Blood Transfusions Flashcards
Common reasons to give blood transfusions
Surgery
Trauma
Anemia’s
Cancers
Allogeneic vs Isogeneic
Allogeneic= different genes
Isogeneic = same genes
- only identical twins are truly Isogeneic
Alloimmunization
Process of presenting a non-self antigen to the immune system to make the immune system know it isn’t self-antigen
Type H blood (Bombay blood)
Rare blood type that cannot accept any blood except from H which is almost impossible to find
Blood type alleles and possible combinations with their resulting blood types
A/B and O
A+A = A
A+O = A
A+B = AB
B+B = B
B+O = B
O+O = O
Rhesus factor in pregnancy and HDFN
If the mother does not have the same Rhesus factor as her child, the mothers body will develop antibodies against the Rhesus factors.
Produces hemolytic disease of a fetus (HDFN) or newborn
- usually does not affect the 1st pregnancy but is problematic for a 2nd pregnancy.
- still can affect 1st pregnancy though.
Whole blood indications and specific contents
Indicated for trauma and massive blood loss
Provides colloid osmotic pressure and coagulation factors
Shelf-life is 35 days
used often in military
RBC infusion indications and specific contents
Correction of defect in oxygen carrying capacity (chronic anemias)
Platelet rich plasma is removed, but leukocytes remain
Shelf life is 42 days
Type O RBCs is indicated in unknown blood type or type O recipients situations
Leukocyte-reduced RBCs (LRRCs) indications and specific contents
No leukocytes and platelets, just RBCs
Indicated in patients to prevent febrile non-hemolytic transfusion reaction (donor WBCs attack recipient cells)
-also prevents CMV infections
Prevents transfusion related immunomodulation (TRIM) which if present increases chances of infections for a lifetime
Is pretty expensive
Washed or irradiated RBCs indications and contents
Washed: removed plasma proteins
- indicated in patients that have had an allergic transfusion reaction previously
- also used in IgA deficient patients (IgA from donor can lead to anaphylaxis in recipient)
Irradiated: kills immunocomplexes in WBCs
- indicated for prevention of rare but often fatal transfusion associated GVHD (donor WBCs proliferate and attack recipient blood with immunodeficencies/neonates patients
Frozen RBCs
Only used for rare donor types and autologous donations (donating for yourself for future use)
- freezing destroys most of the blood except RBCs and very small amounts of WBCs
Expensive
acute intravascular hemolytic transfusion reactions
Giving wrong blood types causes compliment induced inflammatory event
Clinical signs:
- red urine
- fever
- renal vasoconstriction
- increased thrombosis activation
- blood pressure from and tissue edema/shock (caused by IL-8 presence from Neutrophils)
- once fever is noted, STOP TREATMENT since its can be fatal via renal failure or DIC*
Acute extravascular hemolytic transfusion reaction
Clinical symptoms:
- fevers
- chills
- jaundice
- clinically stable
Seen in 3-10 days after poor transfusion
Much more dangerous in patients with sickle cell disease
- lab sign is increase DAT and IgG in blood*
Febrile nonhemolytic transfusion reactions
Presents with fever, chills and rigors
- fever is rise of 1 degree C or over 38C during the transfusion with no infection present
Hypothesized to be due to a build up of donor cytokines
LRRCs prevent this reaction
Transfusion Related Acute Lung Injury (TRALI)
Donor blood attaches lung epithelium
Clinical symptoms:
- dyspnea
- tachypnea
- hypoxemia
- fever
- hypotension
Usually requires chest radiograph and increase in HLA antineutrophil antibodies to diagnosis
Treatment is to stop transfusion and provide respiratory support until the reaction ceases
- no drugs to treat
