Transfusion medicine

Question 1

what is the universal donor

what is the universal receiver

Answer 1

donor: O-
receiver: AB+

Question 2

how long is a group and save sample valid in a patient?

Answer 2

Sample validity is 28 days for normal patients with no Abs and not trasnfused in last 3 mo

72 hours for pregnant patients / transfused

(7 days for pregnant with placenta praevia/ patients with multiple transfusion and no Abs - guess cause they need it and benefits>risks)

Question 3

When to transfuse?

Answer 3

• No universal trigger fro transfusion
  ○ Generally Hb<70-80 g/L
  ○ Treat underlying cause if possible
  Consider difference between acute and chronic; symptoms
  • Hb <50
  • Hb 50-80 and symptomatic
  • Hb 80-100 rarely with significatn symptoms
  • Hb >100 should not be transfused

Question 4

advise clients about their suitability to donate blood

Answer 4

• Fit and healthy
  
  • 50kg and 120 kg
  • 17-66 yo (or 70 if you have given blood before)
  • > 70 is have given blood in last 2 years
  • Men can give every 12 weeks and women every 16 weeks
  • Check before if:
    
    • if you are receiving medical or hospital treatment
    • if you are taking medication
    • after travelling outside of the UK - some countries have to wait 4 months
    • after having a tattoo or piercing - wait 4 months
    • during and after pregnancy
    • if you feel ill
    • if you have cancer
    • after receiving blood, blood products or organs.
  • You cannot if:
    ○ IVDU
    ○ Blood borne virus carrier
  • You cannot within 3 months if
    ○ You are sex worker
    ○ MSM
    ○ Partner with HIV / Hep / Syphilis
    ○ Partner who is IVDU / sex worker / had sex in Africa

Question 5

indications for platelet transfusion?

Answer 5

• Thrombocytopaenia
• Blood loss
• Bone marrow failure
• Prophylaxis pre-procedure eg bone marrow aspirate/LP/epidrual

Question 6

indications for FFP?

Answer 6

• Clotting defects
• DIC
• Warfarin overdose is Vit K too slow
• Liver disease
• TTCP
• Alternative product is Octoplex

Question 7

Types of transfusion reactions?

Answer 7

Febrile non-haemolytic transfusion reaction

Allergic transfusion reactions

Acute Haemolytic transfusion reaction
(due to ABO incompatibility)

Infective contamination

TACO - Transfusion Associated Circulatory Overload (>70)

TRALI - Transfusion Associated Acute Lung Injury

Question 8

how long can red cells be out of fridge?

Answer 8

• RBCs max 4 hours out of fridge to prevent bacterial proliferation