The Sanguine Transfuser must be crafted at The Cold Forge using three specific items:

The applies Bleeding on hit. The build stacks Shadowcast (for Shadow's Embrace ) or Flamecharm (for Burning + Jus Karita ) to trigger Thirst for Blood or Sanguine Hunger .

A more advanced PvP strategy involves turning the weapon's "friendly" healing into a weapon against enemies.