Transfusion Biolgy o Flashcards
What are alloantibodies
Alloantibodies are antibodies that a person forms against other groups
Antibodies against RBCs typically result from environmental exposure especially to saprophyte bacteria
Formation of which type of antibody may hemolyze blood
Formation of IgG antibodies may hemolyze blood.
Which Blood type is the universal donor vs recipient
Major Blood groups are: A, B, AB, and O
• Universal recipient AB
• Universal donor O
What are isoagglutinins
Isoagglutinins: naturally occurring anti a and anti b antibodies
• Both are found in type O
When are whole blood transfusions indicated
Hard to come by
Ideal for patients who’ve lost >25% of blood volume
Typically only used in emergency situations
When are PRBC transfusions indicated
Increases O2 carrying capacity in an anemic patient
Transfuse <7 hgb or <8 in cardiac patients
Leukocyte reduced RBCs are now recommended
• Lowers incidence of post transfusion reaction
When are platelet transfusions indiciated
Transfuse plts <10K or 50K for invasive proceedures
When is FFP indicated
Stable coagulation factors; fibrin, fibrinogen, antithrombin, albumin, protein C and S.
Used to reverses coagulopathies and warfarin, TTP
If the patient is IgA deficient then they should receive FFP from an IgA deficient donor
What is cryo
Source of fibrinogen, VWF, and VIII
What is the difference between immune and non immune mediated transfusion reactions
Immune Mediated
• Due to donor or recipient antibody
Non-immune mediated
• Chemical and physical properties of the blood component/additives
What is an acute hemolytic reaction, s/s, and treatment
• Typically anti-A or anti-B antigens that are responsible
• S/S: fever, hypotension, tachypnea, tachycardia, chills, hemoglobinemia, hemoglobinuria, chest/flank pain, infusion site pain
• Treatment: stop transfusion, send blood to blood bank, diuresis, watch for DIC (coag testing)
What is an anaphylactic reaction to blood transfusion, s/s, and treatment
• Typically occurs after a few mls of transfusion
• S/S: difficulty breathing, coughing, nausea, vomiting, hypotension, shock
• Treatment: stop transfusion, epinepherine, glucocorticoids
What is the graft venous host disease, s/s, and prevention
• Complication of stem cell transplant where lymphocytes from donor attack and can not be eliminated from the immunodeficient host
• S/S: cutaneous eruptions, diarrhea, liver dysfunction, aphasia, and pancytopenia
• Prevention is preferred by radiating cellular components prior to transfusion. Resistant to immunosuppressive therapy.
• Manifestations occur 8-10 days post transfusion and death occurs 3-4 weeks
What is TRALI s/s and risk factors
• Most common cause of transfusion fatalities
• Donor plasma contains high anti HLA antibodies that bind to recipient leukocytes. It causes increased pulmonary capillary permeability
• S/s: hypoxia, pulmonary edema, b/l infiltrates
• Occurs within 6hours of transfusion
• Risk factors: Smoking, ETOH, shock, liver surgery, ventilation, fluid overload
What is post transfusion purpura and treatment
• Thrombocytopenia 7-10 days post platelet transfusion
• Additional platelet transfusion will worsen
• Treatment IVIG or plasmaphoresis
