UCSF: Transfusion Reactions, HDFN Flashcards
What might cause shock and an extreme temperature increase during a transfusion?
Bacterial sepsis causes a temperature increase as the body attempts to kill off the invading bacteria. The unit was most likely contaminated.
What component has the highest rate of causing bacterial sepsis?
Platelets. Pooled platelets have a higher risk than those obtained through apheresis.
Platelets are at higher risk because they are stored at room temperature, which is ideal for bacterial growth.
What is he protocol for a donor unit that has a positive DAT?
The unit must be discarded, because the weak D test cannot be interpreted.
What blood system is the most common cause of mother/fetus incompatibility?
ABO is the most common cause, but also rarely causes clinical systems.
Fetomaternal hemorrhage is suspected when…
A weak D test on the mothers blood gives a mixed field reaction, indicating the presence of fetal RBCs in the others circulation.
Kleihauer-Betke Acid Elution
The number of fetal cells in 2000 maternal cells are counted and the volume of the hemorrhage is calculated by:
(# of fetal cells / # of maternal cells) x material blood volume (~ 5000mL) = fetal bleed
Equivalent to: fetal cells as percentage of mothers cells x 50mL = mL of fetal whole blood
What does a positive auto control at AHG indicate?
That there is a positive DAT.
If the screening cells are positive, it could be caused by a warm autoantibody
What is the best treatment course for patients with Warm Autoimmune Hemolytic Anemia?
Steroids will help slow the production of antibodies, including those causing the anemia.
What blood group is most commonly associated with Warm Autoimmune Hemolytic Anemia?
Rh is most commonly associated; anti-e being the most common simple specificity, although most are of broad specificity
In patients with Warm Autoimmune Hemolytic Anemia, what considerations must be taken when testing for a transfusion?
To determine any underlying alloantibodies that may be present with the autoantibodies.
What medications cause factions with all panel cells?
Alpha-methyldopa, L-dopa, procainamide, and some non-steroidal inflammatory drugs
What is the procedure if a patient has an alloantibody and a rare autoantibody?
If blood missing the antigen of the autoantibody is difficult to obtain and there is another alloantibody present, the procedure is to find donor blood missing the antigen of the alloantibody over the autoantibody as the autoantibody will remove the donor cells at the same rate it removes the patients own cells.
