BLOOD TRANSFUSIONS LECTURE Flashcards
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What protein do the blood group molecules attache to?What additional molecules added to this protein make it blood group A or B?
H proteinBlood group has no extra molecules attached to protein HBlood group A has N-acetyl galactosamineBlood group B has galactoseAB has both
What are the other blood groups that are relevant?
RhesusKellDuffyKiddMNSs
Red cell antibodies.What are the function of IgG vs IgM?
IgGStick to foreign proteinsFacilitate their destruction in the spleenEngulfed by macrophagesSlow processIgMStick to foreign proteinsCause immediate activation of complementOccurs in blood vesselsAcute and dramatic process
Which antibodies can cross the placenta?
IgG
What is the shelf life of blood?What is the additive solution in blood?
35 daysSAGM
What is the appropriate dosing of plasma?How is it stored?
12-15ml/kgFrozen
Do Rh D neg individuals have anti-D antibodies?
No, only if exposed to Rh D. This is different to the ABO blood groupings, where the antibodies against the blood not had is constitutively present.
How long will transfused cells last in the circulation?
3-4 weeks
What are the triggers for red blood cell transfusion?
Acute blood loss with haemodynamic instabilityHb<70g/L stable patientHb <80g/L cardiovascular patientChronic transfusion dependent anaemia (Hb threshold <80g/L)
What are the triggers for platelet transfusion?
ProphylacticPrior to invasive procedureTherapeutic use to treat significant bleedingSpecific clinical concernsPlatelet dysfunction
Triggers for fresh frozen plasma transfusion?
Major haemorrhagePT Ratio/INR <1.5 with bleeding, <1 pre-procedure, <2 with liver disease
What are the definitions of major haemorrhage?
Loss of more than one blood volume within 24 hours50% total blood loss in less than 3 hoursBleeding in excess of 150ml/min
What is TACO?What is FNHTR?
Transfusion associated cardiac overload
The primary symptoms of TACO aredyspnea,orthopnea, peripheraledema, and rapid increase ofblood pressure.[3]TACO must be suspected when there is respiratory distress with other signs, including pulmonary edema, unanticipated cardiovascular system changes, and evidence of fluid overload (including improvement afterdiuretic, morphine or nitrate treatment), during or up to 24 hours after transfusion.[1]
Febrile non-hemolytic transfusion reactionis a type oftransfusion reactionthat is associated withfeverbut not directly withhemolysis. It is most commonly caused by antibodies directed against donor leukocytes and HLA antigens. This is in contrast totransfusion-associated acute lung injury, in which the donor plasma has antibodies directed against the recipient HLA antigens, mediating the characteristic lung damage. Alternatively, FNHTR can be mediated by pre-formedcytokinesin the donor plasma as a consequence of white blood cell breakdown.
Deficiency of which immunoglobulin can lead to transfusion reaction?
Anaphylactic reactions to products are common among individuals with selective IgA deficiency. Selective IgA deficiency is the most common primary immunodeficiency and individuals with this condition have low IgA levels despite normal levels of the IgG and IgM. Patients often suffer from recurrent airway infections, atopy, autoimmune diseases and are prone to have giardiasis infection. To avoid this, these patients must receive blood products without IgA.
