Transfusion Medicine 1 Flashcards
What are the 2 reasons provided for transfusing blood components vs. whole blood?
- Conservation of blood resources
- Storage of each component at optimal conditions
RBCs are stored in _ to extend their shelf life
Preservative solutions
What is the major determinant of RBCs delf life?
The preservative solution chosen
What is the optimal storage temperature for RBCs?
1-6 degrees C
What is the indication for RBC transfusion?
Anemia with compromised clinical status
True or false, RBC are frequently used as volume expanders, especially in immunocompromised patients
FALSE!! Use crystalloid or colloid instead
One unit of RBC will increase an adults hemoglobin by _ g/dl. What about a child?
Adult (1g/dl) and pediatric (2g/dl)
A patient with A blood can receive what type of blood (transfusion)?
A or O
A person w/ B blood can receive what type of blood?
B or O
A person w/ AB blood can receive what type of blood?
AB, A, B or O
A person w/ O blood can receive what type of blood?
O
What is the major reason for matching up blood during transfusion?
Prevents immune hemolysis
For storage, platelets are suspended in _
Plasma
Platelets can be obtained form either a single donor or pooled. What are the advantages of single donor platelets? (2)
Decreased risk of disease transmission and decreased risk of immunization with platelet antigens
Platelets are pooled from how many blood donors to equal a single apheresis platelet donor?
Blood from 6-8 donors
What is the shelf life of platelets and how are they stored?
5 day shelf life, stored at room temp (20-24 degrees)
T/F. In cases of quantitative deficiencies, platelets are indicated to stop bleeding or to prevent bleeding before a proceedure
True
T/F in cases of qualitative deficiencies, platelets are indicated for congenital platelet dysfunction syndromes or when a patient has been treated w/ a drug that inactivates platelets
True
What are the 2 examples from this lecture of congenital platelet dysfunction diseases?
Bernard Soulier and Glanzmann’s thrombastenia
I unit of platelets will Increase platelet counts by how much in a child? In an adult?
Child (140K/ul) and adult (30K/ul)
T/F. Platelets are only transfused if they were obtained from a donor of the same blood type as the receipient
False. Matched blood types ideal but not essential
Granulocytes for transfusion are usually contaminated w/ what 3 things?
RBCs, platelets and lymphocytes
What is the shelf life for granulocytes? How are they stored?
24 hr shelf life, stored at room temp (20-24 degrees)
What are the indications for granulocyte infusion?
Bacterial or fungal infection unresponsive to
antibiotics AND
•Neutropenia (WBC <500/μL) or
•Hereditary neutrophil function defect
What is the dosing regimen for granulocytes? What detemines when you stop administering granulocytes?
1 unit per day until infection resolves or WBC level recover.
T/F granulocyte infusions must be blood type compatible. Why?
True, because granulocytes are contaminated with RBCs
T/F granulocytes infusions significantly raise WBC counts
False, hard to substantially change WBC count
The acellular blood component is referred to as _. What is its shelf life and how is it stored?
Plasma, stored frozen for up to 1 year
How long is thawed plasma good for? How is thawed plasma stored?
Good for 5 days, stored at 1-6 degrees C
When plasma is thawed, what 2 factors are degraded after 24 hrs
Factors V and VIII
What are the 2 indications of plasma?
1) Multiple coagulation factor deficiencies AND current bleeding / planned proceedure
2) Congenital factor deficiency w/ our concentrate available (Factor 10)
There is a logarithmic relationship between plasma coagulation factor concentration and INR. How does this affect infusion rates?
Need to infuse plasma fast, as a bolus
What are the major components of cryoprecipitate?
Factor XIII, fibrinogen, VWF and Factor 8
How is cryoprecipitate made?
Centrifuge thawed plasma, retain precipitate, redissolve and freeze
What are the 2 current indications of cryoprecipitate?
1) Fibrinogen deficiency + bleeding or planned proceedure
2) Congenital deficiency of factor 13
What are the 2 types of blood products that can undergo leukocyte reduction?
RBCs and platelets
What are 3 reasons to for leukocyte reduction?
1) CMV infection,
2) Ab formation vs HLA Ag expressed on WBC
3) Febrile reactions to transfusion (caused by cytokines in products)
What are the 3 types of blood products that can undergo irradiation?
RBCs, granulocytes and platelets
What is the indication of irradiation of blood products?
Prevention of transfusion associated graft vs. host disease (GVHD) by preventing lymphocyte proliferation
Quality of what 2 blood products are adversely affected by washing?
Platelets and granulocytes
What is the indication of washing of a blood product? (2)
Reduce risk of allergic reaction and to remove excess potassium from RBCs
Under what circumstances would RBCs be frozen?
Performed for RBC lacking common RBC Ag (rare blood types), increases shelf life to 10 yrs
