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Lecture 29

Transfusion Medicine II

What situation indicates the tranfusion of whole blood? When both red cells and volume are needed.
Why can't an A or B blood type individual be transfused with large volumes of O whole blood? The anti-A and anti-B antibodies in the O plasma will eventually react with the recipient's cells causing hemolysis.
How much serum is found in a unit of packed red blood cells? About 20 cc per unit
What ABO type can recieve type O packed red blood cells? All ABO groups
What ABO type can recieve any ABO type packed red blood cells? Blood type AB
What is the general indication for packed red blood cells? When the patient exhibits signs and symptoms of an oxygen-carrying deficit.
How many tranfusions of D-positive blood can be given to an D-negative individual? Only one.
What are the indications for transfusion of fresh frozen plasma? 1)Acquired coagulopathies where PT and PTT > 1.5 times the upper limit of normal 2)Factor replacement for bleeding where no factor concetrate is available.
What ABO type can recieve type AB fresh frozen plasma? All ABO groups
What ABO type fresh frozen plasma can be safely transfused into a type O recipient? Type O fresh frozen plasma
What are the indications for platelet transfusions? 1)Plt count < 50,000 and there is either hemorrhage or an invasive procedure anticipated 2) prophylaxis when plt count <10,000 3) when there bleeding int he presence of a qualitative plt defect
What are the ABO compatibilty requirements for safe transfusion of platelet concentrates. None. Platelets of any ABO type can be transfused into any recipient.
Can a D negative patient be immunized aganist the D antigen from platelet concentrate transfusion? Yes, a few red cells may be present in platelet concetrates; therefore a D negative patient can be immunized by a platelet product from a D positive donor.
What complication can occur with chronic platelet transfusions? Antibodies can be formed aganist HLA antigens present on transfused platelets. Once these antibodies are made, they can accelerate platelet destruction.
What can prevent alloimmunization to HLA antigens from frequent platelet concetrate transfusion? Use of leukocyte reduced blood products
What are the indications for leukocyte reduced blood products? 1)Prevent recurrent febrile nonhemolytic transfusion reactions 2)Prevent transmission of CMV in patients where CMV infection is life threatening 3)Prevent alloimmunization to platelets
What are leukocyte reduced blood products? Blood products which have been filtered to remove 3 to 4 logs of white blood cells.
What types of blood products require leukocyte reduction? Platelet concetrate and red blood cells
What blood products do not require leukocyte reduction? Fresh frozen plasma and cryoprecipitate becuase WBCs do not survive the freezing process.
What is the therapy for febrile nonhemolytic transfusion reaction? Acetaminophen and observation
A transfusion reaction characterized by a temp elevation of 1 deg C or more during or within 2 hours of a transfusion. Febrile nonhemolytic transfusion reaction
A transfusion reaction characterized by an immediate type I hypersensitivity reaction caused by exposure to foreign proteins in the transfused unit. Urticaria
What are the consequences of transfusion of ABO incompatible whole blood transfusion? 1)Acute intravascular hemolytic transfusion 2)Hypotension with ensuing renal failure 3)Activation of the coagulation cascade with DIC
How long after a transfusion does delayed extravascular hemolytic transfusion reaction present? typically 7-9 days after transfusion
What subtype of immunoglobulin are responsible for the delayed extravascular hemolytic transfusion reaction? IgG that were too low a titer to be detected by the antibody screen.
Created by: UVAPATH4



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