Reaction Flashcards
Cardiac monitorung of acute hemolytic rxns because of
Hypokalemia
Supportive care
ABC +/- pressors
Gen occurs within 2-10 days of tranx
Delayed hemolytic transfusion rxns
Usually due to senescent Ab on re exposure to foreign red cell
Delayed hemolytic transfusion
Hidtory of previous preg, trasfusion of rransplant
Usually extravascula and less severe than acute
Othe abs often rh and kidd
Delayed hemolytic transfusion rxns
Clinical presentation delayed hemolytic transfusion rxns
Falling hct, low grade fever, slight increase in indirect bill, spherocytes on blood smear
Diagnosis of delayed hemolytic transfusion rxns
New dat and new ab test when blood is ordered
Life threatening emergency
Anaphylactic rxns
Occurs with a few second to minutes following tranx
Anaphylactic reaction
Characterized by rapid onsetof anaphylaxis
Anaphylactic rxns
Can occur with all blood products but generally unseen with serum albumin, plasma protein fraction or coagulation factors
Anaphylactic rxns
Incidence of anaphylactic rxns
1 to 20-50,000
Treatment of anaphylaxis
Stop trans epi 0.3 ml of 1.1000 son IM
Consider IV epinephrine drip
ABC +/- pressor support
Presence of class specific Igg and anti IgA abs in patients who are IgA def
Selective IgA def is fairly common, occuring 1/300-500 people but majority of them do not develop abs
Similar snd occur primarily in east asian
Aphatoglobinemia with antihaotiglobin
Prevention of anaphylaxis
Use iga product for further tranx extra washed red cell or platelets
Allergenic products in blood products activates ige in recipients leading to histamine release from mast cell and baso
Urticarial raction
Only rxns which trans can be resumed
Urticaria, rxns
If urticaria is extensive
Benadryl 25-50mg IV/PO
Vare rare complication seen in immunocomp individual esp in solid tumor cancer pts oj chemo but can occur with acuteo chronic leukemia. Lymphomas, new borne with erythroblastosis fetalis and transplant pts
Transfusion rxns gvhd
Different from gransplant gvhd by its effect on
Bone marrow. Bone marrow aplasia
It occurs in immunocomp recipients of blood products from donor woth identical hla haplotypes
Transfusion rxns gvhd
For hla they are what
Heterozygous
Which donor for haplotype is
Homozygous
This shared by donor and recipients thus other one is egrated by recipients because they are the only Ag seen by the host
Hla Ag; donor lymphocytes
Primary cause of death in transfusion ass gvhd
Bone marrow aplasia
Skin in transfusion ass gvhd
Swollen eythroedema and bullae for,ation
Gi tract in transfusion ass gvhd
Diarrhea and abdominal cramps
Liver in transfusion ass gvhd
Elevated LFT and hyprbilirubinemia
Heme in transfusion ass gvhd
Bone marrow aplasia, persistent thrombocytopenia
Implicated products
Onon irradiated whole blood Prbc Plts Granulocytes Fresh non frozen plasma
Treatment in transfusion ass gvhd
Poor response to standard immunosuppresive therapies, thalidomide has been tried success
Prevention in transfusion gvhd
Gamma irradiation and leukoreduction of products
Avoid blood products from genetically identical donor
New acute lung injury occurring during of whin
6hrs of blood product tranx
All blood products have been implicated
May progress to ARDs
Transfusion related acute lung injury
Immune non mediaed non cardiogenic pulmonary edema
Transfusion related acute lung injury
Risk factor of transfusion related acute lung injury
No risk factors but prolonged storage of blood products, massive trans, cytokine, multiparity, thrombocytopenia, and active infection have implicated no studies
Pathogenesis of tranx acute lung
Abs against HLA
