Transfusion (1*)

Question 1

What is a Group and Save (G&S)?

What is Crossmatching?

Answer 1

➊ Blood group found out and screened for any atypical antibodies - Needed if blood loss isn’t anticipated but blood may be required should there be more blood loss than expected

➋ Way to ensure donor blood is compatible (no reaction on mixing) - Needed if blood loss is anticipated

Question 2

Types of Blood Products:
What are Packed Red cells used for?
→ How much does 1 unit increase Hb count by?

What are Platelets used for?
→ How much does 1 unit increase platelet count by?

What is FFP used for?
→ What are the problems with this?

What is Cryoprecipitate?

What is Human Albumin Solution used for?

Answer 2

➊ To correct anaemia or blood loss
→ 10-15g/L

➋ When bleeding or platelet count < 20 (Severe Thrombocytopenia)

➌ To correct clotting defects
→ Expensive and carries all the risks of blood transfusion

➍ Fibrinogen

➎ To replace protein in those with hypoalbuminemia and oedema e.g. nephrotic syndrome

Question 3

Complications:
What are the main early complications?
→ How does it present?
→ How is it managed?

What are the main late complications?

Answer 3

➊ • Allergy
→ Ranges from urticaria to angioedema to anaphylaxis
→ Stop transfusion, give adrenaline
• Acute haemolytic transfusion reaction
→ Fever, hypotension, DIC
→ Stop transfusion, give fluids
• Febrile non-haemolytic transfusion reaction
→ Fever, rigors, but pt is well otherwise
→ Slow transfusion, give paracetamol
• Transfusion-related acute lung injury (TRALI)
→ Pulmonary oedema and ARDS (bilateral diffuse infiltrates)
→ Stop transfusion, give fluids
• Transfusion-associated circulatory overload (TACO)
→ Fluid overload
→ Slow transfusion, give diuretic

➋ • Infection
• Post-transfusion purpura
• Delayed haemolytic transfusion reaction – Presents with fever, anaemia, jaundice, usually 5 days post-transfusion