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BB Week 1
Donation and units
| Question | Answer |
|---|---|
| Clinical significance of ABO Antibodies | IgM and activate complement |
| Anti-A,B reagent | Used to confirm Type O donations |
| Anti-A,B antibody | Produced in some Type O patients and is a separate antibody from Anti-A or Anti-B; reacts with BOTH A and B |
| ABO Inheritance Pattern | Codominant |
| Type O Prevalence | Roughly half in all races |
| Type A Prevalence | 40% in whites, roughly 30% for everyone else |
| Type B Prevalence | 20% in Black/Asian, 10% in Hispanic/White |
| Type AB Prevalence | 7% in Asian, roughly 3% for everyone else |
| Se gene | Determines if ABH antigens are found in secretions |
| H gene | Adds L-fucose to the terminal Galactose on an oligosaccharide chain on RBC surface |
| A-Antigen | Gal-Nac |
| B-Antigen | D-Gal |
| Bombay Phenotype | hh Genotype. Cannot produce H antigen, will type as O despite genotype but IS INCOMPATIBLE WITH O. Anti-H is an IgM that reacts at 37C. |
| Maximum collection of blood for donation | 10.5 mL per kg body weight |
| Minimum weight for donation | 110 lbs or 50 kg |
| Minimum age for donation | 16 or state law |
| Hgb needed for donation | 12.5 g/dL females or 13.0 g/dL males |
| Hct needed for donation | 38% females or 39% males |
| Temperature needed for donation | Less than 99.5 F or 37.5 C |
| Blood pressure needed for donation | Systolic: 90-180 mmHg; Diastolic: 50-100 mmHg |
| Time needed to wait between WB donations | 2 weeks |
| What if the donor took medication that irreversibly alters PLT function within the last 48 hours? | PLTs may be used as a pool but not the sole source |
| Hepatitis B Immunoglobin | 1 year deferral |
| Possible exposure to HIV, hepatitis, or malaria | 1 year deferral |
| Recipient of blood products | 1 year deferral |
| Tattoo (unless at a state regulated facility) | 1 year deferral |
| Skin puncture or mucous membrane exposure to blood or bodily fluid | 1 year deferral |
| Living with or had sex with someone who is HIV, HBsAg or HBV NAT positive; is symptomatic for Hep C or any viral hepatitis; or is in high-risk category | 1 year deferral |
| From the date of completion of treatment of syphilis, gonorrhoeae, or reactive STS | 1 year deferral |
| Traveled to area endemic for malaria | 1 year deferral |
| Spent more than 72 hrs in a correctional facility | 1 year deferral |
| Immigrant from an area endemic for malaria | 3 year deferral |
| Previously diagnosed with malaria but is now asymptomatic | 3 year deferral |
| Viral hepatitis after age 11 | Permanent or indefinite deferral |
| Confirmed HBsAg or HBV NAT positive test | Permanent or indefinite deferral |
| Repeatedly reactive for anti-HBc or anti-HTLV | Permanent or indefinite deferral |
| Sole donor after a recipient developed post-transfusion HIV, hepatitis, or HTLV | Permanent or indefinite deferral |
| Previous infection with HTLV, HCV, T. cruzi, or HIV | Permanent or indefinite deferral |
| Evidence of parenteral drug use | Permanent or indefinite deferral |
| Family history of CJD | Permanent or indefinite deferral |
| History of babesiosis | Permanent or indefinite deferral |
| Expiration of units with ACD, CPD, or CPD2 | 21 days |
| Expiration of units with CPDA-1 | 35 days |
| Expiration of units with additives | 42 days |
| Purpose of rejuvenating solutions | Restores 2,3-DPG and ATP |
| Storage of units with rejuvenating solutions | Frozen or at 1-6 C if used within 24 hours (must wash cells to remove solution!) |
| Requirements for autologous donations | No age limit, Hct +33%, Hgb +11 g/dL, no bacteremia, and collected >72 hours prior to need |
| Waiting period between donation of PLTs or WBCs | At least 2 days apart and no more than 2 within one week (if donated RBCs, must wait 8 weeks) |
| Waiting period between donating 2 unit RBC apheresis | 16 weeks |
| A 3 unit RBC donation must not decrease donor's Hct and Hgb below... | Hct: not below 30%; Hgb: not below 10 g/dL |
| Guidelines for allogenic marrow donation | HLA identical match lowers risk of GVHD; ABO compatibility NOT required |
| Tests performed on donor blood | ABO, Rh (+ wk D if Rh neg), Antibody screens, Serologic tests, Tests for viral diseases |
| Serologic tests done on donor blood | RPR for syphilis and antibody to T. cruzi |
| Viral disease tests done on donor blood | Hepatitis C and B, HIV, Zika, HTLV, West Nile |
| Use for whole blood | Massive volume loss in trauma or shock |
| How much does 1 pRBC raise the Hgb by? | 1 g/dL |
| How much does 1 pRBC raise the Hct by? | 3% |
| Changed in plasma in RBC storage over time | NH4 and K+ rises while pH and Na+ lowers |
| Criteria for a unit of RBCs to be returned | Unopened seal and less than 10 C |
| Purpose of washed RBCs | To prevent anaphylactic shock in IgA deficient patients who have antibodies to IgA; Removes complement; Removes maternal anti-HPA-1a for neonatal transfusions |
| RBC storage | 1-6 C for: 21 days (ACD, CPD, CPD2), 35 days (CPDA-1), 42 days (Additive), or 24 hours (open system) |
| Apheresis leukoreduced RBC QC | >51 Hgb or >42.5 Hgb in 95% units tested |
| Frozen RBC storage | 10 years at -65C in 40% glycerol or -120C in 20% glycerol; good for 24 hours once thawed and rinsed |
| Fresh Frozen Plasma or FFP24 storage | 12 months at <-18C or 7 years <-65C |
| Cryoprecipitated AHF storage | 12 months at <-18C |
| Purpose of Leukoreduced RBCs | Prevents febrile nonhemolytic (FNH) reactions, HLA alloimmunization, and transmission of CMV |
| FFP Preparation | Centrifuged from WB and frozen within 8 hours of collection |
| FFP Expiration | 1 year if stored at <-18C, 7 years if at <-65C OR within 24 hours of thawing if 1-6C |
| Uses for FFP | Multiple coagulation deficiencies, Factor XI deficiency, or deficiencies where there is no concentrate available |
| Ideal collection from FFP | Males or never pregnant women to prevent TRALI |
| PF24 | Plasma frozen to <-18 within 24 hours of collection |
| How Cryoprecipitate is made | Precipitate formed when FFP from WB collection is thawed at 1-6C |
| What's in cryo? | Fibrinogen, vWF, Factor VIII, Factor XIII, fibronectin, ristocetin cofactor activity |
| How long cryo is good for after collection | <-18C for 1 year |
| How long cryo is good for once thawed | 6 hours if closed system, 4 if open system |
| Most common uses for cryo | Replace fibrinogen loss due to DIC or massive bleeding, or for dysfibrinogenemia with active bleeding |
| Use for Factor VII concentrates | Treats moderate to severe Hemophilia A |
| Transfusion treatment for vWD | Factor VIII concentrates containing vWF |
| Transfusion treatment for Hemophilia B | Prothrombin complex concentrates (contains Vit K dependant factors, FII, FVII, FIX, FX) or Factor IX concentrates |
| Treatment for patients with Hemophilia A or B with inhibitor antibodies (causing FVIII to be bypassed) | Recombinant activated Factor VIIa |
| Uses for DDAVP | Synthetic hormone used for mild hemophilia A and type 1 vWD by increasing circulating vWF (releases from endothelial cells) and FVIII |
| PLT storage | 5 days at RT with agitation |
| How long PLTs are good for once in open system | 4 hours |
| PLT preparation from WB | 1) Light spin to remove RBCs 2) Heavy spin to remove plasma and WBCs |
| Uses for PLTs | Thrombocytopenia and platelet dysfunction |
| PLT transfusion is NOT recommended for... | TTP, ITP, and Heparin Induced Thrombocytopenia (HIT) |
| Usual cause for dysfunction in PLT refractoriness | HLA or platelet specific antibodies |
| How much 1 unit of PLTs raise PLT count by | 5000 to 10,000 per uL |
| How much 1 APHERESIS unit of PLTs raise PLT count by | 20,000 to 60,000 per uL |
| Why we keep small volume of plasma in PLT units | To maintain pH above 6.2 |
| Does Rh matter for PLTs? | Only if Rh- women of childbearing age receive Rh+ unit due to residual RBCs. May need Rhogam. |
| Use for granulocyte pheresis | Neutropenic patients with GN sepsis not responsive to antibiotics |
| Potential complications of granulocyte infusions if not IRR | Transmission of CMV, GVHD, alloimmunization of HLA antibodies |
| Storage of granulocytes | RT without agitation for 24 hours or ASAP |
| Do granulocytes need to be ABO compatible? | YES. XM if >2mL RBCs. |
| Uses of IRR RBCs | Prevents GVHD in: neonates, transfusions with relatives or HLA-matched donations, or congenital immunodeficiency |
| Outdate for IRR RBCs | 28 days or original expiration, whichever comes first |
| Expiration of RT products when seal is broken (pooled or packed) | 4 hours |
| Expiration of refrigerated products when seal is broken (pooled or packed) | 24 hours |
Created by:
rachelkayw