Transfusion Therapy

Question 1

Outline the ideal canine blood donor…

Answer 1

Friendly
Clinically healthy
Large breed
Easily accessible veins
1.5-5YO

Question 2

Outline the ideal feline blood donor….

Answer 2

Friendly 
Clinically healthy
Large >4.5kg
1.5-8YO
Indoor

Question 3

What substrates can be transfused?

Answer 3

Whole blood
Packed RBCs
Fresh frozen plasma
Cryoprecipitate
Cryosupernatent

Question 4

What are the advantages of transfusing whole blood?

Answer 4

Can bleed donor on demand

No separating or storage facilities required

Question 5

When is a whole blood transfusion indicated?

Answer 5

Substantial acute haemorrhage

Haemorrhage due to haemostatic disorders

Question 6

What are the advantages of transfusing blood components?

Answer 6

Can acquire multiple products from on donation

Decreases risk of side effects

Question 7

What are packed RBCs composed of?

Answer 7

Centrifuged whole blood
Additive solutions
1-6’C

Question 8

When is a packed RBC transfusion indicated?

Answer 8

Anaemia without hypovolaemia
Anaemia without deficits of other components
Anaemia with risk of volume overload

Question 9

What does fresh plasma contain high levels of?

Answer 9

All clotting factors

Question 10

How fast does fresh plasma need to be separated from the blood? How long can it be kept frozen?

Answer 10

Separated <24HR

Frozen <1Y

Question 11

When is a fresh plasma transfusion indicated?

Answer 11

Coagulopathies
Pancreatitis
Acts as am IG source
To supply albumin

Question 12

How long can plasma be refrigerated and frozen for after collection?

Answer 12

Refrigerated <6W

Frozen <5Y

Question 13

What does plasma lack compared to fresh plasma?

Answer 13

Clotting factors V, VIII and vWF

Question 14

When is a normal plasma transfusion indicated?

Answer 14

Rodenticide toxicity

Haemophilia B

Question 15

How is cryoprecipitate prepared?

Answer 15

Partial thawing and centrifugation of fresh frozen plasma

Question 16

How long can cryoprecipitate be frozen for?

Answer 16

<1Y

Question 17

What is cryoprecipitate enriched in?

Answer 17

Clotting factor VIII
vWF
Fibrinogen

Question 18

What can be given to donor prior to taking blood for cryoprecipitate and why?

Answer 18

Desmopressin

Causes release of vWF into endothelial cells => blood donation is very enriched

Question 19

What does cryosupernatent contain?

Answer 19

Vit K dependent clotting factors
Albumin
Anti-thrombin

Question 20

What is cryosupernatent?

Answer 20

The resulting plasma after cryoprecipitate has been removed

Question 21

When is a cryosupernatent transfusion indicated?

Answer 21

Rodenticide toxicity
Vit K deficiency
Haemophilia B
Hypoalbuminaemia

Question 22

What elements make up the antigen on the RBC surface?

Answer 22

Proteins
Glycoproteins
Glycolipids
Carbohydrates

Question 23

What are the dog blood groups?

Answer 23

DEA 1, 3-7

Question 24

What are the feline blood groups?

Answer 24

A
B
AB

Question 25

Which canine blood groups need to be tested for?

Answer 25

DEA 1 only: DEA 1 +ve => universal recipient and donor DEA 1 -ve => universal donor but can only receive DEA 1-ve blood

Question 26

Which feline blood groups need to be tested for?

Answer 26

All 3 in both donor and recipient

Question 27

Outline how blood is administered to a recipient in a transfusion...

Answer 27

Dedicated catheter Appropriate giving set Slow initial rate 4-6HRS

Question 28

What kind of transfusion reactions can occur?

Answer 28

Immunological, non-immunological | Acute, delayed

Question 29

What are the clinical signs of a possible transfusion reaction?

Answer 29

``` Pyrexia Tachycardia Tachy/dyspnoea Erythema Urticaria ```

Question 30

How is a transfusion monitored?

Answer 30

Stop transfusion Check ECG and BP Symptomatic treatment

Question 31

What treatments can be used to alleviate the clinical signs of a trasnsfusion reaction?

Answer 31

Adrenaline and CPR Anti-histamines Anti-pyrexics

Question 32

When is cross-matching required in a transfusion?

Answer 32

Recipient has been transfused <4days previously History of transfusion reaction Transfusion history unknown

Question 33

Outline the minor and major cross matches

Answer 33

Major - donor antibodies + recipient plasma Minor - donor plasma + recipient antibodies (less important as v little plasma donated with packed RBCs)

Question 34

Why should anti-coagulated blood not be administered with fluids containing calcium?

Answer 34

Can result in calcium salts or microthrombi formation

Question 35

How much fresh blood equates to 1% PCV?

Answer 35

2ml