Haematology 14: Blood Transfusions 2 Flashcards
What is the most common cause of acute transfusion reactions ?
TACO - transfusion associated circulatory overload
What signs do you see in ABO mismatch transfusion reactions ?
Signs of acute intravascular haemolysis
- fever
- vomiting
- Collapse
- Haemoglobinurea
- hypotension
Chest pain
What signs do you get in TACO - transfusion associated circulatory overload ?
SOB Tachycardia Hypertension Fluid overload Heart failure
Give 2 ways in which TACO is different from TRALI ?
TACO responds to Furosemide TRALI does not
TACO has raised JVP TRALI does not
Why is male blood less likely to cause TRALI ?
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
What happens in Transfusion related acute lung injury (TRALI) ?
- 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
Delayed haemolytic transfusion reactions involve …………vascular haemolysis
Extravascular haemolysis
They are IgG mediated
What is alloimmunisation ?
- When a recipient receives a blood product with antigens they don’t have themselves.
- They produce antibodies to these antigens
What is post transfusion purpura ?
- A delayed transfusion reaction (7-10 days)
- human platelet antigen 1 ( HPA-1) negative patients previously immunised via transfusion or pregnancy
Which types of immunoglobulins can cross the placenta ?
IgG
Is anti-D given routinely to RhD -ve women in the UK?
Yes at 28-30 weeks and again at 34 weeks
What causes febrile non haemolytic transfusion reaction ?
Antibodies against donor leukocytes or HLA molecules.
-Acute onset of mild fever and rigors with no signs of haemolyisis
Which people require washed blood transfusions ?
- Previous allergic reaction to blood products
- IgA deficiency
Which people require irradiated blood products ?
- Immunosuppressed
When would cell salvage be used ?
-Any elective operations which have cardiorespiratory bypass e.g AAA repair, CABG