Blood groups and transfusion medicine Flashcards
what blood groups can cats have
A
B
AB
What type of antibodies does type A feline blood carry
Naturally occurring weak anti-type B antibodies
What type of antibodies does type B feline blood carry
Naturally occurring very strong anti-type A antibodies
what cats must be blood typed prior to a transfusion
all cats- even in an emergency
What will giving type A blood to a type B cat result in
intravascular haemolysis of type A blood within seconds of transfusion
May be fatal
What will giving type B blood to a type A cat result in
extravascular haemolysis
PCV will fall to pre-transfusion levels within days
When does feline neonatal isoerythrolysis occur
Type A or AB kitten born from type B queen
Anti A antibodies transfer from colostrum while <24 hrs old
What type of antibodies does type AB feline blood carry
carries no antibodies against type A or B antigens
List the signs of feline neonatal isoerythrolysis in a kitten
Red/Brown urine
Jaundice
Anaemia
Sudden death
What blood type should the donor dog be if giving an untyped transfusion reaction
DEA 1 NEGATIVE
T/F Dogs do have pre-formed antibodies against non-self canine blood types
False
What patients should DEA 1 positive blood only be given to and why
DEA 1 positive patient
Prevent sensitizing a DEA 1 NEGATIVE dog to DEA 1 antigen
Reduce chance of delayed haemolytic reaction
What happens if DEA 1 POSITIVE blood is given to a sensitised DEA negative dog
acute haemolytic transfusion reaction (potentially fatal)
What does a major cross match detect
Assesses compatibility between donor red blood cells and patient plasma/serum
most important type of cross match
what does a minor cross match detect
Assesses compatibility between donor plasma/serum and patient RBCs.
When is cross matching required in dogs
if recipient has been previously transfused >4d prior
history of previous transfusion reaction
transfusion history unknown
List 4 indications for a blood transfusion
evidence of circulatory collapse
rapid drop in PCV to <20% in dog or <15% in cats
absolute PCV of <20%
signs of specific organ hypoxia
Within how many hours of collection must fresh whole blood be used
8 hrs
List 3 things that fresh whole blood contains that stored whole blood doesn’t
platelets
WBCs
Liable clotting factors
List 2 situations where whole blood is indicated for
acute blood loss
active bleeding
how long can packed red blood cells be stored in the fridge
42 days
What is the difference between fresh frozen plasma and frozen plasma
fresh frozen plasma froze within 24hrs of collection
liable and non-liable clotting factors (only non-liable in FP)
shelf life of 1 yr (FP shelf life= 5 years)
What patients are PRBCs indicated for
patients developing clinical signs of low tissue oxygenation due to anaemia
what patients is FFP indicated for
patients with coagulopathies
what patients is FP indicated for
toxicities causing coagulopathies
Haemophilia B
what can FFP be further processed into
Cryoprecipitate
Cryosupernatant
what concentrated labile clotting factors does cryoprecipitate contain
Fibrinogen
Factor 8
vWF
what does cryoprecipitate tend to be used for
pre-treatment for vWD deficiency
List the products that cryosupernatant contain
plasma proteins: albumin
Vitamin K dependent clotting factors: II, VII, IX, X
List 4 advantages of autologus transfusion
reduces potential for exposure to allogenic blood
reduced risk of new infectious diseases
reduces chance of transfusion reactions
immediate availability
List 7 donor criteria for dogs
Fit and healthy
1-8 yrs old
>25kg
never travelled abroad
vaccinated
good temperament
not on any medication
what is performed before taking donor blood from a dog
full physical health check
Haematology and biochemistry ( minimal PCV/TS)
blood typing
how much blood is collected from canine donors
450mls
List 4 criteria for feline donors
healthy
1-8 yrs old
>4kg lean BW
preferably indoor cat?
what is performed before taking donor blood from a cat
full physical exam
haematology and biochemistry (minimal PCV/TS)
FeLV/FIV test if outdoor cat
blood typing
what sedation is commonly used on feline donors
ketamine and midazolam combo
how much blood is collected from feline donors
11-13ml/kg
what is added to the blood in a 60ml syringe in feline blood donor harvesting
CPD (A)
How many mls/kg of whole blood to raise PCV by 1%
2ml
how many mls/kg of PRBCs to raise PCV by 1%
1ml
within how long of starting the transfusion should unit of blood or blood product be administered
4hrs
to what PCV should you transfuse to
25-30%
what does of plasma products should be given
20ml/kg
how often should patient parameters be checked when transfusing
every 5 ins for first 30 mins
then every 15-30mins
what is the calculation to work out volume to transfuse
volume to transfuse = (target PCV – recipient PCV)/donor PCV x kg x N
N= 90 for dogs
N= 60 for cats
what is the definition of a transfusion reaction
any undesirable effect noted as a consequence of a blood product transfusion
What should transfusions not be administered down the same line as
any solutions containing Ca or glucose
What are the two types of immunological transfusion reaction
haemolytic and non-haemolytic
List 6 clinical signs that indicate a transfusion reaction
increase in temperature
change in RR/HR
change in MM colour
Visible oedema
GI signs
How should an acute (intravascular) haemolytic reaction be treated?
stop transfusion
IV fluids
+/- corticosteroids
How are transfusion reactions avoided?
Blood typing
Cross matching
Appropriate donor screening
Correct collection, preperation, storage and administration of products
What is the general therapeutic plan for a transfusion reaction?
Stop transfusion
Clinical exam
Supportive treatment
Check blood typing or cross matching
Check bag for evidence of lysis
List the two types of haemolytic immunological transfusion reaction
acute and delayed
List the two types of non-haemolytic transfusion reactions
febrile and acute hypersensitivity
Describe febrile non-haemolytic transfusion reaction
acute platelet and WBC hypersensitivty
Describe acute hypersensitivity non-haemolytic transfusion reaction
anaphylactic
Describe non-immunological transfusion reactions
not mediated through immune mechanisms - circulatory overload, bacterial contamination, hypothermia, citrate toxicity, dilutional coagulopathy, disease transmission
