Blood Transfusion

Question 1

What is the purpose of leucodepletion?

Answer 1

Filtration of whole blood to remove white blood cells. WBCs have no therapeutic benefit in transfusion and can contribute to adverse reactions.

Question 2

1 Unit of Red Blood Cells
Transfusion Time
Storage (3)

Answer 2

Transfusion time - 1.30-3 hours (4 hour limit from removal of cold storage).
Stored at 4 degrees Centigrade for up to 35 days from collection.
Plasma is removed and replaced by a solution of electrolytes, glucose and adenine.

Question 3

Pre transfusion patient tests

Group and Screen…

Answer 3

ABO and Rh(D) group determined.

Screened for antibodies against clinically significant blood group antigens (Antiglobulin test).

Question 4

Pre transfusion patient tests

Compatibility

Answer 4

Crossmatching - patient plasma is mixed with aliquots of donor red cells to see if a reaction occurs.
Reaction can be agglutination or haemolysis.

Question 5

Indications of RBC transfusion

Answer 5

Symptomatic anaemia

Prevention of Ischaemic damage

Question 6

Definition of Anaemia
Diagnosed via…
Normal levels are… g/l

Answer 6

In which the number of red blood cells or their oxygen capacity is insufficient to meet physiologic needs.
Diagnosed via haemoglobin levels (g/l)
Normal levels.
Non-pregnant women - <120 
Men - <130

Question 7

Adaption to anaemia

Answer 7

Increased CO
Increased Cardiac artery blood flow
Increase of 2,3 DPG
Increased EPO production

Acute is characterised by an increased respiration rate.

Question 8

Transfusion Thresholds

Answer 8

The [Hb] at or below which packed red blood cells are ordered for transfusion.

Question 9

Transfusion Thresholds

Anaemia

Answer 9

Anaemia -
<70g/l for mild symptoms
<80g/l for cardiovascular disease.
It varies for patients with chronic anaemia.

Question 10

Transfusion Thresholds

Haemorrhage

Answer 10

Class1 - 15% reduction in blood volume - not necessary*
Class 2 - 15-30% reduction in blood volume - not necessary*
Class 3 - 30-40% reduction in blood volume - probably necessary.
Class 4 - 40% reduction in blood volume - necessary.

*except in cases with pre-existing anaemia.

Question 11

Chronic Anaemia

Answer 11

Slide 22 ; continue