TransfusionMedicine Flashcards
- A patient had a transfusion reaction to packed red blood cells. The medical laboratory scientist began the laboratory investigation of the transfusion reaction by assembling pre- and post-transfusion specimens and all paperwork and computer printouts.
What should he do next?
A. Perform a DAT on the post-transfusion sample
B. Check for a clerical error(s)
C. Repeat ABO and Rh typing of patient and
donor unit
D. Perform an antibody screen on the posttransfusion sample
B
Criteria for the acceptability of blood donors, performance of
pretransfusion testing, manufacture of blood components,
donor infectious disease testing, and evaluation and reporting
of adverse events associated with transfusion are all defined
by the ______
FDA
Donor Screening
■ ________ requirements for the donor
■ Mini physical examination
■ _______ testing of the donor blood
Medical history
Serologic
Types of Deferral
Prospective donor is unable to donate blood for a limited period of time.
Temporary Deferral
Types of Deferral
Prospective donor is unable to donate blood for someone else for an unspecified period of time. This donor would not be able to donate blood until the current requirement changes. These donors may be eligible to donate autologous blood
Indefinite Deferral
Types of Deferral
Prospective donor will never be eligible to donate blood for someone else. These donor may be eligible to donate autologous blood
Permanent Deferral
■ a unit collected under the same requirements as those for
allogeneic donors, except that the unit collected is directed toward a specific patient.
Directed Donation
■ collecting a specific blood component while returning the remaining whole blood components back to the patient
■ used to collect platelets, plasma, white cells (leukocytes), red cells, and stem cells.
Apheresis Donation
_______ is the process of removing normal (donor) or abnormal (patient) blood constituents from circulating blood.
Hemapheresis
______ – erythrocytapheresis, plateletapheresis, leukocytapheresis
Cytapheresis
Types of Apheresis Machine:
1. by centrifugation - based on density.
It is performed in cycles or passes
One cycle in includes withdrawing of blood through a pump, addition of anticoagulant and separation processes, which is then followed by reinfusion back into the donor
Equipment used is smaller and mobile compared to continuous flow centrifugation
Intermittent flow centrifugation (IFC)
Types of Apheresis Machine:
1. by centrifugation - based on density.
Involves withdrawal, processing and reinfusing of blood to the individual simultaneously
Does not involve cycle and passes
Blood is drawn and returned continuously and would require two arms for the procedure
Continuous flow centrifugation (CFC)
Plateletpheresis
A pheresis platelet unit is equivalent to six to eight random donor platelets, so a single product is a typical therapeutic
dose for most adult patients.
The interval between donations is at least ______, not to exceed more than twice a week or more than 24 times a year.
Each pheresis platelet unit is required to contain at least _____
Donor reactions to platelet pheresis collection are most commonly a reaction to the citrate or ______used in
the procedure.
2 days
3 × 10^11 platelets.
anticoagulant
Plateletpheresis
Test requirements:
- ABO group/Rh type
- antibody screen
- infectious disease markers
______ if donation is repeatedly done
FDA guidelines require that the donation records of regular platelet pheresis donors be reviewed by a physician at least
every ______.
30 days
4 months
Classification:
Infrequent/occasional
Serial
The red cell loss must not exceed 25 mL/week or 200 mL in an 8-week period.
if the donor’s red cells cannot be returned, the donor must be deferred for 8 weeks before returning to a plasma pheresis
program.
The donor must be tested for total serum/plasma protein levels and quantitative immunoglobulin levels, and protein
electrophoresis must be performed.
Plasmapheresis
A typical therapeutic dose is at least 1 × 1011 granulocytes each day for 5 consecutive days.
donor must be given certain drugs or sedimenting agents, and specific informed consent must be obtained from the
donor prior to administering these drugs.
AABB Standards states that any of these drugs or agents used to facilitate leukapheresis will not be used on donors
whose medical history suggests that such a drug will exacerbate previous disease.
Leukopheresis
_______ – common sedimenting agent
hydroxyethyl starch (HES)