Transfusion Medicine Flashcards
What is an acute haemolytic transfusion due to?
Usually related to ABO incompatibility
Recipient pre-formed antibodies coating and lysing donor cells
What causes a delayed haemolytic transfusion reaction?
Anamnestic antibody response occurring after re-exposure to a foreign red cell antigen previously encountered in transfusion, pregnancy or transplant
How does delayed haemolytic transfusion reaction present?
3-30 days after transfusion mild fever, jaundice, slight drop in Hb
Spherocytes on blood film
What causes febrile non-haemolytic transfusion reactions?
Recipient antibodies against donor leucocytes and HLA antigens on leucocytes
Prevention of febrile NHTR?
Leucodepletion of blood products
What is an urticarial transfusion reaction?
Reaction to plasma proteins in donor products
Symptoms of urticarial transfusion reaction?
Widespread rash without other symptoms of anaphylaxis
Prevention of urticarial transfusion reaction?
Washing of blood products
What are symptoms of an acute haemolytic transfusion reaction?
Fever, chills, pain at site of infusion
Back pain, chest pain
Hypotension, tachycardia
Haemoglobinuria, haemoglobinaemia
Who does anaphylaxis to blood products mostly occur in?
IgA deficiency
Prevention of anaphylaxis to blood products?
Give IgA deficient plasma
Washed products
Screen all who have had anaphylaxis to blood for IgA def
What is transfusion-associated graft vs host?
Donor t- lymphocytes recognise recipient HLA antigens as foreign and mount ann immune response and engraft in bone marrow
Symptoms of transfusion related GVHD?
Fever, diarrhoea, raised LFTs, rash, marrow aplasia, death within 3-4 weeks. No tx available
Patients at risk of transfusion related GVHD and prevention?
HSCT, immunocompromised, fludarabine, transfusions from family members
Prevent by giving irradiated products
What is TRALI?
Acute lung injury
Donor HLA antibodies bind recipient leucocytes which Lyse and cause increased permeability of capillaries in lung
