an infection (a risk for spreading an infection to the recipient). Once the blood has been collected, it is tested for infectious diseases, including hepatitis and HIV.

The blood supply in the United States is among the safest in the world, however, if you are in a country outside of the U.S., the level of safety may vary widely. Abroad, you may have difficulty obtaining a blood transfusion (limited supply), the supply may not be considered safe, or testing may not be adequate.

Cost of PRBC Blood Transfusion

A PRBC transfusion of one unit (one bag) can range from $522 to $1,183. The number of units given in a PRBC transfusion can range anywhere from one unit for someone who is anemic, to forty or fifty for a critically ill patient who is hemorrhaging and will die without blood immediately.

While it is true that donors are not compensated for donating their blood, aside from a token gift or a snack, blood is still quite costly. These fees help pay for the staff that runs blood drives, the laboratory that processes the blood, transportation costs, blood bank technologists who match and issue the blood, and the nursing staff that gives the blood.