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IMED2002 UWA > Blood Groups and Blood Transfusion > Flashcards

Blood Groups and Blood Transfusion Flashcards

1
Q

How much blood is collected from a donor?

A

Approximately 400 ml (anti-coagulated)

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2
Q

What is donated blood tested for?

A

ABO, Rh(D) blood groups, antibody screen

Infectious agents to prevent infections

HIV, Hep B+C, syphilis, HTLV-1

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3
Q

What happens to donor blood?

A

It is fractionated into its major components:

Packed RBCs

Fresh Frozen Plasma

Platelets

Cryopercipitate

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4
Q

Is it possible to get whole blood transfusions in Aus?

A

No

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5
Q

What is the haematocrit of packed red blood cells?

A

60 - 70%

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6
Q

How can clotting factors be transfused into another person?

A

Through fresh frozen plasma

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7
Q

What happens to plasma after fractionation?

A

Some of it is transported to melbourne (CSL) where it is further fractionated into individual proteins such as albumin, prothrombin x, and other important proteins.

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8
Q

What are the blood grouping systems that are used?

A

ABO

Rhesus

Other (not tested routinely)

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9
Q

How many blood groups do we have?

A

approximately 400 on RBC membrane

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10
Q

What is the H in ABO(H)?

A

precursor molecule for groups A and B

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11
Q

When do we produce antibodies to opposite blood group?

A

By 3 - 6 months of age

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12
Q

What type of antibodies are anti-A and anti-B antibodies?

A

IgM

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13
Q

What happens if antibodies interact with blood type?

A

Cause rapid severe intramuscular haemolysis and immediate transfusion reaction

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14
Q

What kind of disease does Group O mother cause to a group A baby?

A

Mild haemolytic disease

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15
Q

What are the frequencies of blood groups?

A

A: 39%

B: 11%

AB: 4%

O: 46%

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16
Q

How many Rh antigens are there?

A

40 (d does not exist and D is the one we use most often)

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17
Q

What is the frequency of Rh(D) positive and Rh(D) negative?

A

Positive 85%

Negative 15%

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18
Q

Is there a naturally occuring anti-D antibody?

A

Only after exposure to D antigen.

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19
Q

What is a condition that is problematic in Rh(D)?

A

Anti-D Ig given to Rh(D) negative mothers after birth of Rh(D) positive infant to prevent production of immune anti-D that causes haemolysis in subsequent pregnancies

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20
Q

What causes haemolytic disease of the newborn? What is allo-immune haemolytic anaemia?

A

Maternal IgG antibodies from maternal circulation to the foetus via the placenta. Foetal RBC destroyed by maternal antibodies.

Anti-D is made in 1st pregnancy by Rh(D) negative mother and then subsequent pregnancies result in anti Rh(D) antibodies.

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21
Q

What are some other major blood group systems?

A

Kell (K/k)

Duffy (Fy)

Kidd (jk)

Lewis (Le)

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22
Q

What percentage of people have Kell antigens?

A

10%

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23
Q

What does K antigen do?

A

it is immunogenic and can cause haemolysis

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24
Q

How does malaria invade RBC?

A

Through Duffy antigen

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25
Q

What is an antibody screen needed for?

A

To check if any unexpected antibodies are present in patient plasma including antibodies to other blood groups such as anti-E,K,Jka

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26
Q

What is crossmatching?

A

Final step before patient receives transfusion.

A fail-safe method of preventing incompatibilities between donor and recipient blood.

27
Q

What is the most common blood component used?

A

Packed Red Blood Cells

28
Q

What is the haematocrit in packed RBCs?

A

60 - 70%; stored as 250 - 300ml packets

29
Q

How are packed RBCs stored?

A

2 - 6 degrees for up to 42 days.

30
Q

What is done to leucocytes in packed RBCs?

A

They are removed through filtration system

31
Q

What are packed RBCs used to increase?

A

Oxygen carrying capacity

32
Q

Who is given packed RBCs?

A

Patients with haemorrhage

Symptomatic anaemia

Anaemia and urgent surgery

Bone marrow dysfunction or failure

33
Q

How much does a bag of packed red blood cells increase haemoglobin?

A

10 g/L

34
Q

Who is the universal donor of blood?

A

Group O Rh(D) Negative

35
Q

How are platelets stored?

A

at 20 - 24 degrees for up to 5 days

36
Q

Do platelets have AB antigens?

A

No

37
Q

How many platelets are transferred per transfusion?

A

3 x 10^11 from whole blood

38
Q

What is apheresis?

A

a technique by which a particular substance or component is removed from the blood, the main volume being returned to the body.

39
Q

What blood group is a universal plasma donor?

A

AB

40
Q

Who can donate fresh frozen plasma? What does it contain?

A

Males only, contains all plasma proteins

41
Q

How is fresh frozen plasma stored?

A

-30 degrees for up to a year and thawed before use

42
Q

How much fresh frozen plasma is there per bag and what is the dose used?

A

Bag = 200ml

Dose = 10 - 15 ml/kg

43
Q

When should FFP be used?

A

Coagulopathic bleeding

Massive haemorrhage

Massive transfusion

44
Q

When should platelets be used?

A

Thrombocytopenia and bleeding or surgery

Prophylaxis

45
Q

When should packed RBCs be used?

A

Haemorrhage

Symptomatic anaemia

Anaemia and urgent surgery

Bone marrow dysfunction or failure

46
Q

What is cryoprecipitate?

A

The white precipitate derived from FFP concentrated in clotting factores (particularly fibrinogen, factor VIII, and Von Willebrand Factor)

47
Q

How much does a bag of cryoprecipitate contain?

A

30 - 40ml

48
Q

How is cryoprecipitate stored?

A

Below -25 degrees

49
Q

Is cryoprecipitate ABO testing necessary?

A

No but cryoprecipitate should be compatible with recipient RBCs

50
Q

Is cryoprecipitate ABO testing necessary?

A

No but cryoprecipitate should be compatible with recipient RBCs

51
Q

What concentrates are formed from blood products?

A

Albumin

Immunoglobulins

Factor concentrates

Testing reagents

52
Q

What can go wrong early with transfusion?

A

Haemolytic transfusion reaction (ABO incompatibility)

Sepsis: Bacteria contaminated blood product

Transfusion related acute lung injury

Transfusion associated circulatory overload

Febrile non-haemolytic transfusion reaction

Urticarial (allergic) reactions

53
Q

What can go wrong in 7 - 10 days after transfusion?

A

Delayed haemolytic transfusion reaction

54
Q

What can go wrong later after transfusion?

A

Viral infections

Immune sensitisation

Iron overload

55
Q

What causes delayed haemolytic reactions?

A

Patients form antibodies in response to a transfusion

56
Q

How often do delayed haemolytic reactions occur?

A

1:5000 transfusions

57
Q

What causes delayed haemolytic reactions?

A

Patients form antibodies in response to a transfusion.

Antibodies are made in response to prior RBC exposure. Exposure to the antigen with current transfusion generates an anamnestic antibody response.

58
Q

What are the symptoms of delayed haemolytic reactions?

A

Unexplained anaemia, fever and jaundice

59
Q

What causes transfusion related lung injury?

A

Neutrophils present in transfused blood product

60
Q

What is the frequency of death in transfusion relatedacute lung injury?

A

1:5000 to 1:100000 (high mortality due to pulmonary oedema)

61
Q

What causes febrile and allergic reactions?

A

Recipient antibodies react with donor white cells or proteins

62
Q

How common are febrile reactions?

A

Low due to use of leucodepleted red cell units

63
Q

How are febrile and allergic reactions managed?

A

Supportive management with antipyretics and antihistamines

64
Q

What can potentially occur in febrile and allergic reactions due to blood transfusion?

A

Anaphylaxis in IgA deficient patients

IMED2002 UWA (29 decks)

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