Transfusion Medicine Flashcards
What blood type is universal RBC donor?
O-
What blood type is universal RBC recipient?
AB+
What is the second most immunogenic non-ABO antigen?
Kell
What is the purpose of leukocyte reduction? (4)
Reduce risk of:
Febrile nonhemolytic reaction
CMV transmission
HLA alloimmunization
Platelet refractoriness
What is the purpose of blood product irradiation?
Reduce risk of TA-GVHD
What is the purpose of washing blood products?
Severe or recurrent allergic or anaphylactic reactions
IgA deficiency
Intrauterine transfusions
Explain forward typing and reverse typing
Patient RBCs are mixed with sera that contain anti-A or anti-B IgM. Agglutination with either reagent indicates the presence of that Ag on RBC surface.
Reverse typing uses patient serum mixing with known RBCs
How does forward typing work with Rh antigen?
Only forward typing is needed. Unknown cells are tested against anti-D serum. If that patient is RhD-, there will be no reaction
What are some reasons why forward and reverse typing might not match?
If someone was recently transfused with type O blood
Newborns
Patients who received alloHCT from a different blood type
Some bacterial infections can cause a false B antigen to be detected on forward typing
What to do for patient with AIHA that needs transfusion?
Bloodbank testing will interpret the autoantibodies as there being no compatible blood.
Extended phenotypically matched cells may be needed, but don’t withhold transfusion
What transfusion reaction occurs within second/minutes of transfusion and is characterized by itching, hives?
Allergic/anaphylactic
Management of transfusion reaction where within second/minutes of transfusion and is characterized by itching, hives?
Stop transfusion
Antihistamines and steroids
What is the transfusion reaction where within seconds/minutes of transfusion you see fever, pain, hypotension, dark urine, and hemolysis
Acute hemolytic transfusion reaction
Management acute hemolytic transfusion reaction
Stop transfusion
hydrate
diuresis
maintain alkaline urine environment
What is the transfusion reaction that occurs within hours of transfusion and characterized by fever, rigors, chills, DAT negative
Febrile nonhemolytic transfusion reaction
Treatment for febrile nonhemolytic transfusion reaction
Antipyretics and meperidine for symptomatic treatment
what can be used for prevention of febrile nonhemolytic transfusion risks
Leukoreduction
Time frame for TACE?
Hours, up to 6 hours after
Time period of TRALI
within 6 hours transfusion
What is the mechanism of TRALI?
Anti-HLA or anti-neutrophil Abs present in donor plasma. Once transfused, these Abs bind to and active recipient leukocytes in pulmonary vascularture, causing noncardiogenic pulmonary edema
What blood product has the highest risk of infection?
Platelets, because they are stored at room temperature
Pathogenesis of delayed hemolytic transfusion reaction
Within 7-10 days of transfusion, patients have pre-existing antibodies to non-ABO group Abs. Once patient is transfused, an amnestic reaction occurs
Pathogenesis of TA-GVHD
Within 7-10 days of transfusion, donor lymphocytes are transfused to immunocompromised patient. Donor lymphocytes engraft and cause diffuse maculopapular rash, jaundice, N/V/D
Pathogenesis of post-transfusion purpura
5-10 days following transfusion. Anamnestic response to previously encountered foreign platelet antigen (most often against HPA-1a). Leads to increase in production of anti-platelet antibodies by the recipient, directed against donor platelet
management of post transfusion purpura
IVIG x5 days
Steroids occasionally
What is contained in FFP?
All coagulation factors
What does cryoprecipitate contain?
Fibrinogen
Factor VIII
Factor XIII
Von Willebrand Factor
Fibronectin
What is contained within activated PCC
Contains Factor II, VII, IX, X
