Blood Transfusions

Question 1

Describe fresh whole blood

Answer 1

Contains rbcs, platelets, wbcs, plasma protein and all clotting factors
Used in anaemia (haemorrhage), thrombocytopenia, pancytopenia

Question 2

Describe whole blood

Answer 2

Contains rbcs, plasma proteins, stable clotting factors

Used in anaemia (haemorrhage)

Question 3

Describe packed red blood cells

Answer 3

Used for anaemia (haemolysis, non-regenerative anaemia, chronic blood loss)

Question 4

Describe fresh frozen plasma (FFP)

Answer 4

Contains all clotting factors, vWF, plasma proteins

Used in coagulopathoes (esp associated with liver disease, factor VII deficiency, Vwd)

Question 5

What blood transfusion can cats get?

Answer 5

Fresh whole blood only

Prone to volume overload

Question 6

Name the dog blood types

Answer 6

1.1, 1.2, 3,4,5,6,7 and 8 and DAL antigen

Question 7

What is important when transfusing blood in dogs?

Answer 7

Imperative to cross match prior to subsequent transfusions since first transfusions rarely result in reactions
Better to blood type prior to first transfusion

Question 8

Name the feline blood groups

Answer 8

A, B, AB

Question 9

What is important when transfusing blood in cats?

Answer 9

Have naturally occurring alloantibodies
So need to be blood typed before first transfusion
Cross matching must be performed before subsequent transfusions

Question 10

Why is blood typing important?

Answer 10

Minimises risk of transfusion reaction
Avoid formation of alloantibodies in the future
Breed blood types not a rule

Question 11

Describe cross matching

Answer 11

• identifies reactions between donor and receipient blood using agglutination or haemolysis
• cases with autoagglutination cant be easily typed or cross matched

Question 12

When is cross matching used in dogs and cats?

Answer 12

dogs- if they had have previous transfusion 4 days before, any unknown transfusion, history of transfusion or a previous pregnancy

cats- ALL THE TIME

Question 13

What are the benefits of a blood bank?

Answer 13

• increased availability for patient
• products are tailored to individual needs
• risk of complications are minimised
• convient for the donor
• allows donor screening/typing

Question 14

Describe the requirements for canine blood donation

Answer 14

• 1-8 yrs old
• over 25kg
• fully vaccinated and wormed
• healthy and not receiving any medication
• never travelled out of UK
• good temperament
• never had puppies/or pregnant
• never had transfusion before

Question 15

What sedation is used in blood donation?

Answer 15

butorphanol IV

Question 16

What is the maximum amount of blood a dog can give?

Answer 16

18ml/kg every 8 wks

Question 17

What are the requirements for feline blood donation?

Answer 17

Over 4kg
Fully vaccinated and wormed
Healthy and not receiving any medication
FIV/FeLV negative
no previous kittens or is pregnant and overall good temperament
Mycoplasma felis PCR negaitive, never travelled outside of UK, has not received transufion previously

Question 18

Why is it important to have the correct anti-coagulant: blood ratio?

Answer 18

Too much anticoagulant can lead to citrate toxicity and citrate binds to calcium which will lead to hypocalcaemia resulting in either cramps, seizures or respiratory arrest

Question 19

What needs to be known once blood is taken?

Answer 19

Recipients blood type
Previous donor history
Current drug and fluid therapy
Concurrent disease eg cardiac

Question 20

Why should lactate ringers solution not be administrated through the same line as the blood product?

Answer 20

Because calcium within the fluid precipitates with anticoagulants present in WB and pRBCs

Question 21

What is the maximum volume of blood given?

Answer 21

22ml/kg

Question 22

What formula is used to calculate required volume of blood?

Answer 22

K x bodyweight x (desired PCV-recipient PCV)/donor PCV

K= 90 for dogs and 60 for cats

Question 23

What can cause non-immunological reactions to transfusion?

Answer 23

Too rapid infusion rate
Volume overload
Microbial contamination
Thrombosis
Air embolus, TRALI etc

Question 24

What are signs of a transfusion reaction?

Answer 24

• tachycardia or bradycardia
• vocalisation
• shock
• vomiting
• jaundice
• pyrexia
• coughing

Question 25

What can be done to treat transfusion reactions?

Answer 25

Stop transfusion immediately
Monitor patient
Oxygen +/- artificial ventilation
Adrenaline IV
IV fluids
Antihistamines such as piriton and H2 blockers
Dexamethasone
Anti-emetics
Can reintroduce slowly but remember 4 hr window