Transfusion Flashcards
What are the indications for rhEPO and what are possible adverse effects?
Patient with anemia and renal insuffiency and possibly malignancy-related anemia, though this is controversial. Hemoglobin should not be increased above 10-12, as there is increased risk for venous thrombosis.
What is the conversion of single-donor to random-donor platelets and how much is the expected rise in platelets?
A single-donor unit is equal to approximately six random donor units and should raise the platelet count by at least 20,000 to 30,000/µL (20-30 × 109/L). Whether transfusion of single-donor platelets leads to a decreased incidence of alloimmunization and transfusion reactions is uncertain
What is the volume in 1 unit of FFP and approximately how much should be given?
200-300mL per unit. Typically need 10-15mL/kg (about 3-4 units for 70kg person).
What factors are found in cryoprecipitate?
factors VIII, XIII, von Willebrand factor, fibrinogen, and fibronectin.
How many units of cryoprecipitate should be given?
1-2 units per 10kg
What causes acute hemolytic transfusion reaction (AHTR) and what are the clinical features?
Almost always ABO incompatibility. Fever, hypotension, kidney failure, pain at infusion site, and DIC. Treatment is supportive.
What is Delayed Hemolytic Transfusion Reaction and when does it present?
Occurs as a response to preformed erythrocyte alloantibody after reexposure to an erythrocyte antigen outside the ABO system. Usually occurs 5 to 10 days after transfusion and includes anemia, jaundice, and fever, or asymptomatic.
What are the signs of Transfusion-associated Circulatory Overload (TACO) and when is it seen? How is it treated?
Dyspnea, cough, tachycardia, cyanosis, edema, and chest tightness during or within 1 to 2 hours of a transfusion. Treatment includes oxygen and diuretics.
What is the cause of Transfusion-related Acute Lung Injury (TRALI)? What is the prognosis and treatment?
TRALI results from antibodies in donor plasma directed against recipient neutrophil antigens. Upon binding, leukocyte sequestration occurs in the lung, and capillary leak ensues. 5% mortality rate. Treatment is supportive with expected response within days.
What should you do if a patient has a fever during transfusion?
Stop transfusion and send type/screen to assure no evidence of AHTR. Consider other causes of fever. If negative, can resume transfusion with close monitoring.
Which patients tend to have anaphylaxis with transfusions?
IgA deficient patient because they form anti-IgA antibodies. Cellular products should subsequently be washed.
When should cellular products be γ-Irradiated and who is at risk for Transfusion-associated GVHD?
This should be done for all those at risk for T-GVHD, which include hematopoietic stem cell transplant recipients, recipients of blood transfusion from first-degree relatives, and patients with immunosuppression associated with hematologic malignancies
Which transfusion products is most likely to have bacterial contamination?
Platelets since they are stored at room temperature.
Which bacteria can survive the refrigeration process of pRBCs.
Yersinia enterocolitica.
What is therapeutic apheresis, erythrocytapheresis, plasmapheresis, and plasma exchange?
TA refers to separation of whole blood into its components, removal of affected product and return rest to body. Erythrocytapheresis removes affected RBCs. Plasmapheresis involves removal of patient plasma with albumin/saline vs. donor plasma (plasma exchange).
