Blood transfusions in palliative care: a method to improve quality of life or a double-edged sword? A mini-review

Blood transfusions are uncommon in the palliative care setting. There are no guidelines to make decisions about blood transfusions in palliative care. Certainly, these decisions cannot be made basing on the hemoglobin level only. Occasionally the issue of blood transfusion is being discussed with the family. Instead of being a bridge to recovery and self-sufficiency of the bone marrow, like non-palliative medicine, blood transfusions are appreciated as buying some quality time for the patient. However, this issue is questionable in the light of available data and experience. Blood transfusion can boost the patient’s energy for days or a week, but it can also have more adverse effects including re-bleeding and unexplained death. Controlled data on this subject are absent. In the discussions on blood transfusions with the patients and their families these aspects should not be forgotten. Blood transfusions remain, not without reason a rare but possible procedure in palliative care.