Haematology 14: Blood Transfusions 2 Flashcards

1
Q

What is the most common cause of acute transfusion reactions ?

A

TACO - transfusion associated circulatory overload

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2
Q

What signs do you see in ABO mismatch transfusion reactions ?

A

Signs of acute intravascular haemolysis

  • fever
  • vomiting
  • Collapse
  • Haemoglobinurea
  • hypotension

Chest pain

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3
Q

What signs do you get in TACO - transfusion associated circulatory overload ?

A
SOB
Tachycardia
Hypertension
Fluid overload
Heart failure
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4
Q

Give 2 ways in which TACO is different from TRALI ?

A

TACO responds to Furosemide TRALI does not

TACO has raised JVP TRALI does not

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5
Q

Why is male blood less likely to cause TRALI ?

A

They have not been pregnant so are less likely to have anti-HLA antibodies

Even less likely if the donor has also never received blood himself

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6
Q

What happens in Transfusion related acute lung injury (TRALI) ?

A
  • Antibodies against WBCs from the donor blood cause aggregation and deposition of recipients WBCs.
  • The aggregates of WBCs deposit in pulmonary capillaries and cause damage
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7
Q

Delayed haemolytic transfusion reactions involve …………vascular haemolysis

A

Extravascular haemolysis

They are IgG mediated

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8
Q

What is alloimmunisation ?

A
  • When a recipient receives a blood product with antigens they don’t have themselves.
  • They produce antibodies to these antigens
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9
Q

What is post transfusion purpura ?

A
  • A delayed transfusion reaction (7-10 days)

- human platelet antigen 1 ( HPA-1) negative patients previously immunised via transfusion or pregnancy

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10
Q

Which types of immunoglobulins can cross the placenta ?

A

IgG

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11
Q

Is anti-D given routinely to RhD -ve women in the UK?

A

Yes at 28-30 weeks and again at 34 weeks

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12
Q

What causes febrile non haemolytic transfusion reaction ?

A

Antibodies against donor leukocytes or HLA molecules.

-Acute onset of mild fever and rigors with no signs of haemolyisis

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13
Q

Which people require washed blood transfusions ?

A
  • Previous allergic reaction to blood products

- IgA deficiency

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14
Q

Which people require irradiated blood products ?

A
  • Immunosuppressed
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15
Q

When would cell salvage be used ?

A

-Any elective operations which have cardiorespiratory bypass e.g AAA repair, CABG

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16
Q

What causes a delayed transfusion reaction ?

A
  • IgG mediated reaction with extravascular haemolysis
  • E.g antibodies to Rhesus, kell, duffy and kidd antigens
  • 5-10 days later Splenomegaly, jaundice, haemoglobinuria