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blood bank stuff

blood bank guy notes practical

QuestionAnswer
What types of RBCs should be issued with massive transfusion protocol? O negative for young women. For males and postmenopausal females, it’s reasonable to BEGIN by using O-positive blood in emergencies
List causes of warm autoimmune hemolytic anemia 1) Idiopathic (~ 50%) 2) Malignancies (CLL, NHL) (~25%) 3) Autoimmune disease (SLE) 4) Drugs (α-methyldopa)
Triggers for Neonatal RBC Transfusions (Birth to 4 months) Generally higher RBC transfusion thresholds than in adults; common thresholds follow: 1) No symptoms: 8 g/dL 2) Cardiopulmonary disease, major surgery: 10 g/dL 3) Severe cardiopulmonary disease: 12-13 g/dL
Why is ABO compatibility more of a concern in neonatal platelet transfusions? 1) Minor ABO mismatch that is ok in adult PLT transfusions may be disastrous in neonates 2) Remember incompatible plasma and smaller baby volumes; keep ABO compatible if at all possible
Describe the ASFA categories for therapeutic apheresis a. Category I: TA accepted, proven for primary therapy b. Category II: TA accepted, useful for 2 nd -line therapy c. Category III: TA not proven but might be helpful d. Category IV: TA not helpful and may be harmful
Most common type of HDFN ABO HDFN
Why are ABO HDFN generally mild or undiagnosed? 1) Weak ABO antigen expression in utero 2) Soluble plasma ABO antigens neutralize antibodies
Describe blood types of ABO HDFN Group O moms, group A or B babies
Obstetric indications for Rhogam a) D-neg female at about 28 weeks gestation b) D-neg female < 72 hours of D+ infant’s birth c) D-neg female with pregnancy complications or invasive procedures (amnio, cordocentesis)
How much blood does a full dose of Rhogam cover? One full dose vial (300 g or 1500 IU) per 30 ml of D+ whole blood (15 ml D+ RBCs)
Why is HDFN particularly severe with anti-K? Anti-K attaches to K antigen on early RBC precursors and causes severe fetal anemia
Created by: jfshikle