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Haematology > Blood Transfusion > Flashcards

Blood Transfusion Flashcards

1
Q

What is the requirement for blood donation?

A

Hb 135 g/L men
Hb 125 g/L women
Weight 50kg
Aged 17-65

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2
Q

How is donated blood processed and tested?

A

Bag of whole blood centrifuged to separate into component parts
Samples undergo microbial testing; HIV, hep B + C, hep E, HTLV, syphilis

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3
Q

How are the components of donated blood stored?

A

Red cells; 4 degrees for 35 days
FFP; -30 for 3 years
Platelets; 22 degrees for 7 days with agitation

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4
Q

What blood components are available from donated blood?

A

Red cells
FFP
Platelets
Cryoprecipitate

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5
Q

What blood products are available from donated blood?

A

Anti-D Ig

Prothrombin complex - used in warfarin overdose

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6
Q

What are the most important antigens to match up when transfusing blood?

A

ABO

Rh D

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7
Q

On what chromosome is the ABO gene located?

A

9

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8
Q

What do A and B genes code for?

A

Transferases which modify precursors called “H substance” on the red cell membrane

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9
Q

What is the most common blood group?

A

O
Then A
Then B
Then AB

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10
Q

What is the genotype of group O and what antibodies are present in the plasma?

A

OO

Anti A and anti B

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11
Q

What is the genotype of group A and what antibodies are present in the plasma?

A

AA or AO

Anti-B

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12
Q

What is the genotype of group B and what antibodies are present in the plasma?

A

BB or BO

Anti-A

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13
Q

What is the genotype of group AB and what antibodies are present in the plasma?

A

AB

Neither

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14
Q

What is landsteiner’s law?

A

When an individual lacks the A or B antigen, the corresponding antibody is produced in their plasma

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15
Q

What % of the population are RhD positive?

A

85%

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16
Q

Is rhesus status autosomal dominant or recessive?

A

Dominant for positive rhesus status

17
Q

What can anti-D antibody reaction cause?

A

Transfusion reaction

Haemolytic disease of the foetus and newborn

18
Q

What are the aims of pre-transfusion testing?

A

To identify ABO and RhD groups

To identify presence of clinically significant red cell antibodies

19
Q

How can ABO be grouped?

A

Use reagents with known antibody specificity to identify antigens present on red cells
Use red cells with known antigen specificity to identify antibodies present in plasma

20
Q

What is the purpose of testing patient’s red cells with anti-A, anti-B and anti-D antisera?

A

Identify antigens on red cells

IgM reagents; direct agglutination

21
Q

What is the purpose of testing patients plasma against reagent red cells of group A and B?

A

Identify antibodies in the plasma

22
Q

How are antibodies screened for in the blood?

A

Tests patient’s plasma against several reagent red cells which express a known range of antigens
Identifies antibodies in the plasma
Use the indirect anti-globulin test (addition of anti-human globulin to plasma/ red cell suspension facilitates red cell agglutination)

23
Q

What does agglutination suggest in an indirect coombs test?

A

Presence of an antibody

24
Q

What is the final test done before a blood transfusion occurs?

A

Cross match to check the donor cells and compatible with patient plasma

25
Q

What does agglutination suggest in a crossmatch?

A

Donor cells are incompatible with patient plasma

26
Q

What are indications for red cell transfusion?

A

Symptomatic anaemia Hb <70 g/L (80g/L if cardiac disease)

Major bleeding

27
Q

What are the indications for a platelet transfusion?

A

Prophylaxis in patients with bone marrow failure and very low platelet counts
Treatment of bleeding in thrombocytopenic patients
Prophylaxis prior to surgery/ procedure in thrombocytopenic patient
Always consider cause before transfusion

28
Q

What are the indications for an FFP transfusion?

A

Treatment of bleeding in patient with coagulopathy (PT ratio >1.5)
Prophylaxis prior to surgery or procedure in patient with coagulopathy (PR >1.5)
Management of massive haemorrhage
Transfuse early in trauma
NOT in the absence of bleeding/ planned procedure

29
Q

How should a patient be monitored during a transfusion?

A

Observations before blood is commenced
Observations at 15 mins
Observations within 60 mins of completion

Haematology (31 decks)

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