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Transfusion 231 > Week 10 > Flashcards

Week 10 Flashcards

1
Q

Types of Donor

What is an Allogenic donor

A

-when donated blood goes into general inventory
-used by gen pop
-single or random donor

Apheresis (RBC, Plasma and Platelets)

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2
Q

What is an autologous donor

A

when you donate blood for yourself or freeze for the future like if youre having surgeries or youre a bombay patient

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3
Q

What is a directed donation

A

for rare blood types
reserved for use by a specific patient - bombay

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4
Q

Why is an autologous donation important
advantages and disadvantages

A

-prevents transfusion transmitted diseases
prevents alloimmunization
supplements blood supply
prevents febrile and allergic reactions

disadv
inventory control issues
preoperative anemia
increased cost
high waste
high incidence of adverse reactions to donation

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5
Q

what supplies are needed when prepping patient for blood donation

A

clean with 2% chlorhexidine followed by alcohol
BP cuff, 16 gauge needle , and blood mixer bag
1 hour for donation process

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6
Q

What is the donation process like

A

450-500ml blood collected in bag with anticoagulant
-first 30 mls are directed into a diversion pouch (reduces contamination with skin flora to be used for serological testing before the whole bag is used)
-underfilled bags used for research

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7
Q

As RBCs age what happens to
hgb
ph
glu
atp
2, 3 BPG
K

A

hgb- decreases
ph- decreases
glu- decreases
atp- decreases
2, 3 BPG -decreases
K-decreases

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8
Q

What do the following preservatives help with
dextrose
adenine
citrate
Na biphosphate
mannitol

A

dextrose -ATP generation
adenine- substrate for ATP synthesis
citrate - chelates CA
Na biphosphate - stops pH decrease
mannitol - membrane stabilizer

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9
Q

Why do you need a preservative in the blood bag

A

-minimize biological changes and max out shelf life
do not want an increase in K and you want to maximize 2,3 DPG levels because it helps increase release O2 from hgb

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10
Q

what is the additive CBS puts in their blood bags

A
  • Saline
  • Adenine
  • Glucose
  • Mannitol

CPD

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11
Q

When is the additive solution added

A

after RBC and plasma have been separated
-helps to reduce viscosity
-reduces hemolysis
-needs to be added 72 hours after collection

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12
Q

What is Apheresis

A

whole blood is centrifuged you keep what you want and return the rest
*Component preparation
* Therapeutic Apheresis for treatment

if you want plasma
collect 70 ml in bag with ACDA or trisodium
-no additive added because there are no Red cells
-Fresh Frozen Plasma= with FV and FVIII= freeze in 24hrs

if you want plts
-collect 50 ml in bag with ACDA with leukocyte reduced method
-no additive because no red cells

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13
Q

What is therapeutic apheresis

A

-removal of diseased blood components to alleviate disease symptoms
-return healthy blood back to patient
-replace cell loss with colloid or fresh frozen plasma

  • Therapeutic Plasma Exchange or TPE
  • Cytapheresis is the removal of RBC, PLT, or WBC
  • Erythrocytapheresis
  • Leukopheresis
  • Plateletpheresis
  • Photopheresis
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14
Q

What is the difference between
Intermittent flow centrifugation and
Continuous flow centrifugation in Apheresis

A

Intermittent flow centrifugation
-cycle with small blood volume
-takes longer
-single venous site

Continuous flow centrifugation
-simultaneous removal and processing
-two vascular sites

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15
Q

What is therapeutic phlebotomy

A

-drawing of blood for medical reasons
-removing blood doesnt cure disease but treats the symptoms
-polycythemia vera, hemochromatosis and porphyria

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16
Q

What does the type of replacement fluid depend on

A
  • Diagnosis
  • Apheresis frequency
  • Component removed
17
Q

TPE replacement fluids vs Cytapheresis replacement fluids

A

TPE replacement fluids:
* Crystalloids
* Colloids
* Albumin
* Plasma components

Cytapheresis replacement fluids:
* Replace ‘diseased’ red cells with donor red
cells
* Example: used in patients with severe malaria

18
Q

What components are blood donations separated into

A

1) The Anticoagulants
2) The General Volumes
3) The Storage for each component

19
Q

What is the general serological testing for donors

A
  • ABO, RhD, and K (Kell)
  • Weak D typing on ALL Rh-Negative donors
  • Antibody Screening
  • Infectious disease screening
    *OBG antigens (for pts with multiple ABs or if they need lifetime of transfusions like SS or Thals)
    *Red blood cell genotyping
    *molecular testing for Weak D
  • Anti-A and Anti-B isohemagglutinin testing

When Anti-A/B is under RI then its labelled as low titre they are used ABO incompatible plt and plasma transfusion as they will reduce the risk of hemolysis

want to test to ID infectious donors and prevent false positives

20
Q

What testing is completed on repeat donor samples

A

phenotyping for Rh, Kell, Duffy , Kidd and S/s

21
Q

Tests for Transfusion of
Transmitted Diseases/Viruses

What does ELISA do

A
  • Detects antigen and antibody reactions
22
Q

Tests for Transfusion of
Transmitted Diseases/Viruses

Chemiluminescence

A

-light emission from chemical reaction is measured and labels are attached to AG or AB
-better than ELISA- stable and non toxic

23
Q

Tests for Transfusion of
Transmitted Diseases/Viruses

Nucleic Acid Testing (NAT)

A

-viral RNA detection with PCR
-detect viral AG before ABs are detected
-Pools 6 units for testing and if the pool is positive then each plasma sample is tested
-detection of Hepatitis and HIV
-West Nile (in 6 month cycles then done for patients with travel history)

24
Q

What does the donation questionnaire exclude without testing for

A

risk of
Creutzfeldt-Jakob disease, Ebola virus,
malaria, Zika virus, babesiosis, leishmaniasis
or COVID-19

travel history important

25
Q

Transfusion-Transmissible Diseases
Cytomegalovirus CMV

A

asymptomatic
-severe in immunocompromised
-test for Anti CMV
-CMV negative units labelled and used for intrauterine transfusions
* LRF reduces enough WBC to significantly
reduce CMV in most donors

26
Q

how is Bacterial Contamination caught

A

use of BacT/ALERT system to test platelets
-7 day incubation period after inoculation
-inoculation 36 hours AFTER collection so bacteria if present can proliferate
-PLTs given to hospitals as “negative to date”
-if culture is positive then it will be recalled

27
Q

how is Syphilis detected

A

-Micro-Hemagglutination assay for
Treponema Pallidum (detects the antibody).
* Confirmation test is by Fluorescents testing
(FTA-ABS).
-RBCs stored cold so treponema cant grow
-PLTS are kept at RT so they have a risk

28
Q

how is Chagas Disease detected

A

-testing high risk donors from questionnaire

29
Q

What are Human Leukocytes Antigens
or HLA

A

-found on leukocytes
-found on MHC chromosome 6
-markers on immune cells that determine self antigens
-immune cells can detect foreign HLA AG

30
Q

how can a pt have exposure to foreign HLA

A

-Red cell or Plt transfusion
-components have residual RBC, WBC and PLTs
-pregnancy
-production of IgG HLA AB

31
Q

if a patient has ANTI-HLA antibodies, they can:

A
  • Cause an immune response to donor WBC
  • Febrile- nonhemolytic transfusion reaction
  • Need to remove WBC from RBC and
    platelets (Irradiated units to be requested)
32
Q

What are Human Platelet Antigens

A

-found on human PLTs
-AB against these can destroy human PLTs (mom to babys PLTs, pt to donor PLTs)
-AB attach to donor plt and are removed by the spleen
-MUST HLA MATCH DONOR PLT TO PT

33
Q

What is Lookback

A

Donor is positive for transmissible disease
-look at their donations and ID recipient

34
Q

What is traceback

A

RECIPIENT is positive for transmissible disease
-investigate if it could have been from the transfusion
-CBS contacts the donor for testing

35
Q

how long should women wait between donations

A

84 days

or 56 days for men

36
Q

what does the hemoglobin for men have to be before donation

A

130 g/l

WOMEN 135

Transfusion 231 (10 decks)

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