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BLOOD BANKING > Blood Banking Transfusion Reaction > Flashcards

Blood Banking Transfusion Reaction Flashcards

1
Q

Transfusion Reaction Investigation Work-up

A

Clerical Check
Visual inspection
DAT
Repeat ABO/Rh
Repeat Compatibility
Repeat crossmatch
Bilirubin test
Check urine
Hemosiderin check
Hemoglobin and hct check

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2
Q

Specimen contains 20mg/dL free Hgb

A

Pink Plasma

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3
Q

Specimen contains >100 mg/dL free Hgb

A

Red plasma

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4
Q

Plasma Hgb over ___ can be detected by the naked eye

A

25mg/dL

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5
Q

Maximum concentration of bilirubin after hemolysis will be evident in blood approximately ____ after transfusion

A

3-6 hours

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6
Q

First voided specimen is checked for _____ and ______.

A

free Hb and urobilinogen

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7
Q

_____ can be found weeks after transfusion reaction (PBS)

A

Hemosiderin

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8
Q

Possible causes of HTR or Hemolytic Transfusion Reaction

A

Antibody binding to RBC
Release of anaphylatoxin
Activation of cytokines
Activation of the coagulation cascade

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9
Q

Occurs very soon during/just after transfusion
Reaction occurs within first 24 hours
Most severe HTR: usually caused by ABO incompatibility
S/s: Fever with back pain

A

Immediate HTR

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10
Q

Resolution for immediate HTR

A

Considered medical emergency
Stop transfusion and induce diuresis by administering mannitol or potassium sparring diuretics

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11
Q

Resolution for immediate HTR

A

Considered medical emergency
Stop transfusion and induce diuresis by administering mannitol or potassium sparring diuretics

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12
Q

Effects on blood in immediate HTR

A

Increased plasma-free Hb
Increased bilirubin
Decreased Haptoglobin
(+)/(-) DAT

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13
Q

Associated with an anamnestic response in a patient who has previously been sensitized by transfusion, pregnancy or transplant
May be diagnosed 7-10 days up to 14 days after transfusion
S/s: Jaundice and decreasing hematocrit levels

A

Delayed HTR

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14
Q

Common ab implicated is ANTI-Jka, Anti-E, Anti-D, Anti-C, Anti-K, anti-Fya, and anti-M

A

Delayed HTR

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15
Q

Effects on blood in Delayed HTR

A

Decreased Hb and Hct
(+)DAT
(+) Post-transfusion antibody screen

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16
Q

Damage due to intravascular lysis by hypertonic or hypotonic solution

A

Physical damage

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17
Q

Damage cause by blood warmers

A

Heat damage

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18
Q

Damage brought about by the absence of cryopreservatives

A

Freeze damage

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19
Q

Damage done by blood pumps, roller pumps, infusion under high pressure through small bore needles

A

Mechanical damage

20
Q

Most commonly encountered type of Transfusion reaction
Manifestation is fever only. A 1-degree celcius rise is associated with transfusion and without any other explanation
Caused by anti-leukocyte antibodies
Administrate leukoreduced components and remove all plasma before transfusion

A

Febrile NHTR

21
Q

Manifestations are hives and pruritus

A

Allergic/urticarial transfusion reaction

22
Q

Passive transfer of donor plasma which contains foreign protein (allergen) that reacted with patient IgE/IgG
Prevention = administer washed components
Treatment = administer antihistamine

A

Allergic/urticarial transfusion reaction

23
Q

Clinical signs (namely hypotension and shock) are seen suddenly after infusion of only a few mL of blood component (Often before 10mL of plasma has been infused)

A

Anaphylactic transfer reaction

24
Q

Transfusion of IgA-positive blood to an IgA deficient recipient with anti-IgA
Prevention = removing plasma/washed components and transfuse components from IgA deficient donors

A

Anaphylactic transfer reaction

25
Q

Bilateral pulmonary edema, hypotension. Increased respiratory distress shortly after transfusion

A

TRALI or Transfusion-related acute lung injury

26
Q

TRALI occurs within ____ of a plasma-containing transfusion

A

6 hours

27
Q

Prevention of TRALI

A

Transfuse of leukoreduced components

28
Q

Air allowed into infusion equipment or bood in open system infused under pressure causing air bubble

A

Air embolism

29
Q

Rapid infusion of large volume of blood products- Iatrogenic

A

TACO or Transfusion-associated circulatory overload

30
Q

Prevention of TACO

A

Slower rate of infusion 100mL/hr and split into aliquots

31
Q

Treatment for TACO

A

Intravenous diuretics
Therapeutic phlebotomy
O2 therapy

32
Q

Signs and symptoms of:
Shaking chills
Hemoglobinuria
DIC
Oliguria/anuria
2-degree celcius increase in body temp.

A

Transfusion-associated sepsis

33
Q

Causative agents for Transfusion-associated Sepsis

A

Y. enterocolitica
S. liquefascens
P. fluorscence
P.aeruginosa
E.coli

34
Q

Prevention for Transfusion-associated sepsis

A

Visual inspection of unit before transfusion (Check for brown or purple discoloration, hemolysis, clots, cloudiness)

35
Q

Treatment for Transfusion-associated sepsis

A

Introduce broad spectrum antibiotics to IV

36
Q

Cause: prior exposure to blood components

A

Alloimmunization

37
Q

Prevention of Alloimmunization

A

Matching of donor RBC phenotypes
Matching of donor WBC phenotype

38
Q

Anamnestic production of platelet antibodies

A

Post transfusion purpura

39
Q

Most commonly involved Antibody in PTP or Post Transfusion Purpura

A

Anti-Human Platelet Ag-1

40
Q

Prevention for PTP

A

Future transfusion should consist of platelet negative for antigen

41
Q

The proliferation of T lymphocytes from donor blood responding to HLA in the patient

A

TA-GVHD

42
Q

Prevention of TA-GVHD

A

Irradiation

43
Q

Transfusion hemosiderosis
Present in patients with aplastic anemia, congenital hemolytic anemia, thalassemia, chronically transfused patient

A

Iron overload

44
Q

Prevention of Iron overload

A

Transfuse neocyte or neocyte-enriched blood cells

45
Q

Treatment for Iron overload

A

Iron chelating therapy
Deferoxamine
Desferoxamine

46
Q

Caused by massive transfusion and prevention is via negation of calcium chloride and calcium gluconate solution

A

Citrate toxicity

BLOOD BANKING (5 decks)

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