Blood Transfusion Flashcards
List the blood components that make up one donation of blood
Red cells
Platelets
White cells
Plasma
When is plasma deemed “fresh frozen plasma”?
If frozen within 8 hours of blood collection, containing the coagulation proteins in the same concn that was present in the patient’s blood
List some blood products that can be acquired from batches of blood via manufacturing
Albumin
Immunoglobulin
Prothrombin complex concentrates
Blood products are made from thousands of donors. True/False?
True
Giving one bottle of blood product to a patient exposes them to thousands of donors
What must be done to donor blood to separate it into components?
Anticoagulation
For standard blood donation, how often may someone donate blood?
Every 12 weeks
Max 5 a year
List the basic criteria for a blood donor
Able to spare 465ml of blood
Minimum weight 50kg
Hb 13.5 (male)/12.5 (female)
Who should avoid donating blood?
Infective risk
Transmitting disease (malignancy)
Drug addicts
Recent foreign travel to endemic areas
Describe the order/position of blood components in a bag once blood has been centrifuged
Red cells at bottom (most dense)
Platelets + white cells in middle
Plasma at top (least dense)
At what temperature must red cells be stored?
4’C +/- 2’C
What is the shelf life of donated red cells? What happens if they are removed from storage for more than 30 mins?
35 days
If removed for more than 30 mins, must be transfused or discarded
At what temperature must platelets be stored?
22’C
What is the shelf life of donated platelets?
7 days if bacterial monitoring system applied
At what temperature and for how long must fresh frozen plasma be stored?
-30’C for up to 3 years
What are the possible blood groups a person can be?
A
B
AB
O
Describe the red cell membranes of ABO blood groups
A: carry A-antigen
B: carry B-antigen
AB: carry A-antigen + B-antigen
O: no A or B antigen
Order the blood groups from highest to lowest population frequency
O, A, B, AB
Which of the ABO blood groups is the universal donor? Why?
O is universal donor because blood carries no antigen and therefore other blood groups won’t form antibody against it
Which of the ABO blood groups is the universal recipient? Why?
AB is universal recipient because it carries both antigens and therefore won’t form antibody against any of the other blood groups
Naturally occuring ABO antibodies are what - Ig?
IgM
Small proportion are IgG
The genes that determine our ABO group are located on which chromosome?
Chromosome 9
Which alleles for ABO group are dominant?
A and B are co-dominant
O is recessive
The genes that determine Rhesus-D status are located on which chromosome?
Chromosome 1
Inheritance of Rhesus-D follows what pattern?
Autosomal dominant
How is blood group determined?
Agglutination
Giving antibody to individual of same blood type (e.g. anti-A to group A) will cause cells to stick together
What must a doctor’s prescription for blood transfusion state?
Number of units
Special requirements
Rate of transfusion
Accompanying medication
List possible indications for red cell transfusion in anaemia
Reduced exercise capacity
Medical/surgical issue
Heart or lung disease
“anaemic” symptoms
List physiological response to acute blood loss
Increased heart rate + force of contraction
Vasoconstriction to protect organs
Fluid shift from ECF to ICF
List indications for platelet transfusion
Low platelet count (duh!) Bleeding symptoms Underlying infection/fever Surgical requirement/recovery Platelet functional defects (myeloma)
List indications for fresh frozen plasma transfusion
Liver disease (impaired coagulation) Disseminated intravascular coagluation
What does the acute haemolytic transfusion reaction involve?
Activation of complement, coagulation and kinin systems due to circulating antibody to donor blood
What are the effects of complements C3a and C5a?
Increase vascular permeability
Dilate blood vessels
Release toxins and inflammatory markers (serotonin, histamine)
What is the effect of bradykinin?
Arteriolar dilation
Increase vascular permeability
Leading to hypotension
What action must be taken in an acute haemolytic transfusion reaction?
Stop blood transfusion
Give IV fluids
Obtain blood sample: transfusion, FBC, film, coagulation screen, biochemistry, blood culture, haptoglobin)
What does haptoglobin do?
Binds free haemoglobin
