whole blood

Medically Reviewed on 1/5/2023

Generic Name: whole blood

Drug Class: Blood Components

What is whole blood, and what is it used for?

Whole blood is the entire blood collected from donors that contains all the blood components. Whole blood is primarily used for transfusion in adults with massive blood loss and active bleeding, who generally require all the blood components. Whole blood may also be reconstituted using stored plasma, red blood cells (RBCs), and platelets, usually used for cardiovascular surgeries and exchange transfusions in newborn babies.

Fresh whole blood is not commonly used or available any longer in most of the U.S. Currently, the most common use of whole blood is for the donor’s own transfusion (autologous) when needed during or after elective surgery. Whole blood contains all the blood components including red blood cells, platelets, stable clotting factors and plasma, providing volume and all the necessary components to control bleeding in rapidly hemorrhaging patients.


  • Whole blood transfusions should not be used when only a specific blood component is required and available. Whole blood can cause volume overload and other complications in patients who have adequate volume and only require a specific blood component.
  • ABO blood group should be matched to the recipient and only the identical group should be used for transfusion, because whole blood contains plasma and red blood cells.
  • Whole blood is stored at 4 degrees C, and has a 21-to-35-day expiration depending on the anticoagulant solution used.
  • Whole blood may be deficient in clotting factors V and VIII, unless it is fresh, because these clotting factors degrade rapidly during refrigerated storage.
  • Platelets undergo conformational changes with even short-term refrigerated storage and are unlikely to be beneficial since whole blood is stored at 4 degrees C.
  • Transfusion should not be delayed waiting for reconstituted whole blood in emergency transfusions, because reconstitution is a time-consuming process.
  • All whole blood transfusions must be given using blood administration sets containing 170- to 260-micron filters or 20- to 40-micron microaggregate filters, unless transfusion is given via a bedside leukocyte reduction filter.
  • No other medications, or fluids other than normal saline should be simultaneously given through the same line as whole blood without prior consultation with the medical director of the blood bank.
  • Monitor patients for signs of transfusion reaction, including vital signs, before, during, and after whole blood transfusion. If transfusion reaction is suspected, stop the transfusion, assess and stabilize the patient, and notify the blood bank to initiate an investigation.
  • Massive or rapid transfusion of whole blood may lead to arrhythmias, hypothermia, hypocalcemia, hyperkalemia, metabolic alkalosis, and heart failure.
  • Monitor for iron overload due to hemoglobinopathies such as sickle cell disease or thalassemia in chronically transfused patients.
  • Whole blood transfusions carry the risk for non-septic infections including human immunodeficiency virus (HIV) hepatitis B and C viruses (HBV and HCV), human T-lymphotropic virus (HTLV), cytomegalovirus (CMV), West Nile virus (WNV), parvovirus B19, Lyme disease, babesiosis, malaria, Chagas disease and variant Creutzfeldt-Jakob disease (vCJD).
  • Consult with the blood bank medical director or a hematologist if you have questions regarding special transfusion requirements.


Sickle cell disease is named after a farming tool. See Answer

What are the side effects of whole blood?

Common side effects of whole blood include:

Call your doctor immediately if you experience any of the following symptoms or serious side effects while using this drug:

This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

What are the dosages of whole blood?


Acute Hemorrhage

  • As whole blood transfusion is limited to acutely hemorrhaging individuals, dosing should be based on the patient’s clinical condition, estimated blood loss, and other measures being used to maintain hemodynamic stability.

Other Information

  • Whole blood is no longer commonly available or used in most of the United States.
  • The most common use of whole blood in the United States is currently autologous donations for elective surgery.
  • Whole blood, if available, may be indicated for large volume hemorrhaging, such as seen with major trauma, requiring massive transfusion and rapid correction of anemia, coagulopathy, acidosis, and hypothermia. Studies supporting this approach include military trauma where they are able to transfuse very fresh (less than 24 hours old) whole blood which is not currently routinely available in civilian institutions.
  • Reconstituted whole blood is used for neonatal exchange transfusions, most commonly for hemolytic disease of the newborn. It is sometimes used during pediatric cardiovascular surgery as well as in neonatal hemodialysis.


Exchange Transfusions

  • For dosing of reconstituted whole blood for exchange transfusions, please consult with your institutions blood bank medical director or hematologist.
  • Cardiovascular Surgery or Hemodialysis
  • For dosing of reconstituted whole blood for use during cardiovascular surgery or hemodialysis, predefined dosing protocols should be setup by the institution depending on type of procedure performed and the cardiopulmonary circuits used at the institution.


  • Excessive transfusion of whole blood can result in circulatory overload which can cause symptoms such as fluid in the lungs (pulmonary edema), acute respiratory distress, increased blood pressure, and rapid heart rate.
  • Transfusion overload may be treated with diuretic administration, removal of excess fluid by hemodialysis, and other supportive measures as required, including oxygen administration.

What drugs interact with whole blood?

Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.

  • Whole blood has no known severe, serious, moderate, or mild interactions with other drugs.

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.

Pregnancy and breastfeeding

  • Whole blood may be used for transfusion in pregnant women with active bleeding before, during or after delivery.
  • Cytomegalovirus-seronegative or CMV reduced risk (leukocyte reduced) red blood cells should be used in pregnant or breastfeeding women who are CMV-seronegative or whose CMV status is unknown.

Subscribe to MedicineNet's General Health Newsletter

By clicking Submit, I agree to the MedicineNet's Terms & Conditions & Privacy Policy and understand that I may opt out of MedicineNet's subscriptions at any time.


Whole blood is the entire blood collected from donors that contains all the blood components. Whole blood is primarily used for transfusion in adults with massive blood loss and active bleeding, who generally require all the blood components. Whole blood may also be reconstituted using stored plasma, red blood cells (RBCs), and platelets, usually used for cardiovascular surgeries and exchange transfusions in newborn babies. Common side effects of whole blood include hemolytic transfusion reactions, hives (urticaria), itching (pruritus), wheezing, shortness of breath (dyspnea), low blood pressure (hypotension), and serious allergic (anaphylactic) reactions.

Treatment & Diagnosis

Medications & Supplements

Prevention & Wellness

FDA Logo

Report Problems to the Food and Drug Administration

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

Medically Reviewed on 1/5/2023