Blood Typing And Cross Match Flashcards
Cross matching
Detects hemolytic or agglutination reactions in a mixture of serum and cells from two different individuals
Importance of blood typing
- 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
Feline blood types
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
What blood type are DSH usually and what is the percentage?
*99% DSH are Type A
What cat breeds have 0% chance of Blood Type B?
*Siamese, Tonkinese, Burmese, Russian Blue
What are the most common cat breeds with blood type B?
Exotic breeds, Abyssinian, Cornish and Devon Rex
What cat blood type is rare?
Blood type AB
Therefore rare blood donors
What blood type should be used for cat blood type AB if blood AB is not available?
Type A is the best choice
How many Canine blood types are there?
About 13 types
What determines the canine blood types?
Antigens adhered to the surfaces of the red cells using the nomenclature Dog Erythrocyte Antigen (DEA)
What canine blood type commonly cause an antigen-antibody reaction?
1.1, 1.2 and 7
What percentage of dogs are DEA 1.1 positive?
40%
What is the canine universal blood type?
DEA 1.1 negative
*Giving blood type DEA 1.1 negative will reduce or eliminate first time transfusion reactions
Blood typing
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
Cross matching
- 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
What happens when transfusion of incompatible cells occurs?
- Immune response triggered
- detected in cross match within 5-7 days post transfusion
- Once antibodies formed
- will persist clinically for years
What are the three components to cross matching?
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
Transfusion reactions signs
Tachypnea, tachycardia, fever, lethargy, facial swelling, vomiting, diarrhea, change in mentation
How are transfusion reaction categorized?
- Immune mediated or non-immune-mediated
- Acute (within 24 hours) = MOST FEARED as can be fatal
- Delayed (days to years)
When are acute immunological reaction seen?
Administration of blood type A blood to a blood type B cat
What does antibodies directed against foreign red cell cause?
Acute hemolysis, anaphylaxis or shock reaction
What does a delayed immune mediated response cause?
- A shortened cell life span
* Foreign RBC removed from circulation 7-10 days post transfusion
What is a non-hemolytic immunological reaction
*antibody response to WCS, platelets or plasma proteins
What would you expect to see in non-hemolytic immunological reactions?
- Fever
- Hypersensitivity
- Allergic like reactions: urticaria (hives), pyrexia, pruritius (itch), hypotension
- seen within the first mins or hours from the time of transfusion
What are some of the factors responsible for non-immune mediated transfusion reactions?
- Improper collection, processing, or administration of blood products
- Over transfusion or volume overload - most common
- Signs: vomiting, retching, vocalization, dyspnea, tachypnea or pulmonary edema
Hemolysis of blood products
- use of small size bore needle
- overheating
- freezing
- dilution of RBCs with hypotonic solution
- prolonged storage
- bacterial contamination
What does transfusion of hemolyzed blood products cause?
Reduces benefits of RBCs, fever or DIC
What does transfusion of blood products containing micro-clots?
- Pulmonary edema
* DIC or thrombosis
What are the signs of bacterial growth in blood products?
- Dark discoloration of RBC products
- Clumped cells
- Air bubbles
What does transfusion of contaminated blood products cause?
*Acute signs of septic shock : fever, hypotension, hemolysis, vomiting, DIC
Treatment for transfusion reaction
- 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
Administration and handling of whole blood or blood components
- 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
Initial rate of transfusion
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
How long can packed cells and whole blood be stored for in the refrigerator?
25 days
What temperature of water bath should be used to defrost plasma, FFP and cryoprecipitates?
In cold water bath
