Blood transfusion Flashcards
What are most blood transfusions for?
RBC
bleeding
ABO antigens
expressed on surface which can provoke antibodies
A, B, O - dominant, recessive
A and B are co-dominant
O is recessive
blood group A antibodies against
B
Blood group B antibodies against
A
Blood group AB antibodies against
no antibodies
Blood group O antibodies against
A +B
Red cell recipient - group A
donor A and O
Red cell recipient - group B
donor B and O
Red cell recipient - AB
donor AB, A, B, O
Red cell recipient - O
donor O
FFP recipient A, B, AB, O
A - A and AB
B - B and AB
AB - AB
O - all
When can RhD negative make anti-D?
exposed to RhD+ cells ie transfusion/pregnancy
What can Anti-D cause?
transfusion reactions
haemolytic disease of newborn
Blood donors screening
behaviours - sex, tattoo, travel
ABO and Rh
Hep E/B/C, HIV, syphilis
variable - eg malaria, zika
4 indications for red cell transfusion
correct severe acute anaemia - may otherwise cause organ damage
improve QOL for uncorrectable anaemia
prepare for surgery/speed up recovery
reverse damage eg sickle cell
RBC - storage and giving
4 degrees, transfuse over 2-4 hours
1 unit increments 5g/L
Fresh frozen plasma
1 unit from 1 unit of blood
30 minutes to thaw
platelets - storage and giving
22 degrees, 20-30 mins transfusion
cryoprecipitate
fibrinogen
stored frozen - 20 mins to thaw
“practical” blood banking
second sample
group and screen/save
cross match
group and screen
ABO and RhD
historical records
alloantibodies
coombs test
detect antibody on surface of RBC
anti human immunoglobulin
direct coombs
autoimmune haemolytic anaemia
indirect coombs
cross matching
How many blood group systems are there?
21
red cell availability - minutes
O RhD neg red cells (AB plasma)
red cell availability - urgent
type specific - ABO/RhD
red cell availability - non urgent
full crossmatch including alloantibodies
massive haemorrhage
call 2222
rapid control
6 units RBC, 4 units FFP, 1 unit platelets
Risks
TACO, TRALI, fever, febrile, allergic etc
TACO
transfusion associated circulatory overload
prion disease
transmitted by blood transfusion from early disease in sheep
imported FFP now used
Pregnancy - Rh D
if mother -ve and baby +ve
Anti D given at sensitising events and 28/40
tests done with haemolytic disease of newborn
antibody titres
doppler USS
intrauterine infusion
cellular therapies
leucapheresis - bone marrow harvests
other banks eg faecal, bone, milk, heart valves
gene therapies
