L1: Blood And Blood Products (Cooke) Flashcards
Most common dog blood type
DEA 1.1 positive
Cat blood types
A, B, AB
DEA =
Dog erythrocyte antigen
Most common cat blood type
A
-have Ab to type B RBC (usually weak IgG response –> early RBC destruction)
Type B cats have Ab to what RBC?
Type A
-strong IgM Ab response –> severe rxn within minutes
Type B most common in what breeds
- British shorthair
- Devon rex
- Persian
- Abyssinian
- Himalayan
- Birman
Lifespan of properly matched RBCs in a cat?
30 days
Lifespan of type B RBCs given to type A cat?
2 days
Dal antigen
- missing in some Dalmatians
- must acquire Ab to it, so usually won’t have rxn to it on first transfusion
Mik antigen
- uncommon in cats
- type but not cross-match compatible (should cross-match for it)
- cats have PRE-FORMED antibodies to it
What is the minimum time required to create Ab to a transfusion?
4 days
Indications for cross matching
- dog with previous transfusion (+/- pregnancy)
- cats
Major cross match
Recipient plasma with donor RBCs
Minor cross match
Donor plasma with recipient cells
How long can blood be stored?
about 3 weeks
-adsol increases the lifespan
Packed red cells are ___x as concentrated as whole blood
2x
How much whole blood given to increase PCV by 1%?
1 ml/lb
How much PRBCs given to increase PCV by 1%?
1 ml/kg (or 1 ml/lb to increase PCV 2%)
SIRS =
Systemic inflammatory response syndrome
Types of transfusion reactions
1) immune-mediated hemolysis
2) allergic reactions
3) febrile, non-hemolytic reaction
4) Transfusion related acute lung injury (TRALI)
5) Sepsis
6) non-immune mediated hemolysis
Immune-mediated hemolysis
- due to pre-formed Ab (IgG, IgM)
- complement, cytokines –> SIRS
- fever, vomiting, shock
- hemoglobinemia, hemoglobinuria
- tx = stop the transfusion!
- IV hemolysis
- ie. Giving type A blood to type B cat
Transfusion reactions
- IgE mediated –> mast cell degranulation
- mild pruritus to systemic anaphylaxis
- tx: stop transfusion, give benadryl, +/- glucocorticoids and epi
Cause and tx of febrile, non-hemolytic transfusion rxn
- cause: WBC-produced cytokines due to storage, leukoreduction filters
- CS: fever, no hemolysis
- Tx: stop transfusion, give NSAIDs, +/- restart at lower rate
Cause of non-immune mediated hemolysis
Storage/administration issue
Massive transfusion
> 1 blood volume
> 22 ml/kg/day
-can –> hypocalcemia, hypoK, hypothermia, coagulopathy
Indications for fresh whole blood
- massive acute blood loss
- liver failure
- DIC
- no stored products available
Adv/Disadv. Of fresh whole blood
Adv: platelets, clotting factors
Disadv: volume, time
Indications for PRBCs
-acute blood loss (
Most common cat blood type
A
-have Ab to type B RBC (usually weak IgG response –> early RBC destruction)
Type B cats have Ab to what RBC?
Type A
-strong IgM Ab response –> severe rxn within minutes
Type B most common in what breeds
- British shorthair
- Devon rex
- Persian
- Abyssinian
- Himalayan
- Birman
Lifespan of properly matched RBCs in a cat?
30 days
Lifespan of type B RBCs given to type A cat?
2 days
Dal antigen
- missing in some Dalmatians
- must acquire Ab to it, so usually won’t have rxn to it on first transfusion
Mik antigen
- uncommon in cats
- type but not cross-match compatible (should cross-match for it)
- cats have PRE-FORMED antibodies to it
What is the minimum time required to create Ab to a transfusion?
4 days
Indications for cross matching
- dog with previous transfusion (+/- pregnancy)
- cats
Major cross match
Recipient plasma with donor RBCs
Minor cross match
Donor plasma with recipient cells
How long can blood be stored?
about 3 weeks
-adsol increases the lifespan
Packed red cells are ___x as concentrated as whole blood
2x
How much whole blood given to increase PCV by 1%?
1 ml/lb
How much PRBCs given to increase PCV by 1%?
1 ml/kg (or 1 ml/lb to increase PCV 2%)
SIRS =
Systemic inflammatory response syndrome
Types of transfusion reactions
1) immune-mediated hemolysis
2) allergic reactions
3) febrile, non-hemolytic reaction
4) Transfusion related acute lung injury (TRALI)
5) Sepsis
6) non-immune mediated hemolysis
Immune-mediated hemolysis
- due to pre-formed Ab (IgG, IgM)
- complement, cytokines –> SIRS
- fever, vomiting, shock
- hemoglobinemia, hemoglobinuria
- tx = stop the transfusion!
- IV hemolysis
- ie. Giving type A blood to type B cat
Transfusion reactions
- IgE mediated –> mast cell degranulation
- mild pruritus to systemic anaphylaxis
- tx: stop transfusion, give benadryl, +/- glucocorticoids and epi
Cause and tx of febrile, non-hemolytic transfusion rxn
- cause: WBC-produced cytokines due to storage, leukoreduction filters
- CS: fever, no hemolysis
- Tx: stop transfusion, give NSAIDs, +/- restart at lower rate
Cause of non-immune mediated hemolysis
Storage/administration issue
Massive transfusion
> 1 blood volume
> 22 ml/kg/day
-can –> hypocalcemia, hypoK, hypothermia, coagulopathy
Indications for fresh whole blood
- massive acute blood loss
- liver failure
- DIC
- no stored products available
Adv/Disadv. Of fresh whole blood
Adv: platelets, clotting factors
Disadv: volume, time
Indications for PRBCs
-acute blood loss (
Adv/disadv. Of PRBCs
- Adv: less volume, stored
- Disadv: no platelets or factors, ammonia accumulation (don’t use on liver patients)
Fresh frozen plasma contains:
- clotting factors
- antithrombin
- platelets
Indications for fresh frozen plasma
- DIC
- Hemophilia A+B (coagulopathy)
- hypoalbuminemia
Shelf life of FFP
1 year
Adv./Disadv. of FFP
Adv:
- less antigenic (has less cellular components)
- specific
Disadv:
-storage space
Frozen (stored) plasma lacks:
factors V and VIII
Indications of frozen plasma
- Vit. K rodenticide
- Hemophilia B
- Hypoalbuminemia
Adv. of frozen plasma
- stored
- less volume
- long shelf life (5 years)
- cheaper
Cryoprecipitate contains:
-concentrated factor VIII, vWF, fibrinogen, and fibronectin
Indications for cryoprecipitate
- Von Willebrand’s dz
- Hemophilia A
Indication for platelet concentrate
-thrombocytopenia with ACTIVE bleeding (or prior to surgery) ie. Splenectomy
(Infrequently used)
Indication for platelet-rich plasma
-thrombocytopenia with active bleeding
Infrequently used
Indications for concentrated albumin
- hypoproteinemia with CS
- not currently available
- can cause type 3 hypersensitivity rxn
General recommendations
- blood type AND crossmatch prior to any feline transfusion
- blood type cats from breeds likely to be type B
- blood type all potential donors
- donors shouldn’t have been previously transfused or pregnant
- all breeding animals should be blood typed
- patients likely to require multiple transfusions should ideally be blood typed so that type-specific blood can be administered
IF all canine donors are DEA 1.1 negative, and the patient has not been transfused or pregnant before, THEN:
It SHOULD be safe to transfuse cellular products without crossmatching (acute hemolysis unlikely)
