Transfusion

Question 1

What are the causes of splenomegaly?

Answer 1

• Due to involvement by lymphoproliferative disease
• The resumption of extramedullary haematopoiesis in myeloproliferative disease
• Enhanced reticulo-endothelial activity in autoimmune haemolysis
• Expansion of the lymphoid tissue in response to infections, or
• Vascular congestion as a result of portal hypertension

Question 2

What is cryoprecipitate?

Answer 2

Fibrinogen and coagulation factor concentrated from plasma by controlled thawing
10–20 mL pack contains:

Fibrinogen 150–300 mg

Factor VIII 80–120 U

von Willebrand factor 80–120 U

Question 3

What is transfusion-associated graft-versus-host disease (TA GVHD)?

Answer 3

It occurs when there is sharing of a human leucocyte antigen (HLA) haplotype between donor and recipient, which allows transfused lymphocytes to engraft, proliferate and recognise the recipient as foreign, resulting in acute GVHD

Question 4

What is the way to prevent acute transfusion associated GVHD?

Answer 4

Prevention is by gamma- or X-ray irradiation of blood components before their administration to prevent lymphocyte proliferation

Question 5

Who is at risk of transfusion associated GVHD?

Answer 5

Patients with congenital T-cell immunodeficiencies or Hodgkin lymphoma,
Patients with aplastic anaemia receiving immunosuppressive therapy with antithymocyte globulin (ATG),
Recipients of haematopoietic stem cell transplants or of blood from a family member,
Neonates who have received an intrauterine transfusion, and
Patients taking T-lymphocyte-suppressing drugs, such as fludarabine and other purine analogues.