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
