Term
| What is the most commmon cause of transfusion reactions? |
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Definition
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Term
| Name 4 signs of acute hemolytic transfusion reaction (AHTR). |
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Definition
| 1) Fever 2) ARF 3) Hypotension 4) Tachycardia |
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Term
| Sx of AHTR? How fast do the onset of s/sx occur? |
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Definition
| Chills, lower back pain, anxiety. <24hr. |
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Term
| Why does hemolysis result in renal failure? |
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Definition
| ARF d/t acidic Hb released by destruction of RBCs |
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Term
| What is AHTR usually related to? |
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Definition
| ABO blood group incompatibility resulting in rapid destruction of RBCs by host Ab |
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Term
| What is the most severe type of ABO incompatibility resulting in AHTR? |
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Definition
| Type A RBCs given to pt w/ type O blood |
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Term
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Definition
| (+) DATs, elevated BUN/Cr, bili, and Hb, dec. haptaglobin (plasma protein that binds to free Hb) |
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Term
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Definition
| 1) Stop transfusion 2) Goal UOP >1mg/kg/hr 3) Analgesics 4) Pressors 5) Give blood prod. PRN |
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Term
| What is the most common transfusion reaction? |
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Definition
| Febrile Non-Hemolytic Transfusion Reaction (FNHTR) |
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Term
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Definition
| 1) Fever 2) Chills 3) HA 4) Vomiting |
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Term
| 3 common causes of FNHTR? |
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Definition
| 1) Recipient HLA Ab a/g donor WBC 2)Cytokines in donor or recipient causing immune response 3) Rx b/t granulocytes, lymphocytes or plt that cause an immune response |
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Term
| Are DATs negative or positive in FNHTR? |
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Definition
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Term
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Definition
| 1) Antipyretics 2) Stop transfusion until afebrile 3) Give leukocyte reduced products |
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Term
| What occurs in a mild allergic transfusion reaction? More severe allergic reaction? |
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Definition
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Term
| Sx of uticaria transfusion reaction? |
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Definition
| Hives, flushing, pruritis, can have mild angioedema |
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Term
| What is the cause of uticaria transfusion reaction? Treatment? |
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Definition
| Ab to donor plasma protein. Antihistamine. |
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Term
| 6 sx of an anaphylactic transfusion reaction? |
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Definition
| 1) Hypotension 2) Severe uticaria 3) Bronchospasm 4) Systemic edema 5) Resp. distress 6) Uncontrollable wheezing |
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Term
| Cause of anaphylactic transfusion reaction? |
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Definition
| Ab to donor plasma protein (type I hypersensitivity) including IgA, haptoglobin, C4, and other cytokines |
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Term
| Tx for anaphylactic transfusion reaction? |
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Definition
| 1) Trendelenberg position 2) Epinephrine 3) If known anti-IgA or IgA def. give product from IgA def. donor or washed RBCs |
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Term
| Bacterial sepsis is usually associated w/ what blood product? |
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Definition
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Term
| 5 signs of bacterial sepsis transfusion reaction? |
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Definition
| 1) Fever 2) Chills 3) Hypotension 4) Tachycardia 5) Shock |
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Term
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Definition
| 1) Broad spectrum Abx 2) Tx shock 3) Inc. UOP if HUS |
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Term
| What transfusion reaction presents w/ HTN instead of hypotension? |
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Definition
| Transfusion Associated Circulatory Overload (TACO) |
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Term
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Definition
| 1) Dyspnea 2) Orthopnea 3) Productive cough 4) Tachycardia 5) HTN 6) HA |
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Term
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Definition
| 1) Upright posture 2) O2 3) IV diuretics 4) Therapeutic phlebotomy in 250ml increments (if d/t RBCs) |
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Term
| what lab finding may indicate a pt has DHTR (delayed hemolytic transfusion reaction)? |
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Definition
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Term
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Definition
| Fever and mild jaundice occuring 1-3 days /p transfusion |
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Term
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Definition
| Ab to blood groups other than ABO (Rh D, Kidd, Duffy, MNS, Kell) |
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Term
| DHTR is rarely fatal except in what situation? |
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Definition
| Hemolytic Disease of the Newborn (Rh D antigen) |
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Term
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Definition
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Term
| 6 s/sx of Graft vs. Host Disease (GVHD)? |
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Definition
| Erythroderma, maculopapular rash, fever, V/D, pancytopenia |
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Term
| What is GVHD typically related to? |
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Definition
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Term
| How is GVHD prevented? Tx? |
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Definition
| irradiation of blood products. No tx once it occurs. |
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Term
| What is the prognosis of GVHD TA? |
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Definition
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Term
| 4 risk factors of GVHD TA? |
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Definition
| 1) Immunocompromised 2) Newborns 3) CA (leukemia and lymphoma) 4) Blood from close relative |
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Term
| When is iron overload seen w/ tranfusion? Lab findings? Tx? |
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Definition
| Massive transfusion (>100 units). Elev. ferritin and LFTs. Iron chelators. |
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Term
| When does hypocalcemia occur in blood transfusion? Why? |
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Definition
| Rapid/large blood transfusion. Anticoagulant will bind out ionized Ca. |
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Term
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Definition
| Tetany and arrythmias. Ca supplementation. |
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Term
| what causes post transfusion purpura? |
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Definition
| recipient platelet Ab that destroy autologous platelets. Shows TP and bleeding 8-10 days /p transfusion. |
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Term
| Tx for post transfusion purpura? |
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Definition
| IVIG or crossmatched platelets |
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Term
| Other than hypotension and fever common to transfusion reactions, what additional signs could suggest transfusion related acute lung injury (TRALI)? |
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Definition
| Respiratory failure, bilateral pulm. edema |
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Term
| Why do many blood centers no longer accept plasma donations from women? |
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Definition
| Women have higher levels of HLA Ab - higher risk of TRALI |
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Term
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Definition
| Only tx is supportive care |
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