Blood Banking I Flashcards
Fully described the circulation and properties of blood
William Harvey
King Louis XIV’s physician who transfused blood from a sheep
Jean-Baptiste Denys
Richard Lewisohn
Sodium citrate as an anticoagulant of blood
Discovered the first human blood groups
Karl Landsteiner
What is blood banking?
The process of collecting (donation), testing, processing, and storing blood for later use (transfusion)
Lead to establishment of blood banks
Discovery of sodium citrate as a blood anticoagulant
First recorded attempt of a blood transfusion
1942: Pope Innocent VIII
Discovered AB blood group
Alfred von Decastello
Adriano Sturli
Ethanol fractionation
Method of breaking down blood into its component parts to obtain albumin, gamma, globulin, and fibrinogen
Albert Hustin
Conducted the first non-direct transfusion using sodium citrate as an anticoagulant
Old term for AIDS
Gay-related Immunodeficiency Disease
First blood depot
Large amounts of Type O were collected, preserved, and used for wounded soldiers
Introduced plastic blood bag
Fenwal Co.
Charles Drew
Pioneer in plasma preservation and a major contributor to the advancement of blood banking in the US
Suggested cross-matching
Reuben Ottenberg
What is babesiosis?
Disease caused by a protozoan, spread by Ixodes scapularis ticks
American Association of Blood Banks
1 Organized to support and encourage continued blood research
2 Promote exchange of information
3 Develop standards of practice for blood banks
Other term for blood banking
Transfusion medicine
Developed ethanol fractionation
Edwin Cohn
Opened first true blood bank
Chicago’s Cook County Hospital
Preparation before donating blood
1 Have enough rest and sleep
2 No alcohol intake 24 hours prior to blood collection
3 No medications for at least 24 hours prior to blood collection
4 Have something to eat prior to blood donation
5 Drink plenty of fluids
Deferral time for pheresis
48 hours
RBCs are transfused back to the patient
Cell saver
Basic requirements
1 In good health
2 Between 16 to 65 years old (16 and 17 year olds need parents’ consent)
3 Weigh at least 110 pounds
4 Have a blood pressure between
Systolic: 90-160 mmHg
Diastolic: 60-100 mmHg
5 Pass the physical and health history assessments
Advantages of autologous donation
1 Blood that is positive for infectious agents and with irregular blood group antibodies are acceptable
2 Safer than allogeneic blood
3 No criteria for testing
4 No allergic reactions
Screening for blood donation
1 Medical history
2 Physical examination
Spread by Trypanosoma cruzi, triatomine bugs
Chagas’ disease
Reduces need for allogeneic blood transfusion
Cell saver
What to do after blood donation?
1 Drink plenty of fluids
2 Refrain from stooping down after blood donation
3 Refrain from strenuous activities
4 Avoid using the punctured arm in lifting heavy objects
5 Apply pressure on the punctured site and lift the arm in case the site is still bleeding
6 If there is discoloration and swelling on the punctured site, you may apply cold compress for 24 hours
7 If there is dizziness, lie down with your feet elevated and drink plenty of fluids
Amount of blood to be drawn
Allowable amount (mL) = (donor’s weight in pounds x 450 mL)/110 mL
Three methods of using patient’s blood
1 Hemodilution
2 Cell saver
3 Wound drainage
Discovered Rh group
Alexander Wiener
Steps in donating blood
1 Have your weight taken
2 Register and complete the donor registration form truthfully
3 Have your blood type and hemoglobin checked
4 A physician will conduct a blood donor examination
5 Actual donation (350 or 450 cc)
6 After donation: 5 to 10 minute rest and plenty of fluid intake
African sleeping sickness
Trypanosoma brucei, tsetse fly
History of heart disease, active pulmonary disease, cancer, leukemia, lymphoma
Deferred
Medical history
1 Donated blood
2 Antibiotics for acne are acceptable
3 History of heart disease, active pulmonary disease, cancer, leukemia, lymphoma
4 History of hepatitis after 11th birthday
5 History of babesios and Chagas’ disease
6 African sleeping sickness
7 Creutzfeldt-Jakob disease
8 Male having sex with men since 1977
Plasmapheresis
Separation and withdrawal of plasma
Temperature
Less than or equal to 37.5 Celsius
Poison ivy and other rashes
Acceptable
Hemoglobin
Greater than or equal to 12.5 g/dL
Blood from surgery is recovered, mixed with saline and anticoagulant, centrifuged, and washed
Cell saver
Blood is collected from cavities
Wound drainage
Pulse
50-100 BPM
Usual granulocytes harvested
1 Basophils
2 Eosinophils
3 Neutrophils
Destroys WBCs that cause TA-GvHD
Gamma irradiation
Previously collected higher hematocrit blood is transfused back to the patient after surgery
Hemodilution
General appearance
1 No cough
2 Not under the influence of drugs or alcohol
3 Normal skin color
4 No signs of skin infection, rash, enlarged lymph nodes
Blood is collected prior to surgery and replaced with plasma
Hemodilution
Principle of centrifugation
Blood components are separated by centrifugal force due to their differences in densities
Blood is for personal use
Autologous donation
Deferral time for those who have donated blood
8 weeks/56 days
Purpose of plateletpheresis
Avoidance of complications of thrombosis, bleeding, DIC, and formation of blood clots
Used for screening for liver problems
ALT
What is therapeutic apheresis?
Removal of blood components that are defective/abnormal and cause pathologic disease
Kinds of hemapheresis
1 Plasmapheresis
2 Plateletpheresis
3 Leukapheresis
Controls the movement of oxygen from red blood cells to body tissues
2,3-Diphosphoglycerate
Affects the transfusion recipient’s bone marrow
TA-GvHD
Removes thrombi and tissue fragments but not cytokines
Filter in wound drainage
Creutzfeldt-Jakob disease
Deferred
Blood is collected for a specific patient such as a family relative
Directed donation
Recipients of plateletpheresis
Patients who have become HLA sensitized and require platelets from donors whose HLA type matches theirs
Other term for Chagas’ disease
American Trypanosomiasis
Blood lost during and immediately after surgery is collected and reinfused
Cell saver
Leukapheresis
Separation and withdrawal of leukocytes
Recipients of clotting factors
1 Hemophiliacs
2 Severe burn patients
Examples of blood components removed by therapeutic apheresis
1 Over-reactive WBCs
2 Pathologic antibodies
3 Defective clotting factors
Process of hemapheresis
1 Separated portions of interest are withdrawn and transfused to the patient
2 Remaining components are re-transfused to the donor
Released into the blood when the liver and heart are damaged
Serum glutamic pyruvic transaminase
Reduces circulating antibodies and immune complexes
Removal of plasma with saline solution
Other term for triatomine bugs
Kissing bugs
Recipients of granulocyte transfusions
1 Neonates with low immune system (septic neonates)
2 Patients with severe fungal infections or leukemia
3 Patients with defective hematopoietic stem cell progenitor cells
Stem cell harvesting
Circulating bone marrow stem cells can be harvested for research on stem cell therapy and treatment
Circulatory problems caused by excess blood proteins
1 Waldenstrom's macroglobulinemia 2 Myasthenia gravis 3 Guillain-Barre syndrome 4 Hyperviscosity syndromes 5 Paraproteinemia 6 Cryoglobulinemia 7 Goodpasture's syndrome
Complications of directed donation
1 Confidentiality
2 Not cost effective
3 Increased risk for transfusion-associated graft-versus-host disease
4 Alloimmunization of potential recipients of transplants
5 Increased risk for hemolytic disease of the newborn
Reduces loss of RBCs during surgery
Hemodilution
Associated with hematopoietic cell transplantation
HCT-associated GvHD
Blood components from least dense to most dense
Plasma - Platelets - Lymphocytes - Monocytes - Granulocyte - RBCs
Other term for SGPT
Alanine aminotransferase
Vaccines that generally do not affect eligibility
Vaccines made from killed/inactivated/recombinant material
Prevented clotting during transfusions by sewing veins and arteries of the donor and recipient together
Alexis Carrel
Double red blood cells
16 weeks/112 days
Causes a shift to the left of the hemoglobin-oxygen dissociation curve
Decreased levels of 2,3-DPG
What is sepsis?
Inflammation triggered by chemicals released into the bloodstream
Alloantigens
Antigens derived from a genetically dissimilar animal of the same species
Other anticoagulants used for storage
Citrate phosphate double dextrose
Plasma and platelets
2-3 weeks
Where is iron found?
1 Hemoglobin
2 Myoglobin
3 Cytochrome
Risk factors for developing TA-GvHD
1 Degree of recipient immunodeficiency
2 Number of viable T lymphocytes (affected by component age, level of leukodepletion, and irradiation status)
3 Genetic diversity in HLA expression between donor and recipient
Abnormally high platelet counts
Myoproliferative disorders
Vaccines that restrict use of some parts of donation for a short period of time
Vaccines made from live material
What is hemochromatosis?
Condition where there is too much absorption or storage of iron
Skin lesions on arms
Deferred
Function of phosphate
Buffer
Function of dextrose
Red cell energy source
3 separate components supplied by a single donation of whole blood
1 Packed RBCs
2 Platelets
3 FFP
Functions of adenine
1 Allows RBCs to resynthesize ATP
2 Extends storage tine from 21 to 35 days
Plateletpheresis
Separation and withdrawal of platelets
Physical examination
1 General appearance 2 Weight 3 Temperature 4 Pulse 5 Blood Pressure 6 Hemoglobin 7 Skin lesions
What is hemapheresis?
Process of removing blood constituents (may be normal or abnormal) from circulating blood via filtration or centrifugation
Other term for hemapheresis
Apheresis
Temperature requirements for storage
1 Whole blood and liquid RBCs (1-6 Celsius)
2 FFP and cryoprecipitate (</= -65 Celsius)
Types of blood collection
1 Autologous donation
2 Directed donation
Used to check hemoglobin level of a donor
Sample of blood taken from a finger prick
Antibiotics for acne
Acceptable
Packed red blood cells
70% of plasma removed via centrifugation
Granulocyte storage
Transfuse within 24 hours
Platelet storage
Room temperature (5 days)
Other term for African sleeping sickness
African trypanosomiasis
Function of citrate
Anticoagulant
Fresh frozen plasma storage
Frozen (1 year)
Washed units
Depleted of plasma and leukocytes
James Blundell
Successfully transfused human blood to a patient who had hemorrhage during child birth
Blood storage
1 EDTA
2 Heparin
3 Citrate phosphate dextrose or citrate phosphate dextrose adenine
Antifreeze action
40% glycerol
Cryoprecipitate AHF from FFP storage
Frozen (1 year)
Types of RBC products
1 Whole blood
2 Packed RBCs
3 Frozen deglycerolized RBCs
Leukocytes with depleted RBCs
Whole blood products
Whole blood - Platelet-rich plasma - Packed red blood cells - Fresh frozen plasma
Advantages of cryopreserved blood
1 Maintains storage of Rh(-) blood
2 Provides plasma-free blood to persons with IgA deficiency
3 Usually given to persons who are difficult to cross-match due to multiple alloantibodies
RBC storage
1 Refrigerated (4 days) 2 Frozen (10 years)