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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