Blood Grouping System

Question 1

Who is irradiated blood required for?

Answer 1

Prevents passenger lymphocytes form engrafting on host

• bone marrow transplant
• transfusions from family or HLA matched donors
• patients treated with purine analogues
• hodgekin’s
• intra uterine + exchange transfusion
• severe combined immunodeficiency

Question 2

Who is CMV negative blood required for?

Answer 2

• Immunocompromised CMV negative patients
• Intra uterine transfusions
• Routine transfusion of CMV-seronegative pregnant women

Question 3

What is RBC transfusion required for?

Answer 3

• To raise oxygen carrying capacity of blood by raising haemoglobin level
• Acute and chronic anaemia
• Preop blood loss

Question 4

How is FFP prepared?

Answer 4

Rapid freezing of plasma from whole blood or apheresis

Contains clotting factors

Question 5

What are the indications for use of FFP?

Answer 5

• Replacement of single factor deficiencies
• DIC
• TTP
• Massive transfusion
• Immediate reversal Warfarin
• Liver disease

Question 6

Who is solvent detergent plasma used for?

Answer 6

Those born after 1996

Very little fibrinogen

Question 7

What is cryoprecipitate useful for?

Answer 7

Ongoing bleeding as richest source of fibrinogen

Question 8

What are platelets given for?

Answer 8

Treatment of haemorrhage in patients with thrombocytopenia or platelet function disorders

Question 9

Which blood groups are most important to consider?

Answer 9

ABO

Rhesus

Question 10

What is acute haemolytic transfusion reaction?

Answer 10

IgM readily destroys incompatible red cells

Question 11

What antibodies does type A blood have and what blood types is it compatible with?

Answer 11

Antibodies: Anti-B

Compatible with: A, O

Question 12

What antibodies does type B blood have and what blood types is it compatible with?

Answer 12

Antibodies: Anti-A

Compatible with: B, O

Question 13

What antibodies does type AB blood have and what blood types is it compatible with?

Answer 13

Antibodies: none
Compatible with: A, B, AB, O
UNIVERSAL RECIPIENT

Question 14

What antibodies does type O blood have and what blood types is it compatible with?

Answer 14

Antibodies: Anti-A, Anti-B
Compatible with: O
UNIVERSAL DONOR

Question 15

How does this differ for FFP?

Answer 15

Opposite way around
AB = universal donors
O = universal recipient

Question 16

How does the Rhesus system work?

Answer 16

Rhesus positivity or negativity = present/absence of antigen D

Question 17

What happens if a RhD (-) pregnant with pre-existing Anti-D is carrying RhD (+) fetus?

Answer 17

• Immune anti-D antibodies = IgG can cross placenta + destroy fetus red cells
• Intra uterine destruction of fetal red cells = haemolytic disease of newborn (HDN)
• In most cases, sensitisation to fetal RBC’s occurs at birth

Question 18

Hows is sensitisation of RhD (-) women prevented during pregnancy?

Answer 18

Anti-D given:

1) After each potentially sensitising event
2) Within 72 hours after child birth (if baby RhD +)

Question 19

What are the main risks of transfusion?

Answer 19

TACO

TRALI

Question 20

What is TACO?

Answer 20

Transfusion associated circulatory overload

Question 21

What is TRALI?

Answer 21

Transfusion related acute lung injury

Acute dyspnoea with hypoxia + bilateral pulmonary infiltrates

Question 22

Why are male FFP donors over female?

Answer 22

Females more likely to be sensitised during pregnancy = more neutrophils in plasma - more allergic reactions possible