Exam 4: Dr. Thomason Transfusions and Blood Groups

Question 1

What are transfusions?

Answer 1

Process of receiving blood products into one’s circulation

Question 2

What are the different types of blood products?

Answer 2

Fresh whole blood
Packed RBCs
Fresh frozen plasma
Platelet concentrations

Question 3

What are indications for transfusions?

Answer 3

Anemia
Disorders of hemostasis/coagulation
Deficiencies of plasma components

Question 4

What are the different anemias?

Answer 4

Hemorrhage
Hemolysis
Non-regenerative anemia

Question 5

What are blood groups?

Answer 5

Inherited antigens on the RBC surface

Question 6

What do RBC antigens do?

Answer 6

Contribute to self recognition

Elicit the production of antibodies when introduced to an animal whose RBCs lack that antigen

Question 7

What are the canine blood types?

Answer 7

Dog erythrocyte antigen (DEA) 1.1, 1.2, 3, 4, 5, 6, 7, and 8

Question 8

Which DEAs are considered to be important in transfusion medicine?

Answer 8

1.1 and 1.2

Question 9

Describe DEA 1.1

Answer 9

Extremely antigenic

The antigen routinely determined in patients and donors

Question 10

What percentage of dogs are DEA 1.1 positive?

Answer 10

42%

Question 11

What are red cell alloantibodies?

Answer 11

IgM, IgG, or IgE antibodies that cause hypersensitivity reactions to blood products

Question 12

Do dogs have naturally occurring alloantibodies to DEA 1.1?

Answer 12

No

Question 13

What will happen when a transfusion uses RBCs with similar DEA antigens?

Answer 13

Less likely to mount an immune response due to similar cells

May recognize another antigen

Question 14

What will happen when a transfusion uses RBCs with different DEA antigens?

Answer 14

The highly antigenic DEA 1.1 antigen is not expressed

Less likely to mount an immune response

Question 15

What will happen when a transfusion uses DEA 1.1 negative dogs transfuse with DEA 1.1 positive blood?

Answer 15

It will likely become sensitized and produce an anti-DEA 1.1 alloantibody

Question 16

What are previously transfused patients with circulating alloantibodies are risk for?

Answer 16

Development of the transfusion reactions

Question 17

What can be used to assess blood compatibility?

Answer 17

RBC antigens and plasma antibody interaction

Question 18

What is the visible reaction of blood compatibility?

Answer 18

Agglutination

Question 19

What is agglutination?

Answer 19

The antibody mediated clumping of cells that express antigen on their surface

Question 20

What does major crossmatch determine?

Answer 20

The compatibility between the donor and recipient

Question 21

What does major crossmatch prevent?

Answer 21

Incompatible transfusions that could result in immune-mediated hemolytic transfusion reactions

Question 22

What are donor RBCs incubated with in major crossmatch?

Answer 22

Recipient serum and observed for agglutination/hemolysis

Question 23

If there is agglutination/hemolysis in major crossmatch, what does it mean?

Answer 23

Incompatible

Question 24

What are the feline blood types?

Answer 24

Type A
Type B
Type AB

Question 25

What is the predominant blood type of felines?

Answer 25

Type A

Question 26

What breeds of cats have the highest frequency of type B blood?

Answer 26

Devon Rex | British Shorthair

Question 27

What do cats have in regards to alloantibodies?

Answer 27

Naturally occurring alloantibodies

Question 28

What do type A cats have?

Answer 28

Circulating B-antibodies

Question 29

What do type B cats have?

Answer 29

Circulating A-antibodies

Question 30

What happens when antibodies and antigens bind?

Answer 30

Agglutination

Question 31

When do acute hemolytic transfusion reactions (AHTRs) develop?

Answer 31

When transfused RBCs interact with preformed circulating antibodies in the recipient that are naturally occurring or acquired

Question 32

What can the interaction between transfused RBCs and circulating antibodies do?

Answer 32

Activate complement and cytokines which leads to a systemic inflammatory response

Question 33

What is the reaction severity of AHTRs related to?

Answer 33

The number of RBCs destroyed

Question 34

In dogs, what are AHTRs predominantly?

Answer 34

IgG

Question 35

In cats, what are AHTRs predominantly?

Answer 35

IgM

Question 36

What are clinical sign of AHTRs?

Answer 36

``` Fever Restlessness Salivation Incontinence Shock ```

Question 37

Describe febrile non-hemolytic transfusion reactions

Answer 37

A temperature increase associated with a transfusion without any other explanation Leukocyte-derived cytokine and/or circulating anti-leukocyte antibodies in the recipient