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Flashcards in Haematology Transfusion Deck (69)
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1

Blood Donors

1. Healthy volunteer donor
2. Age 17-70 (no age limit for regular donors)
a. Medically assessed
i. History
ii. Medication
iii. Travel
b. Fingerprick Hb
i. Women >12.5
ii. Men >13.5 g/dl
3. 450 ml collected, up to every 12 weeks

2

Apheresis donation and therapy

• Selective removal of the component required platelets or plasma (occasionally red cells)
• Up to 3 adult doses of platelets/donor visit
• Also used for therapeutic removal of plasma/WBC/platelets

3

Processing

• Leucocyte depletion – reduces WCC reaction to recipiant
• Split into red cells/platelets/Plasma
• Special processes (to order): irradiation, washing, hyper-concentration

4

Blood components available

Plasma
Platelets (Granulocytes) – rare cases
Red cells

5

Plasma

Fractionated plasma proteins – albumin/clotting factors
Fresh frozen plasma (for clotting factors)
Cryoprocipitate – rich in fibrinogen

6

Red cells: Used for

Blood loss
Anaemia

7

Red cells: Storage

In additive solution
• 280+/-60 ml (slightly more concentrated)
• 0.5-0.7 haematocrit
Risk of bacterial infection post refrigeration (only 4hrs transfusion time)

8

Red cells: Shelf life

35 day shelf life at 4 degrees

9

Platelet Concentration: Used for

Thrombocytopenia
Platelet dysfunction

10

Platelet Concentration: Collection process

Pooled from 4-6 donors

11

Platelet Concentration: Apheresis

Single donor

12

Platelet Concentration: Storage

22 +/- 2oC (room temp) for 5 days on an agitator (7 days if bacterial screening)

13

Fresh Frozen Plasma: Used for

Replacement of clotting factors

14

Fresh Frozen Plasma: Storage

Plasma fraction frozen to -30oC
Stored up to 3 yrs
20 mins to defrost
Infuse with 4 hours

15

Fresh Frozen Plasma: Virally inactivation via and used for

Children and if using large volumes:
• Methylene Blue Treatment
• Solvent detergent treatment

16

Cryoprecipitate: Formed

Precipitate formed when defrosting FFP – rich in fibrinogen (Factor 8)

17

Cryoprecipitate: Contain

Rich in fibrinogen
Factor 8
VWF

18

Cryoprecipitate: Used

For fibrinogen supplementation – mostly bleeding patients

19

Cryoprecipitate: Virally

Inactivation (methylene blue) available

20

Fractionated blood products: Prepared from

They are pharmaceutical products
Prepared from pooled plasma from many donors

21

Fractionated blood products: Contain

Albumin
Clotting factor concentrates
Intravenous immunoglobulin
Disease – specific immunoglobulin

22

Hazards of Transfusions

1. Unavailable blood
2. Transfusion transmitted infections
3. Immunological reactions
4. Overloading:
a. Iron
b. Fluid

23

Lack of Blood







WHO:
1. Each year, more than 500000 women die needlessly during pregnancy or childbirth
2. Severe bleeding can kill even a healthy woman with 2 hrs if she is unattended = 44% of maternal deaths in Africa
3. Up to one-fourth of all maternal deaths could be saved by access to safe blood transfusion
4. Also happens in developed worl – usually organisational problems

24

Transfusion transmitted infection: virus

HIV
HBV
HCV
CMV
HTLV1
Parovirus
West Nile Virus

25

Transfusion transmitted infections: Protozoa

Malaria
Trypanosomes
Syphilus

26

Transfusion transmitted infections: Bacteria

Staphylococci (Skin)
Yersinia

27

Transfusion transmitted infections: Prions

CJD (4 documented cases)

28

Prevention of Infections:

1. Donor Selection – volunteer vs. paid
2. Testing of blood
3. Pathogen inactivation –
4. Avoiding transfusion

See pg27 for effectiveness of testing for infections

29

Immunological reactions: Red cells

Blood Groups: (polymorphic proteins)
• Immediate haemolysis
• Delayed Haemolysis
• Haemolytic disease of the newborn

30

Immunological reactions: Platelets

Post transfusion purpura
HPA – human platelet antigens

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