Transfusion Flashcards
Clinically Significant antigens
Cc D Ee MNSs Kk FyaFya JkaJkb Lea Leb
Blood grouping method
ABO grouping - direct agglutination either via tube or CAT.
Fwd: pt red cells + monoclonal anti A, B, D + control. Inc room temp and spin. Score 0,w,1-4
Rvs: pt plasma + reagent red cells A,B, control. Inc at room temp, spin and read 0,w,1-4
Crossmatch
Required before issuing blood products.
Electronic, immediate spin and IAT(extended)
Isohaemagglutinins
IgM (can also be IgG
Acute haemolytic transfusion reaction
ABO mismatch > IgM > Overwhelming complement activation > shock, renal failure DIC
What is the purpose of testing donations at Lifeblood?
To allow appropriate selection of blood for transfusion, identify unsuitable donors, and minimize adverse consequences of transfusion.
What mandatory tests are performed on fresh blood components for transfusion?
- ABO and RhD blood groups
- Red cell antibody screening
- Syphilis serology
- Viral screening for HIV 1 and 2 antibodies and RNA
- Hepatitis B virus surface antigen and HBV DNA
- Hepatitis C virus antibodies and HCV RNA
When are apheresis platelet collections and buffy coat derived pooled platelets sampled for bacterial contamination screening?
At or after 36 hours post collection.
What additional donation testing may be performed at Lifeblood?
- Confirmatory testing
- Screening for antibodies to CMV
- Screening for human T-lymphotropic virus (HTLV)
- Screening for malaria
What type of facilities perform the tests at Lifeblood?
TGA licensed facilities accredited for good laboratory and manufacturing practices.
What happens if a screening test for infectious disease is confirmed reactive?
The donation is destroyed, and the donor is notified and counselled as part of standard Lifeblood procedures.
What criteria must be met before blood components are labelled for release?
- Donor selection criteria have been met
- Mandatory viral screening is non-reactive
- Blood grouping results have been confirmed
- Red cell antibody screening is complete
- Product quality is acceptable as per defined component specifications.
What testing is performed on donations collected exclusively for plasma fractionation?
- Infectious diseases screening for HIV, HBV, and HCV
- No testing for HTLV 1/2, syphilis, or blood group
- Antibody screen only if the donor was transfused or pregnant since last donating.
What external laboratory is engaged by CSL Behring for testing, and what tests do they perform?
An external laboratory performs hepatitis A and parvovirus B19 nucleic acid testing (NAT) on plasma supplied by Lifeblood.
When did CSL Behring start the additional testing for hepatitis A and parvovirus B19?
From April 2025.
Are hepatitis A and parvovirus B19 release tests for fresh component transfusion?
No.
What actions does Lifeblood take upon receiving positive results for hepatitis A and parvovirus B19?
Performs product recall and clinician notification where the component has been transfused.
What is the primary complication of haemolytic disease of the newborn (HDN)?
Anaemia and jaundice
HDN occurs due to maternal alloantibodies causing immune haemolytic anaemia in the neonate, leading to these complications.
What are the two types of transfusion indicated for a low birth weight neonate with HDN?
Simple transfusion or exchange transfusion
These transfusions address the complications of haemolysis in neonates with HDN.
What diagnostic tests are used to diagnose alloimmune haemolytic anaemia in neonates?
CBE, film, reticulocyte count, bilirubin, and DAT
If DAT is negative, IAT may be performed to confirm diagnosis.
Which blood group incompatibilities are less likely to lead to significant haemolysis?
ABO incompatibility
Rh D and certain minor blood group antigens, like Rh C, E, or Kell, are more likely to cause significant haemolysis.
What type of red cells should be used for all neonatal transfusions?
CMV seronegative, paediatric leukodepleted red cells
This is crucial to minimize the risk of transfusion-related complications.
When should irradiated red cells be used for exchange transfusion?
If the neonate had IUT or meets other criteria
Low birth weight or prematurity alone is not an absolute indication for irradiation.
