Blood products

Question 1

Rhesus D

Answer 1

+ ve - presence of Rhesus D surface antigens on the red blood cells

• ve - absence of Rhesus D surface antigens on the red blood cells

Question 2

Rhesus -ve if given RhD+ blood

Answer 2

Will make RhD antibody
Asymptomatic for pateint as do not have rhesus D antigens

But can affect pregnancy

Question 3

Placenta

Answer 3

RhD antibodies can cross the placenta

Question 4

Haemolytic disease of the newborn (HDN)

Answer 4

1. Fetus blood crosses placenta
2. First child - mother makes RhD antibodies
3. 2nd RhD+ baby - anti RhD antibodies cross the placenta
4. Attacks fetal RhD antigens
5. Foetal anaemia

Question 5

Universal donor

Answer 5

O-ve

No AB or rhesus antigens

Question 6

Universal Acceptor

Answer 6

AB+ve

Question 7

Group A

Answer 7

Anti B antibodies

Question 8

Group and Save

Answer 8

Determines the patient’s blood group

Screens the blood for any atypical antibodies

Takes 40 mins

Question 9

Crossmatch

Answer 9

Physically mixing the patient’s blood with the donor’s blood, in order to see if any immune reaction takes places

40 mins + 40mins for G+S

Question 10

When is X match done

Answer 10

Blood loss is anticipated during surgery

Question 11

Irradiated Blood Products

Answer 11

Reduce the risk of graft-versus-host-disease in at risk populations

Question 12

Which groups should receive irradiated blood (6)

Answer 12

• Those receiving blood from first or second-degree family members
• Patients with Hodgkin’s Lymphoma
• Recent haematpoietic stem cell(HSC) transplants
• After Anti-Thymocyte Globulin (ATG) or Alemtuzumab therapy
• chemotherapy - purine analogues (e.g. fludarabine)
• Intra-uterine transfusions

Question 13

Observations

Answer 13

• Before the transfusion starts
• 15-20 minutes after it has started
• At 1 hour
• At completion

Question 14

Cannula

Answer 14

Blood products should only be administered through a green (18G) or grey (16G) cannula, otherwise the cells haemolyse due to sheering forces in the narrow tube

Question 15

Packed Red Cells Indications

Answer 15

i) Acute blood loss

ii) Chronic anaemia, where the Hb ≤70g/L (or ≤100g/L in those with cardiovascular disease) or symptomatic anaemia

Question 16

Duration over which Packed Red Cells is administered

Answer 16

2-4 hours

It must be completed within 4 hours of coming out of the store

Question 17

Platelets Indication

Answer 17

(i) Haemorrhagic shock
(ii) Profound thrombocytopenia <20 x 109/L
(iii) Bleeding with thrombocytopenia
(iv) Pre-operative platelet level <50 x 109/L

Question 18

Duration over which platelets is administered

Answer 18

30 minutes

Question 19

Fresh Frozen Plasma (FFP) indications and constituents

Answer 19

Major constituents– Clotting factors

Indication:

(i) DIC
(ii) Any haemorrhage secondary to liver disease
(iii) All massive haemorrhages (commonly given after the 2nd unit of packed red cells)

Question 20

Duration over which Fresh Frozen Plasma is administered

Answer 20

30 minutes

Question 21

Cryoprecipitate constituents

Answer 21

Fibrinogen,
von Willebrands Factor (vWF)
Factor VIII
Fibronectin

Question 22

Indications for cryoprecipitate

Answer 22

(i) DIC with fibrinogen <1g/L
(ii) von Willebrands Disease
(iii) Massive haemorrhage

Question 23

Duration over which cryoprecipitate is administered

Answer 23

Stat

Question 24

Massive haemorrhage blood products

Answer 24

Packed red blood cells
Fresh frozen plasma
Platelets

Question 25

In the average patient, how much does 1 unit of blood usually increase the haemoglobin level by

Answer 25

10g/L