Blood Transfusion

Question 1

Why do we Transfuse Blood?

Answer 1

Insufficient ‘blood’
- Bleeding
- Failure of production
- (excess rate of destruction)

Question 2

What are the Requirements and Tests of a Blood Donor?

Answer 2

Health of donor;
- age, size, medication, other diseases

Exposure to infectious agents
- sexual history, travel, tattoos, prions

Screened for Infectious agents
- HepB/C/E, HIV, syphilis, HTLV
- sometimes malaria, West Nile virus, Zika virus, CMV

• Tested for ABO and Rh blood groups

Question 3

Label this

Answer 3

Diversion pouch - Contains first 15 mls of blood with bacteria

Question 4

What are Apheresis donors?

Answer 4

Give Plasma (And something else?)

Question 5

How much blood do we get from a Donor, how is it stores and given?

Answer 5

Usually prescribe by ‘unit’
- 450 mls from donor ie10% total blood volume)
- Red cell concentrate 300-400 mls

• Transfuse over 2-4 hours
• 1 unit increments ~5 g/L
• Stored at 4oC

Question 6

What are the Indications for red cell transfusion?

Answer 6

1). To correct severe acute anaemia, which might otherwise cause organ damage

2). To improve quality of life in patient with otherwise uncorrectable anaemia

3). To prepare a patient for surgery or speed up recovery

4). To reverse damage caused by patient’s own red cells - Sickle Cell Disease

Question 7

How do we describe platelets, how are they stored and transfused?

Answer 7

1 dose platelets (=4 pooled or 1 apheresis donor)
increments ~30.109/L
Stored at ~22oC, shelf life 7 days
Transfuse over 20-30 minutes

*Can cross blood groups in this dont worry

Question 8

What are platalet transfusions used for?

Answer 8

Bone marrow failure (90%)
platelet count <10-15.109/litre
or <20.109/litre if additional risk, e.g. sepsis

*Prevent major haemorrhage and intercerebral haemorrhage (common from acute myeloid leukemia)

Massive haemorrhage
- Keep platelet count above 50

Prophylaxis for surgery
- Minor procedures 50
- More major surgery 80; CNS or eye surgery 100

Cardiopulmonary bypass
- use only if bleeding

Congenital platelet disorders

Question 9

How and what is Plasma components (Fresh Frozen Plasma) used for?

Answer 9

Stored frozen, allow 30 minutes to thaw

Indications
- massive haemorrhage (aim for 1:1 ratio) (1 red cell to 1 FFP (Fresh frozen plasma))
- DIC with bleeding
- Thrombotic thrombocytopenic purpura (TTP)
- Prophylactic for procedures and deranged coagulation

(FINISH ADDING SLIDE STUFF)

Question 10

What is the lab test for plasma levels?

Question 11

What is the Cryoprecipitate and its uses?

Answer 11

1-2 pools if bleeding and fibrinogen <1.0g/dl (1.5g/dl)

Stored frozen; allow 20 minutes to thaw

Fibrinogen concentrate now licensed

Question 12

What is the lab test for Cryoprecipitate?

Answer 12

Fibrinogen <1.0g/dl (1.5g/dl)