Term
| Immediate Transfusion Rxns |
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Definition
| Allergic,Febrile,Hemolytic(intravascular,ABO), |
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Term
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Definition
| Thermal or mechanical, DAT will be neg with all nonimmune rxns |
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Term
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Definition
Extravascular hemolytic,Infectious Disease Jka often implicated will now be IAT+ |
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Term
| What tests are done in transfusion rxn workup? |
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Definition
| ABO,RH,IAT,DAT, Recheck cross match |
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Term
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Definition
| Mom must be Rh= pos IAT w/ D on panel Baby DAT+ Baby Rh+ (beware of masked D from mom aby) |
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Term
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Definition
| mom 0 type IAT= Baby A or B type (mom IgG culprit) Baby DAT weak |
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Term
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Definition
| ABO, Rh, Du, IAT, 1:32 titer sig, fetal screen, Look for weak Du on prev D neg mom for ^ fetal bleed |
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Term
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Definition
| ABO, Rh, DAT, Rh cont pos if DAT+ (use poly spec aby forDAT) may have blocked D when moms anti D titer is high |
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Term
| Blood selection for Amnio |
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Definition
| <5 days old, CMV=, irradiated, ag neg for mom's aby, O neg for inutero, leuko deplete and washed |
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Term
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Definition
| ABO compat w/ mom and baby Rh= if anti D or =baby, otherwise use + Agn neg for mom's aby: group O if neg crossmatch w/ mom or baby eluate |
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Term
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Definition
| confirms what is on cells Lui freeze for ABO:acid or digitonin for others |
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Term
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Definition
| 5 siblings to get 99% acuracy only 25% for 2 |
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Term
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Definition
| If donor becomes HIV+, look back at previous records so we can notify them |
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Term
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Definition
| innactivates lymphs (GVH) will not help refractory plt issue. given to babies and immunocomprimized |
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Term
| can HIV be transmitted by pooled cryo? why higher risk than lypolized fact 8 |
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Definition
| yes, pooled products increase chances b/c from multiple donors. Fact 8 exposed to high temps to kill virus |
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Term
| If I and K abys are present, what phenotype of blood should be given and what precautions be made? |
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Definition
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Term
| what should be given if plt count is norm, PT increased, and PTT increased? |
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Definition
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Term
| could somone who is healthy w/ a hematocrit of 38% have an autologous donation? |
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Definition
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Term
| why are plts likely to be contaminated by bacteria? |
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Definition
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Term
| what Hep virus can be contracted from transfusion? |
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Definition
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Term
| what blood loss can occur and the patient still feel well? |
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Definition
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Term
| examples of immune transfusion reaction? |
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Definition
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Term
| what is an example of delayed adverse rxn? |
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Definition
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Term
| BM transplant, which is more important HLA or ABO? |
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Definition
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Term
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Definition
| decreased hematocrit and increased bilirubin |
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Term
| has the p24 HIV agn test eliminated the window period? |
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Definition
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Term
| when would you not want to salvage blood? |
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Definition
| Cancer such as tumor removal |
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Term
| how much will random platelets increase the platelet count? |
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Definition
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Term
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Definition
| 22-25 days western blot to screen |
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Term
| bacteria implicated in most transfusion bacteremia cases |
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Definition
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Term
| current testing on all units |
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Definition
| ABO, RH/weak D,IAT,hep b,HCV,HIV,HTLV,syphilis,West Nile Virus |
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Term
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Definition
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Term
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Definition
| 10-500 none, 20-1000 increased HR w/ exercise and Hypotension when standing, 30-40 to>1500 dec CO ^pulse SOB Cold, 40/50-2500 shock and death |
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Term
| when blood volume is low, is BV or O2 carrying capacity more important? |
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Definition
| Blood Voume, use crystalloids (saline or tringers) or colloids (albumin or dextran sulfate) |
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Term
| is FFP recommended for volume expansion? |
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Definition
| No, b/c of increased risk of infectious disease |
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Term
| Adverse physiologic consequences of massive transfusion (7) |
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Definition
| Dilutional Thrombocytopenia,Dilutional coagulopathy,Acid base imbalance, citrate toxicity,hypothermia,immunosuppression, potassium overload |
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Term
| What happens to diluted blood stored over 7 days |
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Definition
| Platelets and grans do not work much and fact V and VIII less, citrate toxicity, < 2,3 DPG left shift |
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Term
| What can occur if citrate toxicity gets too bad? |
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Definition
| metabolic acidosis or cardiac arrest. |
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Term
| Impact of rapid infusion of cold blood? |
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Definition
hypothermia, cardiac arrest
cannot metabolize citrate or regenerate 2,3 DPG, metabolize drugs or control acidosis |
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Term
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Definition
| DIC,factor deficiencies,platelet disorders |
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Term
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Definition
| treat primary disorder, FFP, platelets or cryo |
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Term
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Definition
| FFP contains all factors, For hem A use cryo, fact IX for hem B, mild VonW use DDAVP, fact I use cryo |
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Term
| liver disease multiple BB problems |
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Definition
decreased platelets (splenomegaly)
decreased clotting factors
iron folate problems
USE FFP AND PLATELETS
use 15-30 units during a liver transplant |
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Term
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Definition
fluid and protein loss, electrolyte imbalances, infection
give crystalloids for volume and grans to fight sepsis |
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Term
| Auto Immune Hemolytic Anemia |
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Definition
Try not to transfuse
make sure its not an allo
phenotype |
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Term
| Problem with cardiopulmonary Bypass? |
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Definition
| Platelets destroyed by pump |
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Term
| Sickle and thalassemia, what to use? |
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Definition
Iron chelation for thalassemia
hypyer transfuse sickles before surgury to keep HS S at 30%,
Give fresh, phenotype |
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Term
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Definition
| Use own blood, safest, collect ahead, can be drawn up to 72hrs before |
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Term
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Definition
| at least 33%, the higher, the more you can give |
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Term
| intraoperative hemodilution |
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Definition
| once asleep, take out two units and replace w/ IV fluids, fewer red cells lost this way. Blood taken at beginning of surgury and reinfused at end of surgery |
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Term
| intraoperative blood salvage |
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Definition
| half of blood shed can be salvaged, suction site collection, |
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Term
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Definition
leuko deplete, irradiate to decrease GVHD. crates problems when person is in the process of changing blood types, can still have aby's to new blood type or chimeras (2 populations)
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Term
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Definition
| RBC and PLTs, use single donor HLA matched or PLT crossmatch. Do autologous peripheral stem cell collection and give back later |
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Term
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Definition
| Remove RBCs, Remove plasma(Abys), remove T lymphs (GVHD), Remove malignant, freeze |
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Term
| Potential Problems Incompatible Bone Marrow Transplantation |
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Definition
ABO major incompat Donor A Patient O hemolysis in BM Minor incompat Donor O Patient A Hemolysis of patients RBCs by aby in marrow RH Donor neg, Recipient Pos hemolysis by donor aby produced after engraftment |
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Term
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Definition
Remove aby's coating the cells
Lui freeze best for ABO HDN (wash, freeze, thaw to release aby) react w/ cells at 37 and AHG |
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Term
| ELu 2 (digitonin) or ether |
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Definition
Best for Rh and other abys
use when baby +DAT and mom +IAT and blood type does not indicate ABO HDN |
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Term
Eluate plus A= cells
Reaction+ interpretation? |
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Definition
| Anti A, antiB or Anti A,B |
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Term
Eluate plus B= cells
Reaction+ interpretation? |
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Definition
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Term
Eluate plus B= cells
Reaction = interpretation? |
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Definition
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Term
Eluate plus O+ cells
Reaction+ interpretation? |
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Definition
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Term
| when to do exchange transfusion on Baby? |
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Definition
if anemic and bilirubin is high or >20md/dl of indirect bilirubin.
will lower bilirubin, remove mom aby and damaged rbcs. Double crossmatch using mom's serum and baby's serum or eluate |
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Term
| Most common reason for neonatal transfusions? |
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Definition
| Replace blood drawn for lab tests |
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Term
| what do we use for babies instead of CPDA-1? |
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Definition
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Term
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Definition
| Dantibody injected IM to unsensitized Rh neg moms who deliver a Rh + baby |
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Term
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Definition
| given at 28 weeks and w/in 72 hrs of birth. . 99% reduced HDN from 13% |
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Term
| mechanism of moms sensitization to babies Rh |
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Definition
| babies blood gets into mom (injuries or placenta tear) allowing mom to build up abys |
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Term
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Definition
| 28weeks, mom will have +IAT from time given to deliver, mom must be Rh-, Du neg and have no anti D already developed, baby will be DAT+ |
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Term
| When is fetal screen +? what to do next if +? (test for fetal bleed) |
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Definition
| mothers cells w/ anti d, inc/wash. add Rh+ indicator, more than 7 rosettes per 5 fields =>15ml bleed. Do Kleihauer-Betke |
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Term
| Kleihauer-Betke stain (Done if + fetal screen) |
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Definition
| Acid elutes adult cells leaving fetal pink and adults as ghosts. Determine % # of fetal cells x100/500cells= %fetal next % fetalx50= ml of fetal bleed |
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Term
| one vial of Rhig will clear how much of a fetal bleed? |
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Definition
| 15ml of RBCs which corresponds to 30ml fetal bleed |
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Term
| Determine amount of Rhig to give mother |
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Definition
| ml of fetomaternal bleed/30= # of vials to give (always give one more) |
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Term
| final hct for intrauterine transfusion? |
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Definition
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Term
| If First IAT is negative on baby? |
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Definition
| Crossmatch does not need to be done for first baby until four months of age |
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Term
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Definition
| on most nucleated cells of the body |
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Term
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Definition
Encoded by MHC
genes on short arm of chromosome 6
causes rejection of transplanted organs/tissue |
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Term
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Definition
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Term
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Definition
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Term
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Definition
| can detect patient A,B,C agn or aby. patient serum incubated w/ panel of known agns. complement added, if agn/aby complex, complement will destroy cell |
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Term
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Definition
D antigens
donor cells zapped w/ mitomycin preventing proliferation, donor mixed w/ recipient. If cells not identical for D lymph enlargement and blasts occur |
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Term
| best test for BM transplant HLA matching? |
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Definition
| PCR amplification, best for matching class IID agns |
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Term
| HLA important for what transplants? |
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Definition
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Term
| HLA for liver, lung, heart and pancreas? |
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Definition
| No, use immunosuppressive drugs instead |
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Term
| series of importance for matchinG a solid organ HLA |
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Definition
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Term
| series of importance for HLA crossmatch in BM or stem cells |
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Definition
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Term
| HLA matching easy to find a donor? |
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Definition
rare to find a match in unrelated donor
Even w/ a HLA match, there is a 20-50% failure |
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Term
| what does a + platelet procedure look like? |
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Definition
| no indicator cell button (don't use +) we use negative (will have cell button) |
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Term
| B27 HLA found in what diseases? (3) |
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Definition
| ankylosing spondylitis, reiter's, rheumatic arthritis |
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Term
| HLA in rheumatic arthritis |
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
| Juvenile Diabetes mellitus |
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Definition
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Term
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Definition
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Definition
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