Lecture 6: practical aspects of transfusion Flashcards
What are the three classes of transfusion reactions?
- Allergic- Febrile- Haemolytic
When selecting blood for transfusion, which cross matching test is used when there is a positive antibody screen?
Full crossmatch
When selecting blood for transfusion, which cross matching tests are used when there is a negative antibody screen?
- Immediate spin crossmatch (ABO in compatibility)- Computer crossmatching
What are the 3 approaches used for blood transfusion in an emergency situation?
- Emergency O Rh(D)– Group specific blood- Provision of fully compatible blood
What steps should be taken if there are complications with a transfusion?
- Stop transfusion- Maintain line with saline- Seek advice
What is the cause of an immediate haemolytic reaction?
ABO incompatibility
A patient presents with fever, restlessness and retrosternal pain post blood transfusion.What type of reaction is this characteristic of?
Immediate haemolytic reaction
What is the cause of extravascular haemolytic reactions?
IgG antibody in patient plasma
Delayed haemolytic transfusion reaction is due to an ____ antibody response
Anamnestic (rapid production following second contact)
What are the clinical features of a febrile non-haemolytic transfusion reaction?
- Fever >38 degrees starting during transfusion- Often associated with rigors
Transfusion Related Acute Lung Injury is due to antibodies against the ____ antigen causing agglutination of ____ in the _____
HLAWhite cellsPulmonary vasculature
Explain the pathophysiology of post transfusion purpura
- Patient has antibody against platelet antigen- Results in destruction of transfused platelets and then own platelets
How do you manage post transfusion purpura?
- Remove plasma- Give intravenous immunoglobulin
What are clinical features of plasma protein anaphylaxis?
- Early onset severe reaction- Hypotension- Dyspnoea- Abdominal cramps
