Blood transfusion in practice Flashcards
tx of 76 year old with Hb 54 g/L and blood film consistent with megaloblastic anaemia
b12 and folate, don’t transfuse
tx 48 year old lady admitted for a planned hysterectomy with Hb of 95 g/L
No transfusion
can o receive platelets from a?
yes
can o receive rbcs from a?
no
can o receive platelets from a?
yes
glycosyltransferase…effect on ABO blood types
ABO blood type of each person is determined by a single gene. For the A type, there is a gene for GTA, a glycosyltransferase that adds N-acetylgalactosamine. For type B, the gene encodes GTB, a different glycosyltransferase that adds galactose. For type O, neither enzyme is made.
indications for RBC transfusion
To prevent or correct severe acute anaemia – that might otherwise cause organ damage
To improve quality of life in a patient with otherwise uncorrectable anaemia
To prepare a patient for surgery or speed up recovery
To reverse damage caused by patient’s own red cells - Sickle Cell Disease
indications for platelet transfusion,
Prophylactically or therapeutically to stop bleeding, Dilutional Thrombocytopenia [massive transfusion], Cardiopulmonary bypass surgery, D.I.C. if bleeding
Abnormalities of platelet function.
Indications for FFP use - Fresh frozen plasma (FFP) is a blood product made from the liquid portion of whole blood. It is used to treat conditions in which there are low blood clotting factors (INR>1.5) or low levels of other blood proteins.
Replacement of coagulation factors due to major haemorrhage
DIC in the presence of bleeding
Thrombotic Thrombocytopenic Purpura (TTP)
Replacement of coagulation factor deficiencies where factor concentrate unavailable
Indications for cryoprecipitate use - contains coagulation factors-FVIII, vWF, Fibrinogen, F XIII
Hypofibrinogenaemia secondary to massive transfusion; >1.5g/L
DIC with bleeding and fibrinogen <1g/L
Bleeding associated with thrombolytic therapy causing hypofibrinogenaemia
Renal or liver failure and abnormal bleeding
Inherited hypofibrinogenaemia if fibrinogen concentrate unavailable