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Blood Banking HDN

Hemolytic Disease of the Newborn

Define HDN and list the 3 types ABO, Rh and other alloantibodies Mainly Kell but can be kidd, duffy, et.c
Hemolytic Disease of the Newborn is a disease characterized by the destruction of fetal/newborn RBCs resulting from the placental transfer of maternal alloantibody.
Fetal-maternal hemorrhage is passage of red cells from the mother to the fetal circulation as a result of placental transfer or at delivery.
Extramedullary erythropoiesis is production of red cells outside the bone marrow.
Antepartum before delivery
Postpartum after delivery
Kernicterus a grave condition resulting in the passage of bilirubin into the brain and spinal cord.
Toxic levels of bilirubin in a newborn’s brain during the first 2 to 8 days of life, can cause permanent brain damage;
any level > 18mg/dL
Hydrops fetalis clinical condition in infants characterized by cardiac insufficiency with resultant edema and respiratory distress.
Erythroblastosis fetalis hemolytic disease associated with anemia, jaundice, spleenomegaly, edema, and the presence of immature red cells in the circulation (erythroblasts). Another name for HDN.
B19 parvovirus causes fifths disease. Red cheeks, no treatment, there is vaccine. Can cause spontaneous abortion .
With ABO HDN it can happen when with the first pregnancy.
Immediate hemolytic reaction TX of incompatible RBC/whole blood; anti-A, Kell, Jka, Fyasymptoms = intravascular = fever, oliguria, anuria, death, nausea, back or chest pain, vomitingprevention = follow all procedures/policies to ensure safe
Delayed hemolytic reaction secondary response to transfused RBC Symptoms = fever, chills, mild jaundice Prevention = thorough medical history documenting any previous TX, pregnancies, transplants
Febrile reaction antileukocytic antibodies in patient’s plasma Symptoms = 1 C rise in temperature associated with TX and having no medial explanation other than TX
Anaphylactic or anaphylactoid reaction anti-IgA in patient’s plasma Symptoms =occur after TX of only a few ml of plasma or plasma-containing components;coughing, breathing trouble, hives, chest pain, shock, death Prevention = total plasma removal
Allergic reaction allergen complexes = histamine release Symptoms =redness,itching and hivesPrevention = pre-medicate with Benadryl
Bacterial contamination endotoxins produced by bacteria capable of growing in cold; Pseudomonas, E. coli and Yersinia enterocolitica Symptoms = “warm” reaction; dryness and flushing of skin
Prevention strict adherence to component collection, storage, handling and preparation procedures, visual observation of units, Tx within standard maximum allowable time limit = 4 hours
Circulatory Overload massive TX at too fast a rate Symptoms = breathing trouble, coughing, cyanosis, headache Prevention = slow rate of TX = 100mL/hr; aliquot blood
Name three reactions considered to be delayed non-hemolytic reactions Post-transfusion purpura TX-associated graft-versus-host disease Iron overload
Name four diseases transmitted by blood. Hepatitis B, C HIV HTLV-I/II West Nile Virus
Describe kernicterus toxic levels of bilirubin in a newborn’s brain that causes permanent brain damage
Created by: Mgoodall