Emphysema usually is related to long-term smoking and develops over a long period of time. It causes the lungs to lose their elasticity and results in increasing difficulty breathing and shortness of breath. All forms of chronic obstructive pulmonary disease cause air to become trapped in the lungs. There are many types of anemia with low blood counts and this condition also probably developed over a long period of time. Many chronic diseases can interfere with the production of red blood cells and result in anemia.
Poor nutrition can also contribute to anemia.
However, we would advise your friend to try to find more information about the specific cause of his father's low blood count. It is important not to overload the circulatory system, especially in older people who have lung disorders. Thus the wait for additional transfusions. Overloading could lead to congestive heart failure, which is an accumulation of body fluid in the lungs, and further complications. It sounds like your friend's father is going to need supportive care to improve his fatigue and shortness of breath.