Transfusion Medicine Flashcards
What is the screening procedure for people who are donating their blood?
Questionnaire Urged to call back if sick Screening: -Hct -Platelet count
This blood component is stored at 4-6 degrees Celsius for 35 days to optimize RBC recovery.
Whole blood
This blood component is stored at 4-6 degrees Celsius for 35-42 days. The plasma is removed.
Packed RBC
This acellular product is kept at -18 degrees Celsius for one year and contains >80% of all plasma procoagulant and anticoagulant proteins as well as complement factors.
Fresh frozen plasma
This blood component is made from fresh plasma frozen quickly at -80 degrees Celsius and allowed to sit for 18 hours at 4 degrees Celsius. After further prep the bag consists of 80-100 U factor VIII/bag, fibrinogen, and increased levels of factor XIII. Caution for IgM
Cryopercipitate
This blood component is stored at 22-24 degrees Celsius for 5-7 days in a gas permeable bag. There are two types Random donor unit (RDU) or apheresis platelet concentrates
Platelet Concentrates
This blood component is collected by apheresis procedures and does not allow for storage. They must be kept at room temperature and transfused within 8-12 hours
Granulocyte (WBC) concentrates
What are the two standard infectious disease screening tests?
- Antibody against and/or antigen for each infectious agent
- Nucleic acid amplification test (NAT) for:
Hepatitis C
HIV
West Nile Virus
Is there a functional difference between alloantigens?
No
ABO are polysaccharides the the H being the basic sugar chain attached to the RBC. What determines the following:
- O antigen
- A antigen
- B antigen
O= addition of a fructose A= addition of a fructose and N-acetylgalactosamine B= addition of a fructose and D-galactose
At what point do people start making agglutinins to blood types they do not express?
One year of age
Do people normally express antibodies to Rh antigens?
No. In order to develop alloantibodies against an antigen you have to have a prior exposure
Which of the Rh factors is the most immunogenic?
D
If there is no time to cross match and do a Coombs test to determine the compatibility between a donor and recipient, what blood type should you give?
Give O, Rh(D) negative
Males or non-childbearing females: O, Rh(D)
What does the Coomb’s test involve?
Add the donors cells to the recipients plasma. Then add florescently labeled antibody
What is the indication for using whole blood?
Replace O2 carrying capacity AND blood volume when1 blood volume has been lost
What is the indication for using packed RBC?
Transfused for oxygen carrying capacity. For chronic anemia
What is the indication for using fresh frozen plasma?
Procoagulation deficiency (DIC, Liver failure, Vitamin K deficiency)
Deficiencies in Factors VIII, IX, VII
What is the indication for using cyropercipitate?
Low or absent fibrinogen
Replacement for factor XIII deficiency
Factor VIII deficiency + von Willebrands Factor
What is the indication for using platelet concentration?
Bleeding associated with thrombocytopenia or platelet dysfunction
What is the indication for using granulocyte concentrations?
Severe fungal and bacterial infections
What is the adverse reaction associated with > or equal to 1 degree Celsius rise in temperature from pre-transfusion events?
Febrile non-hemolytic transfusion reaction
What adverse reaction is associated with hives after transfusion?
Mild allergic reaction
What adverse reaction is associated with activation of complement and intravascular hemolysis which may lead to shock, acute renal failure and disseminated intravascular coagulation?
Immediate hemolytic transfusion reactions
TX with vigorous supportive care, diuretics and heparin
Incompatible ABO
What adverse reaction is associated with slow destruction of the sensitizing red cells withvery few symptoms and signs?
Delayed hemolytic reaction
What adverse reaction is associated with bronchospasm and/or large airway response and is treated with epinephrine, benadryl and steroids?
What patient population is particularly at risk?
Anaphylactic reaction
IgA deficient individuals
What adverse reaction is associated with acute lung injury, infiltrates, problems breathing and difficulty maintaining peripheral oxygen saturation on room air. This occurs within 6 hours of transfusion
Transfusion related lung injury
TX: Vigorous ventilatory support
What adverse reaction is associated with excessive amounts of products and/or cardiac dysfunction?
Transfusion associated circulatory overload (TACO)
TX: Diuretics
