Transfusion

Question 1

What needs to be done before transfusion? (3)

Answer 1

ABO/RhD blood grouping using anti-A, anti-B etc
Screening plasma for atypical antibodies
Cross-matching patients plasma with blood to be transfused

Question 2

What causes acute haemolytic transfusion reaction?

Answer 2

IgM antibodies against (usually) ABO group antigens

Question 3

Why does IgM cause such a dramatic haemolytic response?

Answer 3

Activates complement cascade and membrane attack complex

Question 4

What is often the consequence of an acute haemolytic reaction? (2)

Answer 4

Disseminated intravascular coagulation and renal failure

Question 5

What usually causes delayed haemolytic transfusion reactions?

Answer 5

Irregular antibodies

Question 6

What is thought to cause febrile non-haemolytic transfusion reactions?

Answer 6

Contaminating white cells in transfused components; either recipient response to these cell, or because of cytokines/vasoactive substances produced by these cells during storage

Question 7

Which groups of patient are prone to developing circulatory overload? (2) How is this managed? (2)

Answer 7

Elderly, those with CCF

Slow the transfusion rate, give furosemide

Question 8

Transfusion risks (5)

Answer 8

Immediate haemolytic reaction
Delayed haemolytic reaction
Febrile non-haemolytic reaction
Circulatory overload
Bacterial/viral infection
Acute lung injury (TRALI)