additional ttransfusion medicine

Question 1

What temp are RBCs stored at and how long do they last?

Answer 1

stored 1-6C

last 42 days

Question 2

What temp are platelets stored at and how long do they last?

Answer 2

20-24C

last 5 days

Question 3

how long can plasma be kept?

Answer 3

Lasts frozen at -18C for one year
Once thawed, plasma can be stored
at 1-6 °C for 5 days

Question 4

what length of time do the factors provided in FFP stay around for?

Answer 4

3-6 hours for factor VII
• 8-12 hours for factor VIII
• 2-3 days for factors II and XI

Question 5

how much fibrinogen is contained in one unit of cryo?

Answer 5

at least 150mg

Question 6

what is the dosing of cryo?

Answer 6

Adults: 10 units. Pediatrics: 1 unit/10 kg
body weight to maximum of 10 units.

Each dose will increase the fibrinogen
by 0.5 g/L in the bleeding patient

Question 7

what are the 2 types of plasma products?

Answer 7

whole blood donor plasma frozen within 24hrs

apheresis donor that is frozen within 8hrs

Question 8

how is cryoprecipitate made?

Answer 8

take frozen plasma at -18C, then thaw it in the cold at 1-6C, a precipitate is formed that is collected

Question 9

what are the indications for the use of cryo

Answer 9

hypofibrinogenemia, DIC, massive transfusion protocol

Question 10

what are the potential complications of granulocyte transfusion?

Answer 10

acute and chronic CMV, other viral infections, HLA alloimmunization
should be crossmatch compatible with donor, as RBC are transfused with the grans

Question 11

describe leukoreduction

Answer 11

standard for all cellular blood components expect granulocytes.
It’s a filtration of the product to remove WBC

Question 12

what are the benefits of leukoreduction?

Answer 12

decreases risk of febrile reactions from 2% to 1%
Decreases the risk of allosensitization
decreases the risk of CMV transmission

Question 13

what is irradiation used for?

Answer 13

used to protect patients from transfusion associated GVHD

Irradiation with 2500cGy, will inactivate lymphocyte division in the blood product

Question 14

describe transfusion associated GVHD

Answer 14

when there is engraftment and proliferation of donor lymphocytes in a transfusion recipient
the donor cells will attack and cause pancytopenia and organ dysfunction. This is a fatal disorder

Question 15

which patient populations should receive irradiated blood products

Answer 15

fetus/newborns up to 4mths
BMT patients
heme malignancies
congenital immunodeficiencies
blood relative blood donors (directed donation)

Question 16

describe washed cellular products and its indications

Answer 16

washing of RBC and platelets is done to reduce plasma proteins and cytokines

For

• Severe or recurrent allergic reactions to plasma proteins in cellular blood products
• anaphylactic reactions due to IgA antibodies in IgA deficient recipients
• infants with NAIT who receive platelets from their mother where washing removes the circulating platelet-specific antibodies responsible for NAIT

washed products expire in 24hr for RBC and 4h for platelets

Question 17

what types of reactions would you consider if a patient developed a fever after a transfusion?

Answer 17

Acute hemolytic reaction
Non-hemolytic reaction
bacterial contamination

Question 18

what is the proposed pathophysiology of TRALI?

Answer 18

donor (multiparous woman) develops HLA antibodies that are passively transferred to patient. These HLA antibodies agglutinate with leukocytes in the pulmonary microvasculature and lead to ARDS/Resp distress

Question 19

when would you expect a delayed hemolytic transfusion reaction?

Answer 19

within 3days to 2 weeks post transfusion

Question 20

what degree of matching is required for plasma products?

Answer 20

crossmatching is not required, however products should be ABO-compatible with the receipients RBC

Question 21

which blood type is the universal donor

Answer 21

Group O, because they have no antigens on the RBC surface

Question 22

which blood type is the universal acceptor?

Answer 22

group AB, because they don’t have any antibodies

Question 23

which type is the universal platelet donor?

Answer 23

type AB, because there are no antibodies in the plasma, and there’s a small amount of RBCs that get into a platelet product

Question 24

describe the indirect coombs test (ie-antibody screen)

Answer 24

main question you are asking: are there RBC antibodies present?
by using patient plasma, reagent red cells and coombs reagent, you can look for agglutination

Question 25

describe the DAT

Answer 25

main question: are there antibodies on the RBC surface?

take patients RBCs and add coombs reagent (that will crosslink) and look for agglutination