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Transfusion Science > Lecture 4 - Adverse Reactions > Flashcards

Lecture 4 - Adverse Reactions Flashcards

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1
Q

what does SHOT stand for?

A

serious hazards of transfusion

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2
Q

what does SHOT do?

A

it is voluntary and anonymous and makes recommendations on how to improve patient safety

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3
Q

what is SABRE?

A

serious adverse blood reactions and events

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4
Q

what two companies merged together in 2017?

A

MHRA and SHOT, SABRE reports to both

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5
Q

what reports does SHOT receive that are not reportable under BSQR?

A

solvent detergent fresh frozen plasma (octaplas) and anti-D immunoglobulin

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6
Q

what is a SAR?

A

an unintended response in a donor or in a patient that is associated with the collection or transfusion of blood or components

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7
Q

what reactions are associated with red cell antibodies?

A

acute haemolytic reaction and delayed haemolytic reaction

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8
Q

what are the clinical symptoms of an allergic/anaphylactic reactions?

A

hypotension associated with a wheeze, swelling of face or limbs or mucus membranes, flushing

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9
Q

how may an allergic reaction be caused?

A

if a patient has an allergy and the donor has consumed that allergen

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10
Q

what type of component are allergic reactions usually associated with?

A

plasma rich components such as platelets or FFP

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11
Q

what is an allergic reaction investigated for?

A

for an IgA deficiency

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12
Q

what are the symptoms of febrile reactions?

A

fever, sometimes with shivering, muscle pain or nausea

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13
Q

how are febrile reactions most commonly caused?

A

by antibodies directed against donor leucocytes and the HLA antigens or by pre-formed cytokines in the donor plasma

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14
Q

how have febrile reactions been reduced?

A

due to leucodepleted blood components

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15
Q

what cases makes febrile reactions more common?

A

more common in multi-transfused patients receiving red cells

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16
Q

what is the treatment of a febrile reaction?

A

paracetamol and slow transfusion

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17
Q

what is TA-GvHD

A

engrafted T lymphocytes from the transfused blood recognise the recipient as foreign and attack host tissues

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18
Q

what makes TA-GvHD more likely to occur?

A

first degree relative donations due to HLA similarities and in immunocompromised patients

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19
Q

how can TA-GvHD be prevented?

A

by irradiation

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20
Q

what does TACO stand for?

A

tranfusion associated circulatory overload

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21
Q

how can TACO be caused?

A

due to rapid transfusion of a large volume of blood

22
Q

what increases the risk of TACO?

A

over the age of 60, cardiac or pulmonary failure, renal impairment, hypoalbuminemia or anaemia

23
Q

what kind of patients are at an increased risk of TACO?

A

small patients such as elderly or children

24
Q

what is TRALI?

A

transfusion related acute lung injury

25
Q

how long does it take for TRALI to occur?

A

most cases present within 2 hours post transfusion with a max of 6 hours

26
Q

with are the signs of TRALI?

A

severe breathlessness and a cough associated with pink froth, hypotension and fever and rigors

27
Q

what kind of treatment is associated with TRALI?

A

supportive treatment, often in the ICU

28
Q

how might close link of TACO and TRALI cause mortality in someone with TRALI?

A

if confused with TACO, powerful diuretics may be given which can worsen TRALI

29
Q

what patients is white cell mediated TRALI common in?

A

females with previous pregnancies

30
Q

what type of products is WCM TRALI common in?

A

plasma products

31
Q

what is the mechanism for WCM TRALI?

A

the recipient must express the specific HLA or neutrophil receptors to which the donor blood has formed antibodies so the antibodies react with the neutrophils

32
Q

how does pulmonary oedema occur with TRALI?

A

activated neutrophils damage the endothelium which leads to vascular leakage into alveolar space

33
Q

what is cytokine mediated TRALI?

A

neutrophils accumulate in microvasculature and a soluble lipid accumulates which cause activation of neutrophils which then induce the release of cytokines which contributes to endothelial damage

34
Q

what effects does cytokine mediated TRALI have on the lungs?

A

cause vascular leaks and pulmonary oedema

35
Q

what are the differences between TACO and TRALI?

A

blood pressure is high in TACO yet low in TRALI, TACO improves with diuretics yet worsens TRALI

36
Q

what is TAD?

A

transfusion associated dyspnoea

37
Q

how is TAD characterised?

A

by respiratory distress within 24 hours of transfusion that does not meet the criteria of TACO or TRALI or an allergic reaction

38
Q

what does PTP stand for?

A

post transfusion purpura

39
Q

what is PTP?

A

unexpected thrombocytopenia 5-12 days post transfusion

40
Q

what type of patients does PTP usually effect?

A

Middle Aged or elderly women who have been alloimmunised against HPA-1a during pregnancy or previously transferred men

41
Q

what are the clinical features of PTP?

A

low platelet count, haemorrhage or widespread purpura and bleeding

42
Q

what is the treatment of PTP?

A

high dose IV IgG

43
Q

how has the incidence of TTI been reduced?

A

new generations of microbiological testing, diversion of first 20mls of blood

44
Q

what is the most common TTI?

A

hepatitis B

45
Q

what does ADU stand for?

A

avoidable or delayed or under transfused adverse event

46
Q

what is an ADU?

A

where a transfusion of a blood component was clinically indicated by not undertaken or availability led to a delay

47
Q

what is WCT?

A

wrong component transfused, patient transfused with component from incorrect blood group

48
Q

what is SRNM?

A

special requirements not met, where a patient transfused with a component that did not meet specific requirements such as irradiated, HLA matched, antigen negative red cells

49
Q

what is HSE?

A

handling and storage errors, component may be rendered unsafe after handling and storage

50
Q

what effect does low temperatures have on blood components?

A

haemolysis in red cell units, activation of platelets, precipitation of coagulation factors

51
Q

what effect does high temperatures have on blood components?

A

microbial infection, denaturing of coagulation factors

Transfusion Science (8 decks)

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