Transfusion Medicine Flashcards
Describe the basic process of donor qualification and blood collection relating specific steps to blood safety
- time of phlebotomy, the donor completes a questionnaire and provides multiple answers to questions about current or past illnesses or surgery, travel, vaccination, and high-risk behavior.
- donor urged to call back the phlebotomy site with the onset of any symptoms of viral syndrome or other infection.
- Abbreviated physical exam (vital signs, general appearance, skin, upper extremities) reaffirms general health
- Screening tests including Hematocrit (Hct) and, in the case of an apheresis platelet donor, platelet count certify the safety for both the recipient and the donor.
- Skin preparation for the phlebotomy reduces the risk of bacterial contamination of blood products, production of components.
Identify the basic components derived from blood donation, explain the biological characteristics of each component, and compare the optimal storage environment and storage time for each component: Whole blood
is kept at 4-6ºC for 35 days to optimize red cell recovery and survival. Platelet and neutrophil function degenerate by 24-48 hours of storage and clotting factors turn over more slowly but well before the outdate.
Identify the basic components derived from blood donation, explain the biological characteristics of each component, and compare the optimal storage environment and storage time for each component: PRBCs
are also stored at 4-6ºC for 35 days or longer (42 days) with addition of special solutions to support higher ATP levels. With the plasma removed, the Hct is 70% in 200-250 ml volume and these products may be leukoreduced with high efficiency filters (
Identify the basic components derived from blood donation, explain the biological characteristics of each component, and compare the optimal storage environment and storage time for each component: FFP
is an acellular product which is kept at -18ºC for one year and contains >80% of all plasma procoagulant and anticoagulant proteins as well as complement factors.
Identify the basic components derived from blood donation, explain the biological characteristics of each component, and compare the optimal storage environment and storage time for each component: Cryoprecipitate
is made from fresh plasma frozen quickly at -80ºC and allowed to sit for 18 hours at 4ºC. Cryoprecipitable proteins are isolated after centrifugation and removal of cryopoor plasma. The resultant prep is frozen at -18ºC for up to one year. Cryoprecipitate contains 80-100 U factor VIII/bag, a biologically equivalent amount of von Willebrand’s factor, 200-250 mg of fibrinogen, and increased levels of factor XIII than is found in plasma. (Caution! IgM isoagglutinins for ABO antigens may also be concentrated and can cause hemolysis if incompatible with patient’s ABO type).
Identify the basic components derived from blood donation, explain the biological characteristics of each component, and compare the optimal storage environment and storage time for each component: Platelet concentrates
come in two types: Random donor unit (RDUs) concentrates (5x1010 platelets in 50 ml) or apheresis platelet concentrates (3x1011 platelets in 200-300 ml). These may be leukoreduced (by filtration after production or elutriation techniques applied to apheresis) for patients receiving many transfusions. Concentrates are stored at 22-24ºC for 5-7 days in gas permeable bags. During storage, reasonable platelet function is maintained but concentrates are a poor source of clotting factors. Apheresis platelets avoid exposure to multiple donors.
Identify the basic components derived from blood donation, explain the biological characteristics of each component, and compare the optimal storage environment and storage time for each component: Granulocyte (white blood cell) concentrates
may be collected by apheresis procedures. No storage is allowed. Granulocytes are kept at room temperature and transfused within 8-12 hours. May collect 2x1010 – 2x1011 neutrophils depending on whether donors are given a single dose of G-CSF or not. Hc, 3-5%. Volume, 200-300 ml. Many platelets contaminate granulocyte products.
Discuss the basic blood groups (ABO and Rh) and contrast the different compatibility requirements of basic blood components
Discuss the basic blood groups (ABO and Rh) and contrast the different compatibility requirements of basic blood components
Discuss the basic blood groups (ABO and Rh) and contrast the different compatibility requirements of basic blood components
Urgent situations require an abbreviated procedure. (1) No time (e.g., exsanguinating hemorrhage, massive trauma).
an abbreviated procedure. (1) No time (e.g., exsanguinating hemorrhage, massive trauma). Give O, Rh(D) negative; or for males and non-childbearing females, use O, Rh(D).
Urgent situations require an abbreviated procedure. (2) Abbreviated testing:
if the donor and recipient ABO and Rh(D) types are identical and the antibody screen is negative in both, the unit may be infused without completing the crossmatch. This should only be used in urgent situations where transfusion cannot be delayed for 45 min to complete the crossmatch. The risk of an adverse event is 1/17,000
Differentiate the specific indications for each of the basic blood components: packed red cells
PRBCs are transfused for oxygen carrying capacity: For chronic anemia, Hct <25-30. Age and disease related changes to level of Hct may apply to indication. PRBCs must be crossmatched and administered like whole blood
Differentiate the specific indications for each of the basic blood components: fresh frozen plasma
FFP may be used to treat coagulopathy related to procoagulant deficiency (DIC, liver failure, vitamin K deficiency, etc.). Specific clotting factor deficiencies (VIII, IX, VII) are treated with factor specific concentrates. FFP may support anticoagulants in general, but AT-III and protein C concentrates are available. FFP must be type specific and administered as tolerated over 1-3 hrs but not >4 hrs.
Differentiate the specific indications for each of the basic blood components: platelets
Platelet concentrates. Indication is for bleeding associated with thrombocytopenia and/or platelet dysfunction. Consider ABO type specific/compatible. Infuse over 30-45 minutes. For pediatric patients, 10 ml/kg or for adults, 1 apheresis unit or a pool of 6-10 random donor units raise platelet count by 50-100,000/μl.
