TRANSFUSION SCIENCE Flashcards
STORAGE TEMP OF SAGM RBC AND SHELF LIFE
42 DAYS, 1-6 C
STORAGE TEMP OF IRRADIATED SAGM RBC AND SHELF LIFE
1-6 C, 14 DAYS FROM DATE OF IRRADIATION OR 28 DAYS WHICHEVER COMES FIRST
WASHED RBC STORAGE TEMP AND SHELF LIFE
1-6 C, 7 DAYS
PLASMA PRODUCT DERIVATIVES STORAGE TEMP AND CONDITONS
DEPENDS ON MANUFACTURER
VISUAL INSPECTION: LIPEMIA/WHITE PARTICULATE MATTER
ACCEPTABLE TO TRANSFUSE/RELEASE
WHAT IS TRANSFUSION-RELATED ACUTE LUNG INJURY? (TRALI)
ANTI-HLA OR ANTI-NEUTROPHIL ANTIBODY IN DONOR PLASMA REACTING WITH RECIPIENT ANTIGENS
Anti-E is a clinically significant antibody because
it can cause hemolytic transfusion reactions
What is complement bound by?
Kidd antibodies
Which set of antibodies could be found in a patient with no history of transfusion or pregnancy?
anti-I, anti-Lea, anti-B
What part of the antigen does the antibody react with?
Epitope
What substance are all antibodies composed of?
Glycoproteins
What does the Fc portion of an antibody bind to?
Site of complement fixation
What does the Fab portion of an antibody bind to?
Binds to antigens
Held together by disulphide bonds
IgM and IgG
Has J Chains
IgM
Most efficient molecule for binding complement
IgM
Has several subclasses and a molecular weight of 150,000-180,000 daltons
IgG
Has alpha heavy chains
IgA
Has mu chains
IgM
Has gamma heavy chains
IgG
Has a monomeric shape
IgG
Name 3 applications of DAT
Diagnosis of hemolytic anemia, compatibility testing for blood transfusion, prenatal testing for hemolytic disease of the newborn
What kind of result can you expect from a 3-5% solution in the prozone?
False positive, cell suspension too light
What kind of result can you expect from a 3-5% solution in the postzone?
False negative, cell suspension too heavy
What is the difference between the monospecific method vs the polyspecific AHG method?
Monospecific contains antibodies specific to either C3d or IgG, polyspecific contains antibodies that react with both.
What are Anti-A, Anti-B and Anti-A,B composed of?
They are derived from Brima-1, they are murine monoclonal antibodies
What is Anti-D composed of?
A blend of IgM and IgG, heterohybridoma
What is in the Rh or monoclonal control?
Everything in Anti-D, except for anti-D
What are A1 & B cells composed of?
2-4% suspension of pooled C-D-E RBC suspended in a buffered solution containing adenosine and adenine
What are screen cells composed of?
Contains a 2-4% suspension of a single donor group O red blood cells prepared in a buffer containing adenosine and adenine.
What are check cells composed of?
A single pool of group O red cells that have been sensitized with an IgG antibody
What is Anti-IgG composed of?
Prepared by blending supernatants produced by individual hybridoma cells
What is PEG composed of?
Glycine polythene, glycol, and propylene oxide/ethylene oxide block polymer.
What are lectins composed of?
Seed extracts
Name 2 lectins.
Anti-A1 (Diluchous biflorous), Anti-H (Ulex uropious)
In which situation might mixed field reactions be seen
S typing of red cells from a recently transfused patient
What are the 3 theories for weak D?
- Inherited genetic coding
- Gene position effect
- Partial D
A positive Rh control may result if:
Patient has warm/cold autoantibodies or a positive DAT
When can Rh positive blood be given to Rh negative individuals?
Males above 18yrs old, women older than 45
Which patients should receive CMV-negative products?
Neonates (older than 14 days do not receive), anyone immunocompromised and organ transplants
Changes to red cells during storage is called
Storage lesion
During storage of red cells what decreases?
Viability of red cells, plasma pH, ATP levels, viable platelets, ability of red cells to metabolize glucose, 2-3 DPG levels
During the storage of red cells what increases?
Plasma K+, plasma hemoglobin, and osmotic fragility
What is cryosupernatant plasma?
The plasma product remaining after cryo-precipitated AHF production
What is cryo-precipitated AHF used for?
Used for patients who require fibrinogen
What is albumin used for?
Most suitable product for treatment of shock due to severe burns
What are red cells useful for?
Treatment of anemia
What is factor IX concentrate used for?
Most suitable for patients with hemophilia B
What is factor VII concentrate used for?
Most suitable for patients with hemophilia A
What does immune serum globulin (ISG) provide?
Provides passive antibody protection after exposure to hepatitis A
What is frozen plasma useful for?
It provides all clotting factors
When will RhIG be required?
Following amniocentesis, trauma or abortion
Why is it possible to have a negative DAT in a hemolytic transfusion reaction?
If RBCs are lysed
Which blood groups system antibodies are commonly associated with delayed transfusion reactions?
Kidd
What is common with an allergic (uticarial) reaction post-transfusion?
Hives, antihistamines may relieve symptoms of this type of reaction
What is common with an intravascular hemolytic reaction?
Usually resulting from transfusing ABO-incompatible blood or clerical errors, a burning sensation at the site of infusion, may activate the coagulation system resulting in DIC
What is common with an extravascular hemolytic reaction?
Red cell destruction by antibodies which do not bind complement, patient demonstrates a decreased hemoglobin level 2 to 10 days post transfusion
What is common with a non-hemolytic febrile reaction?
Fever of at least 1C higher is the only symptom, anti-pyretic may help reduce or control the reaction
What is common with an anaphylactic reaction?
Plasma from IgA deficient donors may prevent this reaction
What percentage of the population has the D antigen?
85%
What percentage of the population has the C antigen?
68%
What percentage of the population has the E antigen?
29%
What percentage of the population has the c antigen?
80%
What percentage of the population has the e antigen?
98%
What percentage of the population has the K antigen?
9%
What percentage of the population has the k antigen?
99.8%
What percentage of the population has the Fya antigen?
66%
What percentage of the population has the Fyb antigen?
83%
What percentage of the population has the Jka antigen?
77%
What percentage of the population has the Jkb antigen?
74%
What percentage of the population has the A antigen?
43%
What percentage of the population has the B antigen?
9%
What percentage of the population has the AB antigen?
4%
What percentage of the population has the O antigen?
44%
R0 in fisher race
Dce
R1 in fisher race
DCe
R2 in fisher race
DcE
Rz in fisher race
DCE
r in fisher race
ce or dce
r’ in fisher race
Ce or dCe
r” in fisher race
cE or dcE
ry in fisher race
CE or dCE
Characteristics of KELL antibodies
Do not bind complement, IgG class usually, associated with hemolytic transfusion reactions and hemolytic disease of the fetus and newborn
Characteristics of DUFFY antibodies
Demonstrate dosage, IgG 37C and do not react with enzyme-treated RBCs
Characteristics of KIDD antibodies
Show dosage, enhanced by enzymes, cause of delayed HTRs
Characteristics of LEWIS antibodies
Anti-Lea naturally occurring, IGM, not clinically significant, commonly reactive at room temp
Characteristics of I antibodies
Bind complement, cold reacting, IgM, reactions are avoided by prewiring techniques
Characteristics of M and N antibodies
Show dosage, IgM, variable reactions
Characteristics of S antibodies
IgG, shows dosage