Transfusion Flashcards
1
Q
Febrile Non Haemolytic Transfusion Reaction
A
- Most common
- RBC > plasma products
- Commonly caused by cytokines that are generated and accumulate during the storage of blood components - IL1, IL6, IL8, TNFa
- Prevention: leukoreduction of the production
- Leukodepletion – febrile non haemolytic transfusion reaction – it occurs due to CYTOKINES
o Leukodepletion to prevent febrile non haemolytic transfusion reaction
2
Q
Transfusion Associated Circulatory Overload (TACO) vs Transfusion Related Acute Lung Injury (TRALI)
A
TACO
- Within 2 hours, often rapid
- Hypotension common
- Pulmonary oedema
- Respond to diuresis
TRALI
- Within 6 hours, may occur earlier and progresses to ARDS
- May get worse with diuretics
3
Q
Acute haemolytic transfusion reaction
A
- Intravascular, immediate destruction of donor erythrocytes by recipient antibodies
- Most commonly caused by ABO incompatibility
- Clinical: fevers, chills, dyspnoea, haemoglobinuria, flank pain, AKI, DIC, hypotension
4
Q
Delayed haemolytic transfusion reaction
A
- Typically caused by an amnestic alloantibody response upon re-exposure to an erythrocyte antigen, alloantibody undetectable at time of initial screening
- Occurs 2-10 days post
- Extravascular
- Repeat DAT positive
5
Q
Mechanism of TRALI
A
- Antibodies in donor plasma to recipient granulocytes
- TRALI has been implicated in transfusion of unfractionated plasma-containing components (red cells, platelets and plasma).
Usual causes?
- The most widely held pathogenesis theory is that passive transfer of human leucocyte antigen (HLA) or human neutrophil antigen (HNA) antibodies found in the donor’s plasma are directed against the recipient’s leucocyte antigen.
- The antigen-antibody reaction activates neutrophils in the lung microcirculation, releasing oxidases and proteases that damage blood vessels and make them lea
6
Q
What is the best way to prevent transfusion GVHD?
A
Irradiation
