Blood transfusion Flashcards
Blood donors must have adequate Hb levels to be suitable for donation. What are the required Hb levels in men and women?
Hb 135g/L in men
Hb 125g/L in women
How much blood can be donated in one sitting?
460 ml
What is donor blood tested for?
HIV
Hep B/C/E
HTLV
Syphilis
How long can red cells, FFP and platelets be stored for?
Red cells are stored for 35 days at 4 degrees
FFP is stored for 3 years at -30 degrees
Platelets are stored for 7 days at room temp with agitation (to prevent sticking together)
ABO blood system genes are found on which chromosome?
Chromosome 9
Describe the dominance of A,B and O genes
A and B are co-dominant and dominant over O
What is meant by genotype and phenotype with reference to the ABO system?
The genotype is which genes are present
The phenotype is which antigens are present
What is Landsteiner’s law?
When a patient lacks the A or B antigen, the corresponding antibody is produced in their plasma against that antigen
(this is not due to exposure to blood products but is due to a response to gut bacteria which have similar structures to antigens on RBCs)
Which blood groups are the most common?
O followed by A
Which blood group is the least common?
AB
Who can receive donor blood which is group A?
A, AB
Who can receive donor blood which is group B?
B, AB
Who can receive donor blood which is group AB?
AB
Who can receive donor blood which is group O?
Anyone
Patients with blood group A can receive blood from which donor groups?
A and O
Patients with blood group B can receive blood from which donor groups?
B and O
Patients with blood group AB can receive blood from which donor groups?
Anyone
Patients with blood group O can receive blood from which donor groups?
O
Which blood group can be donors for anyone?
O
Which blood group can only receive blood transfusions from their own blood group?
O
Which blood group can receive a blood transfusion from any blood group?
AB
Which blood group can only give blood transfusions to patents with the same blood group?
AB
Are most of the population Rh +ve or Rh -ve?
85% of the population are Rh +ve
What testing needs to be done pre-transfusion?
ABO grouping / cross matching / antibody screening
What are the indications for red cell transfusion?
Symptomatic anaemia with Hb<70g/L or cardiac disease
Major bleeding
What are the indications for platelet transfusion?
Prophylaxis in patients with bone marrow failure and very low platelet counts
Treatment of bleeding and prophylaxis prior to surgery and procedures in thrombocytopenic patients
What are the indications for FFP transfusion?
Treatment of bleeding and prophylaxis before surgery in patients with coagulopathy (PT ratio >1.5)
Management of massive haemorrhage
How often should patients be monitored during transfusions?
Observations before, at 15 mins and within 60 mins of completion
What are some of the possible complications of blood transfusion?
Infective
Overload
Immune reactions
What is a febrile non-haemolytic transfusion reaction?
A transfusion reaction in which the only sign is a fever. There is no haemolysis or other signs or symptoms.
How does transfusion associated circulatory overload present?
Patients with chronic anaemia have a high compensatory CO so when they are given a large volume load this results in pulmonary oedema
E.g an elderly patient with chronic anaemia is breathless after transfusion
Why does transfusion related acute lung injury occur?
Anti-leucocyte antibodies present in the donation bind to the patients white cells and cause acute lung injury by degranulation of affected neutrophils in the lungs
Pulmonary infiltrates on CXR are seen with which transfusion reaction?
Transfusion related acute lung injury
there is degranulation of affected neutrophils in the lungs
