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Transfusion > Tranfusion > Flashcards

Tranfusion Flashcards

1
Q

Indications erythropheresis (6)

A
  • Severe babebiosis
  • Severe malaria
  • Polycythemia vera
  • SCD: life or organ-threatening complication
  • SCD: stroke prevention
  • SCD: prevention of iron overload
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2
Q

Indications leukapheresis (1)

A

Symptomatic hyperleucocytosis

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3
Q

Indications plasmapheresis (10)

A
  • ABO incompatible HSCT
  • ABO incompatible organ transplant
  • TTP
  • Myasthenia gravis
  • PANDAS, severe
  • Sydenham chorea, severe
  • Acute Guillain-Barre syndrome
  • Chronic inflammatory demyelinating polyneuropathy
  • Goodpasture disease
  • ANCA-associated glomerulonephritis (Wegener)
  • Other indications exist*
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4
Q

Platelet refractoriness - differential diagnosis

A

Non-immune mechanisms: old platelet product, ABO-incompatibility, fever, sepsis, DIC, splenomegaly
Immune mechanisms: auto-Ab, alloimmunization

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5
Q

Patients at risk for TA-GVHD (5)

A
  • Premature neonates
  • Congenital immunodeficiency syndromes
  • Patients receiving chemotherapy and/or radiation for malignancy
  • Patients receiving immunosuppressive drugs after solid organ transplantation
  • Patients receiving direct donations (heterozygous for HLA antigens)
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6
Q

Name clinically significant auto-Ab on erythrocytes, other than anti-AB and anti-D.

A 
Anti-K
Anti-E
Anti-c, Anti-C
Anti-Fya
Anti-Jka, Anti-Jkb
Anti-S
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7
Q

Tranfusion medecine: describe forward and reverse testing

A

Forward: determination of blood group using patient’s erythrocytes
Reverse: determination of blood group using patient’s serum
Both techniques are done and should correspond.

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8
Q

Name 1 situation where forward and reverse determination of blood group may not correspond?

A

Infants less than 9 months of age re: do not make isohemagglutinins but may carry maternal ones

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9
Q

Choice of RBC for patients with sickle cell anemia

A

Provide fully matched blood (D, C, E, c, e, K, Fya, Fyb, JKa, JKb)

Alternative: partially matched blood (D, C, E, K antigens)

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10
Q

Choice of RBC for patients with thalassemia

A

Usually not phenotypically matched re: very low incidence of alloantibodies, no crisis associated with hemolysis

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11
Q

Types of ABO incompatibility in HSCT

How are they managed?

A

MAJOR: recipient has Ab against donor RBCs; may lead to erythroid aplasia
RBCs removed from HSCT before infusion
MINOR: donor has Ab against recipient RBCs
Plasma is removed from HSCT before infusion

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12
Q

3 reasons for false positive DAT (other than auto- and allo-antibodies)

A
  • Overcentrifugation or contaminated reagents
  • Insufficient washing of patient’s RBCs
  • Prolonged delay between centrifugation and testing
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13
Q

What causes febrile nonhemolytic reactions during transfusion?

A

Presence of cytokines and other pyrogens in the blood product, released by leucocytes and platelets (during storage, or during infusion)

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14
Q

Differential diagnosis of fever, during a transfusion?

A
  • Febrile non-hemolytic reaction
  • Acute hemolysis
  • TRALI
  • Sepsis from a contaminated unit
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15
Q

Delayed hemolytic reaction: typical clinical scenario

A

Anemia, hyperbilirubinemia 3-10 days after RBC transfusion

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16
Q

Delayed hemolytic reaction: how to make the diagnosis?

A

1) (+)ve DAT

2) (+)ve allo-antibodies on patient’s RBC and/or serum

17
Q

TRALI: pathophysiology

A

Partly understood

Appears to be caused by alloantibodies in blood product reacting with patient’s HLA or neutrophil antigens

18
Q

TA-GVHD: diagnostic criteria

A

A clinical syndrome occurring from 2 days to 6 weeks after cessation of transfusion characterized by characteristic rash; diarrhea; fever; hepatomegaly; liver dysfunction (elevated liver enzymes); marrow aplasia; and pancytopenia
DEFINITIVE if confirmed by skin or liver Bx
PROBABLE in absence of biopsy

19
Q

Name 6 potential causes of platelet refractoriness

A
  • Splenomegaly
  • Fever
  • Alloantibodies
  • Autoantibodies
  • DIC
  • Product factors: low platelet volume, washed platelets, ABO mismatch, etc
20
Q

Adverse reactions associated with infusion of hematopoetic stem cells

A 
AE following regular transfusion +
AE related to DMSO (dimethyl sulfoxide)
- nausea, vomiting, flushing, headaches
- anaphylactoid reactions
- embolic events
21
Q

What is the definition of massive transfusion?

A
  • Transfusion of at least 50% of total blood volume in 3h
  • Transfusion of at least 100% of total blood volume in 24h
  • Transfusion support to replace ongoing bloos loss corresponding to 10% of total blood volume/min
22
Q

Name clinical and laboratory features often encountered with massive transfusion (5)

A
  • Hypothermia
  • DIC (in plasma and platelets not replaced)
  • Hypocalcemia
  • Hyperkaliemia or hypokaliemia (large amounts of citrate)
  • Acid-base abnormalities
23
Q

Acute hemolytic reaction: what is the management?

A
  • Stop the transfusion
  • Clerical check
  • Return product to blood bank
  • Supportive management: hydration, aggressive diuresis (furosemide, mannitol)
24
Q

When does TACO and TRALI occur following a transfusion?

A

Up to 8 h following a transfusion

25
Q

List advantages associated with platelets by single-donor apheresis?

A
  • Increased amount of thrombocytes
  • Exposure to only 1 donor
  • Leukoreduced by processing (rather than additional procedure)
26
Q

Granulocytes transfusion in ALL patients; what products to give?

A

ABO compatible, irradiated, CMV (-)ve granulocytes

Need to be given within 24h of collection

Transfusion (1 decks)

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