Removal of whole blood from a donor / recipient for the purpose of isolating a specific component or components, and then transfused back into the patient or discarded if components are septic of cancerous.
3 techniques to perform apheresis?
Process in which granulocytes are separated from whole blood?
Autologous and allogenic peripheral blood stem / progenitor cells (PBSCs / PBPCs) are isolated from whole blood by what pocess?
Removal of diseased or defective components from an individuals blood?
Diseased plasma can be removed and then replaced with what ?
Therapeutic Apheresis is used to treat what conditions?
- Waldenstrom’s macroglobulinemia
- Myasthenia gravis
- HYperviscosity syndrome
- Leukocytosis caused by leukamias
Intraoperative blood salvage is the collection of blood that has been shed at the operative site during major surgery. This blood is collected and then re-infused into the patients. During which circumstances would this procedure be contraindicated?
- Bladder surgery / urine
- Open Bowel Surgery
- Amniotic Fluid
Shed mediastinal blood collected from chest tubes, washed and reinfused. What is this procedure called?
Shed blood collection from post-operative drainage
Advantage of shed blood collection ?
reduced donor exposure to RBC
Disadvantage of shed blood collection ?
Plasma proteins washed away (does not improve clotting status)
How can you reduce the prime volume ?
- Retrograde Autologus Prime
administered by injection to reduce bleeding during complex surgery, such as heart and liver surgery. Its main effect is the slowing down of fibrinolysis, the process that leads to the breakdown of blood clots. The aim in its use was to decrease the need for blood transfusions during surgery.
Aprotinin Binds with the human serine proteases; which decreases affinity. Name all 7 of them?
- Plasma kallikrein
- Tissue kallikrein
– Epsilon amino caproic acid (EACA)
– Tranexamic acid (TA)
Synthetic antifibrinolytics that form reversible
complex with plasmin or plasminogen, preventing the lysis of fibrin
Dosage of Amicar ?
100-150 mg/kg + 10-15 mg/hr
2 Amicar Stats ?
– Blood loss reduced from 900 to 600 in first 24 hours
– Transfusion reduced from 4.2 - 2.8 units in 72 hours
Used to stimulate erythropoiesis preoperatively.
- Simultaneous IV & IM administration 1 - 2 weeks pre-op.
- Several days to a week pos-op
- AKA DDA VP
- Synthetic Vasopression w/o the vasoconstriction effect.
- Mechanism: Increases circulation of VWF, VII, FVII and increases platelet adhesion.