Transfusion Flashcards
Symptomatic anemia
<7g/dl
Thrombocyte count when platelet concentrate should be administered
Less than 50,000/uL
1 unit of whole blood or packed RBC can increase hematocrit by___
3% hematocrit or
1.0-1.5 g/dL hemoglobin
Storage time of CP2D
21 days
Additive solution content
Saline
Adenine
Glucose
Mannitol
SAGM /MAGS
Purpose of Mannitol in additive solutions
Stabilizing agent
Content of Rejuvenating Solutions
PIGPA OR PIPA
Phosphate Inosine Glucose Pyruvate Adenine
light spin speed
End product
3200 xg for 2-3 mins
Or
2000 xg for 3 minutes
Product: platelet Rich Plasma
Temp: 22 deg Celsius
Heavy spin speed
End product
Temperature
5000 xg for 5 minutes Or 3600 RPM for 5 minutes Platelet poor plasma 4 deg Celsius
Platelet concentrate should contain at least _____
And ph
5.5 x 10 ^10 platelets
pH: greater than or equal to 6.2
Agitation of platelets purpose
Prevent aggregation and to promote gas exchange
How many units can platelet concentrate be pooled
6-8
6-10 (Turgeon)
How many mL of plasma should be left after removal of platelets
50 mL
One RDP unit should increase px platelet count by
5,000 to 10,000 uL
One SDP can increase px platelet count by
30,000 to 60,000/uL
SDP unit should contain at least
3.0 x 10 ^11 platelets per unit
Failure to yield an increase in recipient’a platelet count leas than 5,000/uL
Platelet refractoriness
Cryoprecipitate contains (factors)
Factor VIII Factor XIII vWF Factor Fibrinogen Fibronectin
Cryoprecipitate + Thrombin =
Fibrin glue
How many mL of plasma removed in preparation of cryoprecipitate
10-15 mL
Method used to irradiate blood components
Cesium ^137 source
WBC products aka
And examples
BRMs - biologic response modifiers
Cytokines and complement fragments
2 methods to reduce leukocytes
Pre-storage leuko-reduction
- removed prior storage
- prevent febrile transfusion caused by both WBCs and BRMs
Post-storage leuko-reduction
- removed prior to issuing the unit
- can prevent febrile transfusion by WBCs but not by BRMs (BRMs have accumulated during storage)
Removal and storage of blood work or blood components before an elective procedure for reinfusion during or after the procedure
Preoperative Collection
Blood collected before a surgical procedure and simultaneously replaces a comparable volume of crystalloid or colloid solution
Acute Normovolemic Hemodilution
Collection and reinfusion of blood lost by a px during surgery
Device that utilize vacuum used to collect shed blood
Intraoperative Collection
Blood is collected from a drainage tube placed at the surgical site
Used microaggregate filter to screen our debris
Postoperative Collection
General requirements for autologous donation
Age (no requirements)
Hb (11g/dl)
Hct (33%)
3 day intervals (3 day before surgery)
Most common anticoagulant for apheresis
Acid Citrate Dextrose (ACD)
Platelet count of donor for plateletpheresis
150 x10^3/uL
Requirements for erythracytopheresis
Male
Female
Male 5’1” 130 lbs hct 40%
Female 5’5” 150 lbs hct 40%
Mendel’s Law
First
Second
Third
First Law: Law of Segregation
Second Law: Law of Independent Assortment
Third Law: Law of Dominance
Only blood group antigen that has been shown to be sex-linked
Xg
Mathematical formula that explains Mendelian Inheritance
Hardy-Weinberg Principle
p+ q = 1
p^2 + 2pq + q^2 = 1
Trisomy 18
Edward’s Syndrome
Trisomy 13
Patau Syndrome
Anti-A1 Lectin
Dolichos biflorus
Anti-B Lectin
Griffonia (Bandeiraea) simplicifolia
Anti-H lectin
Ulex europaeus
Greatest amount of H Ag to Lowest amount of H ag
O > A2 > B > A2B > A1 > A1B
similar to Bombay except that there is normal ABH expression in secretions and body fluids
Para-Bombay phenotype
Genes: hh, Se
What microorganism associated with acquired B phenomenon
Proteus vulgaris (sometimes E.coli)
Bacterial enzyme associated with acquired B
Deacetylase
Treatment for RBCs with acquired B phenomenon
Acetic Anhydride
ISBT # of Rh
004
Immunogenicity of Rh antigens
D > c > E > C > e
Individuals do not possess the genes needed to synthesize Cc or Ee
D Deletion (D- -)
Antigen expressed when both c and e in the cis position or located in the same haplotype
f (ce)
Who developed Hybridoma technology
Kohler and Milstein
Antibody associated with Paroxysmal Cold Hemoglobinuria and demonstrated by Donath Landsteiner test
Autoanti-P
Second rated to D in terms of immunogenicity
Kell Ag
What phenotype has
- an X linked inheritance
- rbcs are acanthocytic in nature
- wbcs are def of NADH-oxidase enzyme
- associated with CGD
- rbcs lack Kx and Km
McLeod phenotype
Confers to resistance against Plasmodium vivax infections
Duffy null phenotype (anti-Fy3)
Disappear rapidly both in vivo and in vitro thats why they are notoriously known for association with DHTR
- demonstrate dosage
- resist lysis in 2M Urea
Kidd Antibodies
Can produce mixed field agglutination
Anti-Lua
Incomplete antibody best demonstrated in AHG phase
Anti-Lub
Time for centrifugation in serofuge
20 seconds
Presence of two cell populations in a single individual
Chimerism
True chimerism (twins) Mosaicism (dispermy) - two sperm cells fertilized one egg
Gel Card centrifugation time
10 minutes
Sulfhydryl agents (2) And purpose
2-mercaptoethanol (2-ME)
Dithiothreitol (DTT)
- destroys pentameric structure of agglutinating IgM
Lectins is to plants as
Prolectin is to
Snails
Specific gravity of copper sulfate hemoglobin determination and equivalent hemoglobin
Time for reading
1.053 (12.5 g/dL)
15 seconds
How many times blood bank is inspected each year
Once per year
Temperature of storage of antisera
2-6 deg Celsius
Indications of Exchange Transfusion
0.5 mg/dl/hr rise in bilirubin or
Rise of 10 mg/dl in the first 24 hours
Intrauterine transfusion is done by (2)
Intraperitineally
Cordocentesis
Indications of Intrauterine transfusion
- amniotic fluid A450 results are in high zone II or zone III
- hb level < 10g/dl
- fetal hydrops on ultrasound examination
Post thaw storage of FFP
1-6 deg C, transfuses within 24 hours
Purpose of plastic bag in thawing FFP
Prevent water contamination of the entry port
Examples of crystalloid
Ringer’s lactate solution
7.5% normal saline
