Transfusion Medicine Flashcards
What is the Canadian Blood Services responsible for?
- donor screening
- collecting blood from volunteer donors
- blood typing
- performing testing to ensure the blood supply is safe
- producing blood components such as packed red cells, plasma and platelets
- matching bone marrow donors and recipients
What is the primary donation given to the CBS?
whole blood
What is a specialized collection called?
Pheresis
What types of pheresis collections are there?
Collecting of:
- plasma
- platelets
- WBC
How is pheresis done?
whole blood is removed from donor, centrifuged and filtered to separate the desire components, then the remainder is returned to the donor
How is the most plasma donated in Canada?
By apheresis
What is AUTOLOGOUS DONATION?
When a patient donates whole blood for themselves to use.
What tests are done before sending it to Transfusion Medicine that is related to the blood cells itself?
- ABO grouping; extended RBC phenotype
- Rh (rhesus) typing
- antibody screening
What tests are done before sending it to Transfusion Medicine that is related to disease testing?
- Hep B surface antigen and hep-B core antibody
- Anti-HCV/HIV/HTLV
- syphilis screening
- West Nile virus
What’s the difference between blood COMPONENTS and blood PRODUCTS?
Components = the actual components of your donation (i.e. packed red cells, plasma and platelets)
Products = made from your blood; produced from your blood
What is packed red blood cells?
When you remove as much plasma and WBC as you can from donated whole blood.
What is the packed red blood cells for?
It’s used for patients with decreased oxygen carrying capacity (symptomatic anemia)
How is packed red blood cells stored?
For 42 days in a fridge
What is Fresh Frozen Plasma?
plasma that has been collected by plasmapheresis OR prepared from whole blood and is frozen within 8 hours of collection
When is plasma considered Frozen Plasma then?
if the plasma is frozen after 8 hours of collection
How is plasma stored?
in a freezer that is less than -18c for one year
What is plasma used for?
patients with deficiencies of coagulation factors
Why are platelets given to some patients?
It’s because some: patients who can’t produce enough of their own platelets; patients whose platelet function is impaired
How do you store platelets?
at room temperature for up to 5 days WITH continual mechanical agitation
Do blood components or blood products have lot numbers?
blood products do
What are some examples of blood products?
- coagulation factor concentrates
- IV immune globulin
- hyper immune globulins
- Rh immune globulins
- albumin
What is coagulation factor concentrates used for?
patients with bleeding disorders
What do patients with hemophilia get?
Factor VIII concentrates
*they self-administrate at home to prevent/control bleeding
How are clotting factor/coagulation factor concentrates made?
they are derived from pooled donor plasma or recombinant DNA technology
What are the examples of gamma globulin products?
- IVIG (IV immune globulins)
- hyper immune globulins
How do you get IV immune globulins?
prepared by fractionation of pooled plasma
What kind of immunity does IVIG provide?
passive immunity = immediate protection
What is one of the treatments IVIG is used for?
hypoglobulinema
What is hyper immune globulins used for?
passive immunization preparations for those post-exposure
What are some examples things that hyper immune globulin can be used post-exposure to?
- respiratory syncytial virus
- measles
- tetanus
- chicken pox
- rabies
- cytomegalovirus
What is Rh immune globulin?
a specific type of gamma globulin containing antibodies to Rh (D) antibodies
What is an example of when Rh immune globulin is used?
when a woman is Rh (D) negative and their baby is Rh positive
- used to prevent the moms from making anti-D after the brith of their baby
- protects future pregnancies from red cell destruction
What is albumin used for?
patients whose blood volume is depleted (need volume not RBC)
- common for patients with severe burns
Where are the blood products stored from CBS?
in the transfusion medicine division of the clinical lab
What is Transfusion Medicine responsible for?
- storage
- immunohematological testing
- issuing blood components for transfusion
How are most of the testing done in Transfusion Medicine?
antigen-antibody tests
What are some transfusion medicine tests?
- determining ABO and Rh blood type
- screening donors and recipients for unexpected blood group antibodies
- compatibility testing of donor and recipient blood prior to transfusion
- investigating transfusion reactions
- investigate maternal-fetal incompatibilities
What is done during Type and Screen (compatibility testing)?
- ABO group and Rh type of the patient is determined
- antibody screen is performed on the patient
- cross-match is done by mixing donor’s abc with patient’s plasma
What is an important part of specimen collection for TM testing?
TWO people have to independently identify the patient
Blood type: A
Red cell antigen: (1)
Plasma antibodies: (2)
(1) A
(2) anti-B
Blood type: B
Red cell antigen: (1)
Plasma antibodies: (2)
(1) B
(2) anti-A
Blood type: AB
Red cell antigen: (1)
Plasma antibodies: (2)
(1) AB
(2) – NONE
Blood type: O
Red cell antigen: (1)
Plasma antibodies: (2)
(1) – NONE
(2) anti-A, anti-B
What group is the universal donor of RBC?
Group O
What group is the universal donor for plasma?
Group AB
D or Rh positive do/do not have D antigen on their red cells.
DO
Rh +
Red cell antigen: (1)
Plasma antibody: (2)
(1) D
(2) – NONE
Rh -
Red cell antigen: (1)
Plasma antibody: (2)
(1) – NONE
2) anti-D IF previously exposed to D+ cells (through pregnancy or transfusion
Considering ABO and Rh blood groups together, what is the universal donor of red blood cells?
O-
How do you determine ABO group and Rh Type?
By putting reagent anti-A, anti-B, and anti-D into tubes with RBC to see if there sis agglutination (red cell clumping)
How is antibody screening done?
by commercially prepared red cell reagents = antibody screening cells
What are some symptoms of transfusion reactions?
- fevers, chills, shortness of breath, back pain, chest pain, allergic response, rash, blood in urine and shock
When cross-matching, what is a result that means the blood unit can be matched?
When mixing donor’s red cells with recipient’s plasma and no agglutination or hemolysis occurs.
What symptom do babies that are born of hemolytic disease (HDN) have?
- jaundice (due to high levels of bilirubin)
What can you do if a baby is born with mild jaundice?
treating the baby with special lights as bilirubin is photosensitive
If the case of HDN is severe, high levels of bilirubin, then what treatment is there?
exchange transfusion
What happens during post-natal screening?
It’s done on the baby’s cord blood to test for ABO, Rh typing and direct anti globulin testing
