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blood bank2 > transfusion therapy > Flashcards

transfusion therapy Flashcards

1
Q

Why is a type and screen pertinent in transfusion reaction work up

A
  • transfused products either have antigens or antibodies in them
  • knowing the antibodies made tells which antigens they can be given
  • knowing the antigens tells which antibodies they can receive
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2
Q

List common symptoms of a transfusion reaction

A
  • hemolysis
  • increase blood pressure
  • increase temperature
  • shortness of breath
  • pain
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3
Q

How are transfusion reactions classified

A
  • time they occur: acute or delayed
  • response: hemolytic or non hemolytic
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4
Q

Major complications of acute hemolytic TRXN

A

DIC and renal failure

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5
Q

Clinical presentation of acute hemolytic trxn

A
  • fever
  • hypotension
  • hemoglobinuria/emia
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6
Q

Severity factors of both acute and delayed hemolytic trxn

A
  • antibody titer
  • ability to fix compliment
  • antigenicity
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7
Q

Cause of acute hemolytic trxn

A

Compliment activation

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8
Q

Causes of delayed hemolytic trxn

A

Anamnestic (immune response to previous exposure)

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9
Q

Antibodies associated with delayed hemolytic trxn

A
  • Kidd
  • Duffy
  • kell
  • MNS
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10
Q

Where is hemolysis located in delayed hemolytic trxn

A
  • organs effected
  • extra vascular
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11
Q

Where is hemolysis located in delayed hemolytic trxn

A
  • organs effected
  • extra vascular
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12
Q

Antibodies associated with acute hemolytic trxn

A
  • ABO
  • Rh
  • kell
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13
Q

Name the most common trxn

A

Febrile non hemolytic
(FNHTR)

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14
Q

Describe FNHTR
- symptoms
- causes
- lab findings
- treatment
- prevention

A
  • symptoms: fever and chills, nausea
  • causes: HLA Abs in donor or cytokines stored in product
  • lab findings: DAT neg, no hemolysis
  • treatment: acetaminophen
  • prevention: Leuko reduced products
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15
Q

Desrice allergic reaction (trxn)
- symptoms
- causes
- lab findings
- treatment
- prevention

A
  • symptoms: Urticaria (welt rash), itching, hypotension and hives
  • causes: allergens and proteins in donor (IgA)
  • lab findings: DAT neg, no hemolysis
  • treatment: premedication with antihistamines
  • prevention: different donor or washed products
  • prevention
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16
Q

Name the disorder related to a maculopapular rash

A

Graft v host disease

17
Q

Describe graft v host disease
- symptoms
- causes
- lab findings
- treatment
- prevention

A
  • symptoms: maculopapular rash, diarrhea, multi organ failure, 90% mortality rate
  • causes: recipient does not recognize donor as foreign, donor lymphocytes mount immune response on recipient
  • lab findings: pancytopenia
  • treatment: stem cell transplant, immunosuppression
  • prevention: irradiated products
18
Q

Describe TRALI
- symptoms
- causes
- lab findings
- treatment
- prevention

A
  • symptoms: shortness of breath, severe hypoxia
  • causes: donor HLA Ab and recip HLA Ag on WBC prime and complex deposition on lungs
  • lab findings: matching Ag and Ab between recip and donor
  • treatment: stop transfusion, supportive therapy
  • prevention: donor deferral for HLA
19
Q

Describe TACO
- symptoms
- causes
- lab findings
- treatment
- prevention

A
  • symptoms: hypertension, coughing
  • causes: volume not handled (CHF)
  • lab findings: elevated BNP, no hemolysis
  • treatment: O2 supplementation
  • prevention: split products/ check lab values
20
Q

Describe Sepsis
- symptoms
- causes
- lab findings
- treatment
- prevention

A
  • symptoms: increase body temp >2, hypotension and rigors
  • causes: bacterial contaminated products (PLTs)
  • lab findings: blood culture matches patient
  • treatment: antibiotics
  • prevention: correct storage
21
Q

What bacteria are associated wi the PLT products

A

GPC and GNB (enterics)

22
Q

Name bacteria related to RBC products

A

GPC and GNB enterics

23
Q

Name bacteria related to plasma products

A

Water bath contaminants

24
Q

Lab findings of iron overload

A

Increased ferritin
Multi organ failure
Yellow tinged skin

25
Q

Treatment for iron overload

A

Therapeutic phlebotomy, chelation therapy or exchange transfusion

26
Q

describe the work up of a transfusion reaction

A
  • pre analytical (UA and serum) clerical check and hemolysis
  • analytical (pre and post samples) DAT and abo re type
  • post analytical: report findings
27
Q

describe extended workup
- hemolysis
- sepsis
- lung injury

A
  • if hemolysis present: eluate, repeat screens on pre and post, chem test for hemolysis
  • sepsis: blood culture
  • lung injury: HLA and chest x ray
28
Q

when is a trxn reported to the FDA

A
  • product is at fault in causing a trxn
  • sepsis
  • TRALI
  • hemolytic
29
Q

when is a trxn not reported

A
  • delayed reaction
  • most allergic reactions
  • FNHTR
  • circulatory overload

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