Transfusion Medicine Flashcards
What is Fresh whole blood (FWB)
a unit of blood that has been obtained less than 8 hours prior to admin, contains all the cellular and plasma components of the blood
What patients are administered FWB
p’s in need of RBCs, plasma, and platelets
What does stored whole blood contain
all the cellular and plasma components of the blood except platelets
What is the expiration date of stored whole blood and what temperature is it stored at
28days; 4 degrees C
What patients are given stored whole blood
patients that are anemic and hypoproteinemic
What is pack red blood cells (pRBC)
a unit that has had all the RBC separated from the plasma content within 8 hours of collection
What is the expiration date of pRBC and what temperature is it stored at
42 days; 4 degrees C
What is the most common indication for a pRBC transfusion
anemia
What is Fresh frozen plasma (FFP)
a unit of blood that has been separated from RBC and the plasma components remaining
FFP is viable for up to _ _ when it is stored in temperatures of 20-40C
1 year
What is present in FFP
all coagulation factors, albumin, and protein
What is a common indication for use of FFP
primary or secondary coagulopathies
_ transfusions have also been proven to benefit patients with acute pancreatitis, DIC, liver failure, rodenticide toxicity, and parvo
FFP
Frozen or store plasma (SP) is frozen plasma that has been store at temperatures of 20-40C for greater than 1 year. It is viable for up to _ years.
2
Stored plasma no longer contains _ _
clotting factors
What are some indications for transfusing frozen or stored plasma
hypoproteinemia and hypoalbuminemia
What are some other blood products available as component therapy?
cryoprecipitate, cryoprecipitate-poor plasma, platelet-rich plasma
_ contains high levels of fibrinogen, fibronectin, factor VIII, and vWF. It is indicated in patients with coagulopathies due to any of the above plasma protein deficiencies.
Cryoprecipitate
_ is indicated in patients that are hypoproteinemic but the risk of synthetic plasma expanders outweighs the benefit.
Cryoprecipitate- poor plasma
_ is only viable for 5 days at a constant agitation. Most commercial blood banks make it available.
Platelet-rich plasma
The specific surface markers in an individual animal are genetically determined and are referred to as
blood-group antigens
- reactions can occur with blood transfusions due to variation in blood-group antigens between the recipient and the donor.
Antigen-antibody
Once a transfusion has been given to an animal, antibodies against the ____ form.
RBC antigen (immune antibodies)
More than _ different canine blood groups have been described
12
Nomenclature for the blood group systems is designated with the letters ___ followed by a number
DEA (for dog erythrocyte antigen)
For DEA systems, the erythrocytes are designated as _ or _ for that specific antigen.
postive or negative
What are the major blood groups for dogs
DEA 1, DEA 3, DEA 4, DEA 5, and DEA 7
The blood groups considered to be clinically significant for dogs are
DEA 1 and DEA 7
The _ sub-group elicits the greatest antigen response and causes the most serious transfusion reactions.
DEA 1
Approximately _% of all dogs are positive for the DEA 1 antigen
50
_-_dogs are at high risk of transfusion incompatibility if they are to receive multiple blood transfusions. Therefore, Dal blood typing, in addition to standard DEA 1 typing, is recommended in these breeds, especially in previously transfused dogs.
Dal-negative
If a previously immunized DEA 1-negative dog receives DEA 1-positive blood,_ _ occur in less than 1 hour.
severe reactions
One blood group system has been identified in the cat, designated the _ system.
AB
Blood groups of cats include _, _, and _. Few cats have group AB.
A, B, AB
The vast majority of cats have group _, which probably accounts for the low incidence of transfusion reactions in cats.
A
Unlike dogs, cats do possess _ _ _ to the erythrocyte antigen they are lacking.
naturally occurring antibodies
Type _ cats have strong anti-A antibodies while type A cats have weak anti-_ antibodies.
B
Transfusing type B cats with type A blood may result in
serious reaction and death
An additional blood cell antigen, the _ antigen, has also been described in cats
Mik
_ _has been documented in type A or type AB kittens born of type B queens with naturally occurring anti-A antibodies.
Neonatal isoerythrolysis
Methods of identifying some canine and feline blood groups are available for use in veterinary practice. These methods include an _ _ and a / _ _.
immunochromatography assay ; card/slide agglutination assay
The _ method is the gold standard for blood typing but is primarily used in reference laboratories.
tube
The tube method for determining blood type requires the use of _ , which consist of antibodies specific for each possible blood type of a given species.
antisera
The tube method requires collection of a whole blood sample using
EDTA, heparin, or acid-citrate-dextrose anticoagulant
Blood samples used to perform the card-based assay must not already show evidence of _ , usually visible as clumps in the blood sample.
autoagglutination
Whereas blood typing tests reveal the blood group antigens on the red blood cell surface, blood crossmatching tests assess the serologic _ or _ between donor and recipient.
compatibility or incompatibility
the crossmatch test checks for the presence or absence of naturally occurring and induced alloantibodies in serum (or plasma) without determining the blood type and thus does not replace _ _
blood typing
What is true about blood donors
should have never received a blood transfusion to avoid sensitization
A canine blood donor that has never received a blood transfusion is considered to be a universal donor if they are
DEA 1 negative
It is thought that the most important canine blood type is DEA 1 because it has a strong
alloantibody response after sensitization.
_____ reaction is a common immunologic reaction noted.
The febrile nonhemolytic transfusion reaction (FNHTR)
_ _ reactions include transmission of infectious diseases from the donor to the recipient and sepsis induced bacterial contamination from the unit or volume overload.
Non-immunologic
If a patients has a mild reaction to transfusion, what does treatment therapy consist of?
stopping the transfusion and monitoring the patient’s vitals. Restarting the transfusion in approximately thirty minutes at a reduced rate can usually be handled by the patient.
Other clinical signs seen in a mild transfusion reaction include
fever, urticarial, and facial edema
What does a moderate reaction include clinical signs of
fever, tachycardia, tachypnea, or vomiting.
What should be done if a moderate reaction is noted
stop transfusion and administer glucocorticoids, monitor vitals closely and restart transfusion if necessary
Clinical signs of severe reactions
include tachypnea, hypotension, collapse, fever, bradycardia, or even sudden death.
Transfusion to _ _ _ is unnecessary to alleviate clinical signs and will remove the stimulus for the patient to increase its own marrow red cell production.
a normal PCV
Usually a post-transfusion PCV of _% in cats and -% in dogs will be sufficient to reverse the signs of anemia without significantly dampening the regenerative response.
20; 25-30
What equation is used to calculate volume required
Blood volume to be transfused = k * wt in kg (required PCV – recipient PCV) / PCV of donor blood
k = 90 in dogs; 66 in cats
Collection of large volumes of blood from donor animals will result in an immediate _ and anemia within hours of collection
hypovolemia
Dogs and cats can donate _% of their total blood volume with no adverse effect
10
Collection of greater than _% of blood volume can produce hypovolemia of sufficient magnitude to compromise the health of the donor and is therefore not recommended.
20
Blood can be collected from a donor every - weeks; however, it is advisable to routinely check the donor’s PCV before each blood collection to ensure normal red cell regeneration has occurred.
4-6
_ supplementation is therefore advisable if donors are required to give blood at less than monthly intervals.
Iron
_ blood is normally collected directly into a human blood collection bag, which contains enough acid citrate dextrose (ACD), citrate phosphate dextrose (CPD) or citrate phosphate dextrose adenine (CPDA) anticoagulant for approximately 500 ml of blood.
Canine
Feline blood is routinely collected into a 50-ml syringe with an attached butterfly catheter. Although heparin can be added to the syringe, _ or _ are preferred since the blood can then be stored for up to 4 weeks after collection, provided it is refrigerated
ACD or CPD
The most important factor in determining the need for transfusion is the
clinical condition of the patient
Transfusion is always indicated in an anemic patient that exhibits signs of clinical compromise such as
weakness, dyspnea and ataxia
In severely hypotensive or pediatric patients, the blood can be given into the _ _ using an 18–20-g intravenous needle or a spinal needle placed in the trochanteric fossa.
proximal femur
Blood should be administered through a filtered giving set specifically designed for blood products, which reduces the risk of _ entering the circulation.
microthrombi
Blood should not be administered concurrently (through the same catheter) with intravenous fluids containing _ or _.
calcium or glucose
Vomiting during transfusion can be associated with
too rapid flow rates
