Fiser Chapter 3 BLOOD PRODUCTS Flashcards
Blood products without HIV and hepatitis risk
albumin and serum globulins (heat treated)
Diseases donated blood is screened for
HIV, HepB, HepC, HTLV, syphilis, West Nile
Who gets CMV-negative blood?
Low birth weight infants, BMT patients, transplant patients
Universal donor blood
Type O
Hemolysis reactions
Acute hemolysis
Delayed hemolysis
Nonimmune hemolysis
After transfusion: back pain, chills, tachycardia, fever, hemoglobinuria
Acute hemolysis: ABO incompatibility, Ab mediated
Can lead to ATN, DIC, shock
Dx: Haptoglobin 5 g/dL, increased unconjugated bilirubin
Tx: Fluids, diuretics, HCO3, pressors, Benadryl
If intubated may present as diffuse bleeding
Acute hemolysis transfusion reaction mechanism and treatment
ABO incompatibility
Fluids, diuretics, HCO3, pressors, benadryl
Delayed hemolysis mechanism
AB mediated against MINOR antigens
Tx: observe if stable
Nonimmune hemolysis mechanism
Squeezed blood…
Tx: fluids and diuretics
Transfusion reactions
Hemolysis (acute, delayed, nonimmune) Febrile nonhemolytic (most common) Anaphylaxis Urticaria TRALI
Febrile nonhemolytic transfusion reaction mechanism and treatment
- Recipient Ab attacks donor WBC
- Tx: Discontinue transfusion if previous transfusions or if occurred soon after transfusion begun. Use WBC filters for subsequent transfusions
Anaphylaxis transfusion reaction mechanism and treatment
- IgA deficiency: recipient Ab attacks donor IgA
- Tx: fluids, Lasix, pressors, steroids, epinephrine, benadryl
Bronchospasm, hypotension, urticaria with transfusion
Anaphylaxis in IgA deficiency
Urticaria transfusion reaction mechanism and treatment
- Recipient Ab against donor plasma proteins or IgA
- Tx: Benadryl, supportive
TRALI mechanism
Donor Ab to recipient WBC -> clot in pulmonary capillaries
