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Blood Bank 2: Summer 2024 > Platelets/Granulocytes > Flashcards

Platelets/Granulocytes Flashcards

1
Q

Platelet normal value

A

150,000-350,000/ul

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2
Q

What platelet conc may cause spontaneous hemorrhage?

A

Plt < 10,000/ul

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3
Q

What platelet conc can minimize hemorrhage during surgery?

A

Plt > 50,000/ul

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4
Q

Platelet roles in hemostasis

A
  1. Platelet plug
  2. Stabilize plug by fibrin formation
  3. Maintenance of vascular integrity
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5
Q

Why transfuse platelets?

A
  • To increase platelet count
  • Prophylactically for oncology/chemo pts
  • If patients plts not functioning (PFA test)
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6
Q

Refractory

A

Failure to achieve acceptable plt count following plt transfusion

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7
Q

Efficacy calculation

A

Clinical count increment (CCI)

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8
Q

Why are platelets sensitive?

A
  • Must be rocked or they will die bc need oxygen transfer in bag to maintain pH
  • Jostling too hard or overheating will activate them and then they will die
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9
Q

What happens when platelet activates during storage?

A
  • ATP released
  • Plts aggregate
  • Increase glucose consumption/lactic acid conc
  • Decrease pH, plts swell
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10
Q

Platelet storage conditions

A

20-24°C
room temp

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11
Q

How does cold storage affect platelet viability?

A

Irreversible spherical shape change

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12
Q

Platelet expiration date

A
  • 5 days post-collection
  • Increased chance of bacterial contamination at storage, length of time, pH
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13
Q

Platelet additive solution (PAS)

A

Reduces plasma stored with platelets up to 60% (less transfusion reaction)

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14
Q

7-day platelets must be tested for _____

A

Must be tested for bacterial contamination on day of transfusion

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15
Q

How to store frozen platelets?

A

DMSO stored up to 2 yrs, 33% viable

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16
Q

How to inactivate pathogens?

A
  • UV light or alkylating agents damage DNA and impair replication (good for viruses, bacteria, fungi, protozoa, and leukocytes but NOT prions)
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17
Q

List steps of prepping platelets from random donor

A
  1. Whole blood collected and must now prepare plts within 4 hrs of collection
  2. Centrifuge w short/light and heavy spins
  3. Rest 1-2 hrs to unclump and place onto agitator/rocker for storage up to 5 days
  4. Sterile docking pools of 4-6 different donors
  5. Test for bacterial contamination thru blood culture or Virax (3 days post collection)
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18
Q

Platelet count and pH QC

A
  • plt count > 5.5 X 10 ^10
  • pH > 6.2
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19
Q

Leukoreduced platelets WBC count

A

WBC < 5 X 10^6

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20
Q

Anticoagulant in apheresis

A

Citrate
Binds calcium to prevent coag
Body compensates by releasing more calcium and metabolizing citrate

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21
Q

Apheresis centrifugation types

A
  • Intermittent flow (IFC): 1 venipuncture
  • Continuous flow (CFC): 2 venipuncture sites
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22
Q

Apheresis filtration

A

Used instead of centrifugation to remove non-cellular plasma

23
Q

Apheresis therapeutic uses

A

Plasma exchange
Pheresis (cell removal)

24
Q

Apheresis adverse effects

A
  • citrate toxicity
  • hypotensive reactions
  • hematoma (vascular access complications)
25
Q

Platelet apheresis donor qualifications

A
  • must meet RBC donor qualifications
  • plt count > 150,000
  • not taking aspirin (2 day deferral) or plavix (14 day deferral)
26
Q

Interval between platelet apheresis donations

A

days > 2

27
Q

Platelet bag visual inspection

A
  • hemolysis (RBCs > 2ml must be crossmatched)
  • bubbles
  • clots/aggregates
  • color
28
Q

What do green, yellow, and orange platelet colors indicate?

A

Green = contraceptives
Yellow = icterus
Orange = Vit A

29
Q

How to handle granulocyte products

A
  • Stimulate with corticosteroids or CSF
  • Must be transfused asap from collection < 24 hrs
  • ABO type match
30
Q

Granulocytes collected from

A

whole blood or apheresis

31
Q

Granulocytes used for

A

Neutropenic pt transfusions to fight infection (must be irradiated and NOT leukoreduced

32
Q

How to handle hematopoietic progenitor cells (HSCs)

A
  • Growth factors given to pt 4-5 days prior to collection by apheresis or BM
  • Cryopreserved/collected in advance
33
Q

HSCs used for

A
  • stimulating cellular growth after chemo or immune depression
  • HLA type match
34
Q

Plt pre-transfusion testing required

A
  • ABO/Rh type performed per admission
35
Q

Plt pre-transfusion testing not required

A
  • Crossmatch
  • Ab screen
  • ABO match
36
Q

Pre-transfusion labeling

A
  • Unique donor ID
  • Expiration date
  • Donor blood type/Rh
  • E-code
  • CMV neg
  • Irradiation indicator
  • Component assignment tag
37
Q

HLA expresses what proteins

A

MHCI, MHCII, and MHCIII

38
Q

HLA clinical importance

A
  • disease association
  • transplant
  • plt transfusion
39
Q

How to read HLA genes

A

Locus A-D
Subregion P-R
Serologic reactivity 00-99

40
Q

HLA genetics

A
  • Inherited via haplotype
  • Linkage disequilibrium
41
Q

Are HLA alleles antithetical?

A

No

42
Q

T/F HLA genes are highly polymorphic

A

True

43
Q

HLA MHCI

A
  • found on all nucleated cells (important for plts/transplants)
  • Bind CD8 cells after presenting proteins from intracellular attack
44
Q

HLA MHCII

A
  • found on only antigen presenting cells, B cells, and T cells (paternity testing)
  • Bind CD4 cells and present exogenous proteins
45
Q

HLA serology testing

A
  1. Crossmatch recipient plasma against donor RBC
  2. HLA antibody screen
  3. HLA match (recipient and/or donors tested for HLA antigens)
  4. Type plts for A,B, C and stem cells type for A, B, DR
46
Q

What is CREG?

A

Cross-reactive group

47
Q

HLA clinical importance

A
  • Transfusion
  • Transplant matching
  • Associated with autoimmune disease
  • Paternity testing
48
Q

What is more immunogenic in HLA match?

A

Leukocytes

49
Q

Refractoriness cause in HLA match?

A
  • Contaminating lymphs in product
  • May have platelet Ab
50
Q

T/F HLA serological crossmatch required

A

False
May not require
Should be matched in MHCI

51
Q

Platelet crossmatch specific for ___

A

anti-platelet Ab

52
Q

Platelet crossmatch tested by ___

A

testing plt donors against recipient plasma by solid phase method

53
Q

T/F Plt crossmatch shows both HLA and platelet incompatibility

A

True

Blood Bank 2: Summer 2024 (8 decks)

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