Transplant CSH, transfuzii

Question 1

Transplant de cel stem hematopoietice

Answer 1

inloc CSH, de obicei efectuat dupa radio/chimioterapie mieloablativa

Question 2

Surse CSH

Answer 2

mo - transplant clasic

sg perif - citafereza

Question 3

TCSH - Clasif in fct de donator

Answer 3

alte pers - alogenic

pacient - autolog

Question 4

TCSH alogenic - indicatii

Answer 4

leucemii acute
anemie aplastica severa
lmc
limfoame, mm, llc

Question 5

TCSH alogenic - compatibilitate

Answer 5

ideal - compat HLA completa (frati, donatori neinruditi)

alt (fara donator compatibil) - sg cordon ombilic, alti membrii ai familiei

Question 6

Efecte TCSH

Answer 6

ef citotox si anti neo al chimio/radioterapiei mieloablative

ef imuno anti-neo al LyT de la donator

Question 7

Efecte secundare TCSH

Answer 7

lipsa de priza a grefei
rejet
b grefa contra gazda ac/cr - poate sa duca la ef adverse invalidante pe termen lung

Question 8

TCSH autolog - indicatii

Answer 8

pacienti <65 ani
limfoame refract/recidiv
LAM, LAL fara donator
MM

Question 9

TCSH autolog - efecte

Answer 9

ef anti neo al chimio mieloablative, dar fara ef imuno anti neo al grefei

Question 10

TCSH autolog - RA

Answer 10

infectii, hrg in per imediat post chimio

risc crescut de recidiva

Question 11

Transfuzia

Answer 11

substitutie sg integral/prod de sg de la un donator la un primitor

Question 12

Indicatie transfuzie sg integral

Answer 12

hemoragie acuta post traumatica

Question 13

Indicatie transfuzie masa eritrocitara

Answer 13

anemie severa (Hb <7g/dl) in absenta altor mijl terapeutice

Question 14

Compatibilitate transfuzie MER

Answer 14

sist ABO - 4 gr sg, atg A, B; Ac anti A, anti B (naturali, IgM) -> transfuziile incompatibile duc la react hemolitice severe
sist Rh - Atg C,D,E; Ac anti C, anti D, anti E (artificiali, IgG) -> transfuzii incompatibile duc la react hemolitice dupa imunizare

Question 15

Indicatie transfuzie masa trombocitara

Answer 15

trombocitopenie centrala severa

eficienta redusa in trombocitopeniile periferice

Question 16

Compatibilitate transfuzie de masa trombocitara

Answer 16

de dorit - sist ABO, dar nu este obligatorie

transfuzii repetate -> limitarea nr donatori la un primitor pt scad riscului imuniz

Question 17

Indicatia transfuziei de leucocite (buffy coat)

Answer 17

febra persistenta >48 de tratament ATB la pacienti cu neutropenie severa

Question 18

Compatibilitate transfuzie de leucocite

Answer 18

HLA de dorit, dar greu de obt

Question 19

Indicatii transfuzie de PPC

Answer 19

tulb coag

soc

Question 20

Reactii febrile post-transfuzie

Answer 20

cauza: LEU contaminate
trat: antipiretice

Question 21

Reactii alergice posttransfuzionale

Answer 21

cauza: P plasmatice straine
tratament: antihistaminice, corticoizi, adr

Question 22

Reactii hemolitice posttransfuzionale

Answer 22

cauza: incompatibilitate in sist ABO sau Rh

urgente medico-legale -> trat complex, pot necesita dializa

Question 23

Transfuzii de sg infectat

Answer 23

cauza: manip incorecta a prod de sg
pot duce la soc toxico-septice
trat complex

Question 24

Transmiterea bolilor infectioase prin transfuzie

Answer 24

HIV, HBV, HCV, etc

prev: selectia donatorilor, test sg

Question 25

Hemosideroza

Answer 25

cauza: transfuzii multiple (anemii cr)
afect multiorganica
trat: chelatori de fe (desferoxamina, desferasirox)