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Haematology > Transfusion Medicine > Flashcards

Flashcards in Transfusion Medicine Deck (19)
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1
Q

What is an acute haemolytic transfusion due to?

A

Usually related to ABO incompatibility

Recipient pre-formed antibodies coating and lysing donor cells

2
Q

What causes a delayed haemolytic transfusion reaction?

A

Anamnestic antibody response occurring after re-exposure to a foreign red cell antigen previously encountered in transfusion, pregnancy or transplant

3
Q

How does delayed haemolytic transfusion reaction present?

A

3-30 days after transfusion mild fever, jaundice, slight drop in Hb
Spherocytes on blood film

4
Q

What causes febrile non-haemolytic transfusion reactions?

A

Recipient antibodies against donor leucocytes and HLA antigens on leucocytes

5
Q

Prevention of febrile NHTR?

A

Leucodepletion of blood products

6
Q

What is an urticarial transfusion reaction?

A

Reaction to plasma proteins in donor products

7
Q

Symptoms of urticarial transfusion reaction?

A

Widespread rash without other symptoms of anaphylaxis

8
Q

Prevention of urticarial transfusion reaction?

A

Washing of blood products

9
Q

What are symptoms of an acute haemolytic transfusion reaction?

A

Fever, chills, pain at site of infusion
Back pain, chest pain
Hypotension, tachycardia
Haemoglobinuria, haemoglobinaemia

10
Q

Who does anaphylaxis to blood products mostly occur in?

A

IgA deficiency

11
Q

Prevention of anaphylaxis to blood products?

A

Give IgA deficient plasma
Washed products

Screen all who have had anaphylaxis to blood for IgA def

12
Q

What is transfusion-associated graft vs host?

A

Donor t- lymphocytes recognise recipient HLA antigens as foreign and mount ann immune response and engraft in bone marrow

13
Q

Symptoms of transfusion related GVHD?

A

Fever, diarrhoea, raised LFTs, rash, marrow aplasia, death within 3-4 weeks. No tx available

14
Q

Patients at risk of transfusion related GVHD and prevention?

A

HSCT, immunocompromised, fludarabine, transfusions from family members

Prevent by giving irradiated products

15
Q

What is TRALI?

A

Acute lung injury

Donor HLA antibodies bind recipient leucocytes which Lyse and cause increased permeability of capillaries in lung

16
Q

Clinical feature of TRALI?

A

Acute resp distress within 6 hours of transfusion

Bilateral infiltrates on cxr

17
Q

Prevention of TRALI?

A

Avoid donations from multiparous women, esp plasma

18
Q

What is the most common blood product to be contaminated with bacteria?

A

Platelets

19
Q

How can CMV transmission be reduced in blood products?

A

Most effective CMV negative donors

Leucodepletion does reduce risk