Blood Transfusions Flashcards by Stephanye Quinn

Macroscopic crossmatch look for

Hemolysis

Agglutination

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Platelet Rich Plasma

Severe thrombocytopenia → chemotherapy

Severe thrombopathia → inherited disorders

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Interpretation of a negative crossmatch

No agglutination or hemolysis

Recipient is not likely to have transfusion reaction

Transfuse

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Clinical signs of Delayed Hemolytic Immune Mediated Reaction

Icterus, Hyperbilirubinemia, Hyperbiliruninuria

Fever

Anorexia

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Which equine blood systems are implicated in neonatal isoerythrolysis

Aa and Qa

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Feline Type A

Most common

Weak isoantibodies against type B

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Crossmatching

Identifies antibodies against RBC antigens in the plasma of the recipient or donor

Ensures optimal survival of transfused RBCs and of the patient

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Feline Type B

Less common

Strong natural isoantibodies against Type A

Severe and lethal transfusion reactions when given type A

Risk for neonatal isoerythrolysis

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Delayed Hemolytic Immune Mediated reaction

Extravascular Hemolysis

Mild reaction

>24 hours up to 2-3 weeks post transfusion

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Agglutination in blood typing is a (positive/negative) reaction

Positive

_____________________

Agglutination = blood type of patient

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Non-Immunogenic DEA types

DEA 4 and DEA 6

_______________________________

Universal Donors

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Types of transfusion reactions

Immune Mediated

Non Immune Mediated

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Feline Blood Systems

AB Group System

Mik System

___________________________________________

All cats will carry an antigen from the AB blood group and most carry an MIK antigen

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Blood typing identifies a specific RBC

Antigen

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Crossmatching in horses differs from small animals in that

Horses have both agglutinating and hemolytic antibodies:

Crossmatch agglutination test

Hemolytic detection test - to detect exogenous complement (Positive result=hemolysis)

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Minor Crossmatch

Patient RBC + donor serum

Rarely performed

Transfused serum is low volume compared to the patients serum; therefore not enough antibodies present to cause significant issues

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Breed of dogs that are at risk for acute and delayed onset of hemolytic transfusion reactions

Dalmations

Acute Hemolytic Immune Mediated Reaction

Intravascular hemolyisis

Severe Reactions

Can lead to DIC, Hypotension, Shock, Acute Renal Failure, Death

Antiserum

Reagent used in blood typing

Whole Blood

Need to replace RBC and plasma

Severe hemorrhage

Interpretation of a positive crossmatch

Agglutination or hemolysis are detected

Recipient at risk for transfusion reaction

DO NOT TRANSFUSE

Dog Erythrocyte Antigen (DEA) Blood System

Single antigen per blood type

7 DEA blood types

T/F: Equine, ruminants and camelids have pre-existing isoantibodies against erythrocytes

False

________________________

Very rarely they do

Transfusion products

Packed RBC

Whole Blood

Fresh Frozen Plasma

Platelet-Rich Plasma

Non Hemolytic Imune Mediated Reaction

Febrile and Allergic Reactions Common with plasma transfusions Occurs within 15 minutes to a few hours

Feline Type AB

Very rare Usually only purebred cats Universial Recipients

Two major blood groups in canines

DEA blood system Dal blood system

Packed Red Blood Cells

Need to replace RBCs only d/t: Erythrocyte destruction Decreased RBC production

What are the clinical signs of hypoxia

Increased HR, RR Poor pulse quality Abnormal BP Lethargy Weakness Decreased appetite

Dal Blood System

Single Antigen Dalmations - some lack Dal antigen others have Dal isoantibody

Clinical Signs of Non Hemolytic Immune Mediated Reactions

Nausea, Vomiting, Diarrhea, Abdominal Pain Tremors Uticaria, Pruritis, Erythema

Major Crossmatch

Patient Serum + Donor RBC Final check of compatibility between a patient and a donor prior to transfusion

Highly Immunogenic DEA types

DEA 1.1 and DEA 1.2 \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Incite strong agglutination and hemolysis

If you transfuse a type B cat with type A blood, you can expect

Severe reaction. Type B cats have strong isoantibodies against Type A blood

Clinical signs of Acute Hemolytic Immune Mediated Reactions

Hemoglobinemia and hemoglobinuria Anemia Hypoxia Vomiting, Pyrexia

Indications for transfusion therapy

Acute and severe anemia Clinical signs of hypoxia

Why are greyhounds good blood donors?

BIG dogs High PCV Most are DEA 1.1 negative \>50% are universal donors

Fresh Frozen Plasma

Need to replace plasma Clotting factor deficiencies Hypoproteinemia

A positive crossmatch results in

Agglutination \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Do not transfuse!

When should you cross match for a blood transfusion in a cat?

ALWAYS

When should you crossmatch for a blood transfusion in large animals?

Repeated transfusions Plasma transfusions