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Erez's HEM TEST notes 2024 > Tranfusion Facts > Flashcards

Tranfusion Facts Flashcards

1
Q

FNHTR

A

1st/2nd most common
Cytokines
Leukoreduction

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2
Q

Leukoreduction pre/post storage

A

Post storage less effective but cheaper

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3
Q

TACO

A

Common
Slower infusion and diuretics
Most common cause of death

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4
Q

TRALI

A

Less than 6 hours from transfusion
Activation of neutrophils in lung
Ab to HLA (HNA less common)
1st hit of priming to TRALI (infection, cancer)
Neutropenia (relative)
Plasma from multipara donors is a risk factor

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5
Q

AHTR

A

ABO incompatibility
30% mortality

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6
Q

Post transfusion purpura

A

Multiparous women that are HPA1A negative are suseptible
Ab against HPA1A
7-10 days post transfusion
Tx IVIG Steroids
Prevention- HPA1A negative platelets

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7
Q

Bacterial contamination type in PLT

A

Gram positive in platelets

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8
Q

Hypocalcemia post transfusion

A

Citrate
Massive transfusion

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9
Q

Delayed hemolytic reaction prevention methods

A

Rh Kell matched blood mainly in pts requiring many blood transfusions or AIHA
Leukoreduction to reduce APC
reduce possibility for future ab

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10
Q

Reasons of lack of natural antibodies to A,B

A

Neonates and elderly
Hypo/aglubolinemia

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11
Q

Reasons of excessive antibodies to A,B

A

Allo/auto-antibodies
Tx with non ABO matched plasma products
Paraprotein
Passenger Lymphocytes

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12
Q

Bombay phenotype blood

A

Lack of H antigen
Resembles O but can receive only transfusions from Bombay donors

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13
Q

Passenger lymphocyte syndrome

A

Lymphocytes of donor causing homolysis of pts RBCs

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14
Q

Acquired B antigen

A

pts with group A
During infection with GNR
Bacteria changes A to resmble B
But with no hemolysis
Causing ABO discrepancy
Cells will not react with Anti-B serum

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15
Q

Weak D antigen

A

Qunatitive defects in D
All epitopes exist
Donor and neonate must be Classified as D+ bcs they can Cause Ab developement in receipient
Blood receipient and pregnant women- considered D- bcs giving them D+ blood may cause Ab
Genentic tesiting available

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16
Q

Partial D variant

A

Loss of antigens on D (Qualititive)
common in blacks
Discovered when D+ pts develop Ab
No rutine way to diagnose

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17
Q

Ab development % to minor blood types depending on disease

A

30% in SCD, Thalasemia and AIHA
0% in ALL

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18
Q

Leukoreduction of blood products benefits

A

FNHTR
CMV
Alloimmunization to HLA (PLT refractoriness/Allo Ab)

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19
Q

Irradiation of blood product benefit

A

GVHD

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20
Q

Washing of blood product benefit

A

Allergic reactions

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21
Q

Enzyme effect on RBC antigens

A

Allows better determination of alloantibodies after antibody panel

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22
Q

Elution

A

Lysis of RBC covered with Ab allows isolating auto antibodies from the washed allo antibodies

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23
Q

How to deal with Dara interference

A

Phnotype
Genotype
DTT treated RBCs

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24
Q

Which minor blood groups are significant when allo antibodies are present

A

Kell
Kidd

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25
HDFN
IgG of mother causing hemolysis in newborn Usually, in 2nd pregnancy Mother O, newborn A, B mild jaundice
26
Maternal anti-D titer significance
Predicts HDFN
27
Maternal anti-kell titer significance
Titer>4 with very high risk of HDFN
28
Tx of severe HDFN
Intra uterine tansfusion- if signs of hydrops IVIG FU with MCA doppler
29
Tests for women with clinically relevant Ab during pregnancy
Paternal phenotype FU every 2-4 weeks
30
CPDA-1 vs SAG-M storage
CPDA1 35d. Hct 75-80% SAG-M 42d, Hct 60% C = concentrated S = storage
31
LTOWB vs PC
Improves 24h mortality and possibly long term survival in trauma pts
32
Novel therpaies in transfusion medicine
Enzyme converted "O" cells (ECO) Stelath cells (PEG covered cells that do not exhibit there antigens)
33
Acute immune mediated trasfusion reactions
AHTR (intravascular-ABO, extravascular- Rh) Anaphlaxis, mild allergic reaction TRALI FNHTR
34
Delayed immune mediated trasfusion reactions
Delayed hemolysis TRIM TA-GVHD Post transfusion purpura
35
Acute non-immune mediated trasfusion reactions
TACO Metabolic
36
Delayed non-immune mediated trasfusion reactions
Iron oveload
37
Allergic transfusion reaction cause and prevention
Plasma proteins Washing
38
Top transfusion related mortality cause
TACO Delay in transfusion
39
TRALI moratlity %
5-10%
40
TA-GVHD timing
8-10 post transfusion
41
TA-GVHD clinial manifestations
Similar to acute GVHD + pancytiopenia
42
TA-GVHD mortality %
90-95% !!
43
Risk factors for TA-GVHD
Blood donation from realtives HLA- matched PLT (bcs there is alot of plasma) immundefficiecny
44
TRALI prevention
Plasma from male donors
45
Liberal vs restrictive blood transfusion after cardiac surgery
Liberal with less mortality at 90 days in one study and non-inferior in another study TITRe2 vs TRICS III
46
PLT transfusion thresholds before procedures
Surgery- 50K Neurosurgery- 100K Epidural- 80K
47
PLT transfusion benefit before CVC placement- 50K
Less bleeding in non tunneled catheters
48
PLT refractoriness definition
<5K increament
49
Hemostatic levels of FXIII
5%
50
Tx of FXIII def
Fibrogrammin 1/month
51
How to measure plavix effectiveness levels
ADP<50%
52
DOAC effects on PT/aPTT tests
Dabigatran- aPTT Rivaroxaban- PT
53
Liberal vs restrictive blood transfusion in MI pts with anemia
Numeral but not statistically significant benefit for liberal
54
Factor deficiencies that occur together
FV FVIII
55
Blood type transfusion for IUD
O- Fresh Leukoreduction (prevent CMV) Irradiated (GVHD)
56
Workup in hemolysis of newborn
Blood type of mother and infant Screen of mother- indirect coombs DAT If DAT + check eluate in order to phenotype the ab
57
Anti kell hemolysis type in HDFN
Can cause lysis of eryrtoroid progenitor cells + hemolysis
58
Ab titer that is important for HDFN (except kell)
1/32
59
Screening of infant blood
With mother serum Untill 4 months
60
Restrictive vs liberal
Liberal- better in ACS and CVA Restrictive- non inferior in the rest
61
Ab not causing HDFN
p1, lewis, N
62
PLT refractoriness workup
Transfuse- 2X SDP fresh and ABO matched Increment less than < 5K Send HLA and HPA ab Find cross matched PLT (Crossing done in flow)
63
Rh + in Israel
90%
64
PPH blood product management
Give cryo early
65
ECMO management of bleeding
Give PLT early due to thrombocytopenia
66
Rh on blood products
Only on RBC But also when trasfusing PLT there are some RBCs in the bag
67
How to prevent alloimmunization after Rh+ PLT transfusion to Rh- pts
Anti D Washing- to remove RBCs Consider in young pts, especially in women of childbaring age
68
Tests to screen blood products
HIV, HBV, HCV, TPHA, HTLV, WNV (seasonal) CMV (in IUd and immunodeff.)
69
Pts requiring leukoreduction
Pregnancy, IUD, multiple transfusions, planned transplant
70
Indications to wash blood products
TRALI, anaphylaxis, incompatibility after allo transplant or solid transplant
71
Tx of AHTR
Supportive care Ecolizumab Steroids/IVIG
72
Tx of neonates with severe HDFN
Exchange transfusion

Erez's HEM TEST notes 2024 (35 decks)

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