Blood Tranfusion

Question 1

Common reasons red cells are transfused ?

Answer 1

Alleviate signs symptoms of anaemia due to blood loss or disease
Increase oxygen carrying capacity

Question 2

Common reasons platelets are transfused ?

Answer 2

Treat or prevent bleeding in patients with thrombocytopenia (low platelet count) or patients on anti platelet drugs

Prevent bleeding for patients with low platelet due to bone marrow problems

Question 3

Common reasons plasma are transfused ?

Answer 3

Plasma contains proteins, clotting factors and antibodies and separated or process into a number of products :

1. Fresh frozen plasma: contains coagulation factors and plasma proteins and is used to treat bleeding or to reduce the likelihood of bleeding with clotting factor deficiency patients
2. Cryoprecipitate: Contains a number of clotting proteins and is commonly used to treat bleeding and to reduce the likelihood of meeting with fibre fibrinogen is low
3. OtherBlood components: Plasma can be further separated into albumin clotting factor concentrate and immunoglobulins

Question 4

Common causes of anemia and management

Answer 4

1. Haematinic deficiency (iron, B12, folate) - taking supplements / transfusion
2. Blood loss
3. Iatrogenic blood loss - Minimise blood loss from surgery and blood sampling collections
4. Decreased Erythropoietin Production - use Erythropoietin stimulators

Question 5

Transfusion risks

Answer 5

Contracting disease (HIV) due to cross contamination

Transfusion Associated Circulatory Overload (TACO)

Transfusion Related ACUTE Lung Injury (TRALI)

Haemolytic reactions due to blood group compatibility

Allergic reaction

Question 6

What Hb concentration require red cell transfusion ?

Answer 6

<70g/L

Question 7

What is irradiation of transfusion products ?

Answer 7

Irradiation of cellular blood components prevents transfusion associated graft versus host disease which is usually Fatal. Irradiated blood components are used in certain patients or situations:

- Congenital cellular immune deficiencies
- Hodgkin’s lymphoma
- stem cell and bone marrow transplant recipients
- patients treated with certain immunosuppressive drugs

Question 8

What is a cytomegalovirus (CMV) seronegative blood?

Answer 8

Blood components that minimise the risk of transfusion transmitted CMV infection a common virus typically carried by leucocytes which may lead to severe or fatal disease in some patients

considered for use in certain patient groups: Neonatal, pregnant, haematology oncology patients, immuno suppressed patients and transplant recipients

Question 9

What does washing red cells mean?

Answer 9

Removing residual plasma (containing plasma protein which may be the cause of allergic reaction) as well as white cells and platelets

Washed red cells are only required in very specific clinical situations: Patients that have experienced severe allergic reaction or reactions to transfused plasma proteins

Question 10

In non emergency setting how long can red cell be infused for? 

Answer 10

1-3 hours but always within 4 hours

Question 11

The request for pre-transfusion testing

Answer 11

Cross match group
Indication for transfusion
past transfusion history
clinical details such as presenting issue, morbidities, relevant medication history
Pregnancies
history of past transfusion reactions