COMPONENT THERAPY & PRE-TRANSFUSION COMPATIBILITY TESTING

Question 1

All steps in the identification and testing of a potential transfusion recipient and donor blood before transfusion in an attempt to provide a blood product that survives in vivo

Answer 1

Compatibility testing

Question 2

Specimen collection : _______ and ____ of patient blood samples and donor units is absolutely essential

Answer 2

Positive identification and testing

Question 3

If serum is used , blood samples should be collected in siliconized plain tubes without _______

Answer 3

Serum separator gel

Question 4

Age of the specimen for compatibility testing

Answer 4

3 days

Question 5

Specimen for compatibility testing must be retained post-transfusion for at least ____ days

Answer 5

At least 7 days

Question 6

Unacceptable specimens for compat testing

Answer 6

IV line contamination and hemolyzed

Question 7

Final check of ABO group between donor and patient

Answer 7

Crossmatching

Question 8

Crossamatching may detect the presence of _____

Answer 8

Antibodies not detected during the Antibody identification

Question 9

Major crossmatch tests the donor ___ and the patient _____

Answer 9

Donor red cells and patient serum

Question 10

Minor crossmatch tests the donor ___ and the patient _____

Answer 10

Donor serum and patient red cells

Question 11

Regardless of minor crossmatch result, we need to follow the major crossmatch result - True or false

Answer 11

True

Question 12

Two classifications of crossmatch tests

Answer 12

Serologic and computer crossmatch

Question 13

Tests the patients serum with the Donor RBC

Answer 13

Serologic crossmatch

Question 14

Component of serologic crossmatch that detects IgM incompatibility

Answer 14

Immediate spin

Question 15

Component of serologic crossmatch that detects IgG incompatibility

Answer 15

AHG

Question 16

Serologic crossmatch : both immediate spin and AHG are performed

Answer 16

Complete crossmatch

Question 17

Serologic crossmatch immediate spin is only performed

Answer 17

Incomplete or abbreviated crossmatch

Question 18

Incomplete or abbreviated crossmatch is only performed if these 2 criteria are met

Answer 18

1) negative current Ab screening
2) no history of clinically significant antibody

Question 19

May be used only for patients who have no currently clinically significant antibodies or any history of alloantibodies

Answer 19

Computer crossmatch (EXM)

Question 20

All blood units are incompatible with this condition

Answer 20

AIHA

Question 21

If not at correct temp, unit must be returned within ___ mins of issue

Answer 21

30 mins

Question 22

Transfusion of RBC components prior to completion of pretransfusion testing

Answer 22

Emergency transfusion

Question 23

In emergency tranfusion, the blood unit must be

Answer 23

ABO specific and O Rh negative

Question 24

Blood type to be used for plasma emergency transfusion

Answer 24

AB plasma

Question 25

Is it required to perform compatibility testing of plasma products?

Answer 25

Not required, serum typing is only performed

Question 26

In massive transfusion, ___ units of whole blood/packed red cell is given within ____ hours

Answer 26

10 units ; 24 hours

Question 27

For platelet concentrate/FFP transfusion, the unit must be given within ____ mins

Answer 27

20 mins

Question 28

Effects of massive transfusion

Answer 28

Iron overload Bleeding (platelets are diluted) Citrate toxicity (calcium ions are affected)

Question 29

One unit of blood should be transfused within ____ hours

Answer 29

4 hours

Question 30

Time interval for acute transfusion reaction

Answer 30

Within 24 hours

Question 31

Time interval for delayed transfusion reaction

Answer 31

More than 24 hours

Question 32

Other classifications of transfusion reaction

Answer 32

Immune and non immune Infectious and noninfectious

Question 33

Acute immunologic transfusion reactions

Answer 33

Hemolytic Febrile nonhemolytic Allergic TRALI

Question 34

Acute non immunologic transfusion reactions

Answer 34

Bacterial contamination Circulatory overload Physical/chemical hemolysis

Question 35

Delayed immunologic transfusion reactions

Answer 35

Hemolytic Transfusion-associated graft-versus-host disease Post transfusion purpura

Question 36

Delayed non immunologic transfusion reactions

Answer 36

Transfusion-induced hemosiderosis Disease transmission

Question 37

Reaction period varies from 1-2 hours ; main cause is incompatible blood

Answer 37

Immediate hemolytic transfusion reaction

Question 38

Immediate hemolytic transfusion reaction

Answer 38

FNHTR Allergic reaction TRALI DHTR PTP Transfusion-associate graft-versus-host disease Transfusion associated circulatory overload

Question 39

Acute complication of transfusion presenting with at lease 1C increase in body temperature

Answer 39

febrile non hemolytic transfusion reaction

Question 40

2 mechanisms of FNHTR

Answer 40

immune-mediated and platelet storage changes

Question 41

Occurs as a response of recipient antibodies to an allergen present in the blood component ; the more common, milder reactions consist of weals, erythema, or pruritis ; severe reactions (anaphylactic or anaphylactoid)

Answer 41

Allergic reaction

Question 42

With RESPIRATORY distress and severe hypoxemia during or within 6 hours of transfusion in the absence of other causes of lung injury ; mediated by anti-WBC antibodies

Answer 42

TRALI

Question 43

detection of “new” red cell antibodies AFTER 24 hours of transfusion

Answer 43

DHTR

Question 44

Presents with profound thrombocytopenia, frequently accompanied by bleeding 1 to 24 days AFTER a blood transfusion ; the antigen most commonly implicated in this condition is the HUMAN PLATELET ANTIGEN (HPA) 1a

Answer 44

Post transfusion purpura

Question 45

Due to an immunologic attack by viable donor lymphocytes contained in the transfused blood component against the transfusion RECIPIENT

Answer 45

Transfusion-associated graft-versus-host disease

Question 46

With respiratory distress and hypoxemia that can be accompanied by cough, headache, chest tightness, hypertension, jugular vein distention, elevated central venous pressure, and ELEVATED PULMONARY WEDGE pressure during or after transfusion l occurs when the patient’s CARDIOVASCULAR system’s ability to handle additional workload is exceeded manifesting as congestive heart failure

Answer 46

Transfusion-associated circulatory overload

Question 47

Most common causes of transfusion reactions

Answer 47

FNHTR and allergic reaction

Question 48

Blood component given to prevent FNHTR

Answer 48

Leukoreduced

Question 49

Blood component given to prevent allergic reaction

Answer 49

Washed

Question 50

Most common cause of death associated with transfusion reaction

Answer 50

TRALI DHTR IHTR

Question 51

Minutes ; incompatible blood ; free hemoglobin ; DAT (+) - minutes ; urine - free hemoglobin ; intravascular hemolysis ; Hypotension leading to DIC, acute renal failure

Answer 51

Immediate hemolytic TR

Question 52

3-7 days ; blood: bilirubin and methalbumin ; urine: urobilinogen, hemosiderin ; DAT(+) - days ; extravascula hemolysis ; unexplained depletion of Hgb ad Hct leading to anemia

Answer 52

Delayed hemolytic TR

Question 53

Investigation of a TR

Answer 53

Clerical check Visual inspection ( pre or post tranfusion sample) DAT Testing (positive post patient sample)

Question 54

Additional testing for TR

Answer 54

ABO and Rh typing Urine test AB screening Bilirubin test Hgb and Hct