Blood Typing And Cross Match

Question 1

Cross matching

Answer 1

Detects hemolytic or agglutination reactions in a mixture of serum and cells from two different individuals

Question 2

Importance of blood typing

Answer 2

• RBCs to be typed with specific typing reagents
• Reduction of transfusion reactions
• Longer lasting benefits in-patient from RBCs and efficient utilization of donor pool

Question 3

Feline blood types

Answer 3

A, B and AB

• No universal blood types
• Has naturally occurring allo-antibodies
• can be fatal if given wrong blood type
• Blood type B cats can have fatal reaction to Type A blood

Question 4

What blood type are DSH usually and what is the percentage?

Answer 4

*99% DSH are Type A

Question 5

What cat breeds have 0% chance of Blood Type B?

Answer 5

*Siamese, Tonkinese, Burmese, Russian Blue

Question 6

What are the most common cat breeds with blood type B?

Answer 6

Exotic breeds, Abyssinian, Cornish and Devon Rex

Question 7

What cat blood type is rare?

Answer 7

Blood type AB

Therefore rare blood donors

Question 8

What blood type should be used for cat blood type AB if blood AB is not available?

Answer 8

Type A is the best choice

Question 9

How many Canine blood types are there?

Answer 9

About 13 types

Question 10

What determines the canine blood types?

Answer 10

Antigens adhered to the surfaces of the red cells using the nomenclature Dog Erythrocyte Antigen (DEA)

Question 11

What canine blood type commonly cause an antigen-antibody reaction?

Answer 11

1.1, 1.2 and 7

Question 12

What percentage of dogs are DEA 1.1 positive?

Answer 12

40%

Question 13

What is the canine universal blood type?

Answer 13

DEA 1.1 negative

*Giving blood type DEA 1.1 negative will reduce or eliminate first time transfusion reactions

Question 14

Blood typing

Answer 14

Recommended before any blood transfusion are administered

• Kits available for in house test
• small amount of anticoagulant blood
• based on agglutination reaction that occurs within 2 mins when DEA 1.1 positive RBCs interact with antibodies specific to DEA 1.1
• Outside blood typing labs available in US

Question 15

Cross matching

Answer 15

• Used to detect serum or plasma incompatibilities among the recipient and donor
• Should always be used in patients receiving multiple blood transfusions on an untyped recipient or when transfusion history is unclear

Question 16

What happens when transfusion of incompatible cells occurs?

Answer 16

• Immune response triggered
• detected in cross match within 5-7 days post transfusion
• Once antibodies formed
• will persist clinically for years

Question 17

What are the three components to cross matching?

Answer 17

Major, Minor and auto control

Major: donor red cells mixed with recipient plasma
Minor: donor plasma mixed with recipient RBCs
Auto control: recipient red cells mixed with recipient plasma

Question 18

Transfusion reactions signs

Answer 18

Tachypnea, tachycardia, fever, lethargy, facial swelling, vomiting, diarrhea, change in mentation

Question 19

How are transfusion reaction categorized?

Answer 19

• Immune mediated or non-immune-mediated
• Acute (within 24 hours) = MOST FEARED as can be fatal
• Delayed (days to years)

Question 20

When are acute immunological reaction seen?

Answer 20

Administration of blood type A blood to a blood type B cat

Question 21

What does antibodies directed against foreign red cell cause?

Answer 21

Acute hemolysis, anaphylaxis or shock reaction

Question 22

What does a delayed immune mediated response cause?

Answer 22

• A shortened cell life span

* Foreign RBC removed from circulation 7-10 days post transfusion

Question 23

What is a non-hemolytic immunological reaction

Answer 23

*antibody response to WCS, platelets or plasma proteins

Question 24

What would you expect to see in non-hemolytic immunological reactions?

Answer 24

• Fever
• Hypersensitivity
• Allergic like reactions: urticaria (hives), pyrexia, pruritius (itch), hypotension
• seen within the first mins or hours from the time of transfusion

Question 25

What are some of the factors responsible for non-immune mediated transfusion reactions?

Answer 25

* Improper collection, processing, or administration of blood products * Over transfusion or volume overload - most common * Signs: vomiting, retching, vocalization, dyspnea, tachypnea or pulmonary edema

Question 26

Hemolysis of blood products

Answer 26

* use of small size bore needle * overheating * freezing * dilution of RBCs with hypotonic solution * prolonged storage * bacterial contamination

Question 27

What does transfusion of hemolyzed blood products cause?

Answer 27

Reduces benefits of RBCs, fever or DIC

Question 28

What does transfusion of blood products containing micro-clots?

Answer 28

* Pulmonary edema | * DIC or thrombosis

Question 29

What are the signs of bacterial growth in blood products?

Answer 29

* Dark discoloration of RBC products * Clumped cells * Air bubbles

Question 30

What does transfusion of contaminated blood products cause?

Answer 30

*Acute signs of septic shock : fever, hypotension, hemolysis, vomiting, DIC

Question 31

Treatment for transfusion reaction

Answer 31

* Stop transfusion * Symptomatic Tx to alleviate signs * Vol. overload: discontinue transfusion or at a lower rate, diuretic use (furosemide) and oxygen supplementation if dyspnea/pulmonary edema * Acute hemolysis, shock or anaphylactic reaction: fluid support, ventilation, oxygen, epinephrine and glucocorticoids * Urticaria, pruritus, edema: Tx with diphenhydramine, dexamethasone or prednisolone * mild febrile reaction: no Tx * Severe febrile reaction: antipyretics and fluid support

Question 32

Administration and handling of whole blood or blood components

Answer 32

* should not be given solely based on hematocrit or hemoglobin levels * components should be given within 4hrs - reduces bacterial growth * use blood filter to remove fibrin clots, debris, platelet aggrates during collection and storage

Question 33

Initial rate of transfusion

Answer 33

1 ml/kg/hr Or 2ml/lb/hr Reevaluate within 1/2 hour - if normal then give the rest within 4 hours * Do not give with medications * Only use with 0.9%NaCl * Room temperature for neonate or hypothermic Animal * Large animals breeds will not be compromised by cool products

Question 34

How long can packed cells and whole blood be stored for in the refrigerator?

Answer 34

25 days

Question 35

What temperature of water bath should be used to defrost plasma, FFP and cryoprecipitates?

Answer 35

In cold water bath