Random
What can you give to an Rh-negative patient that you had to transfuse Rh-Positive platelets?
RHIG (for small amounts of RBCs present) (will clear out 30 mL of D+ RBCs from D- patient before their body can respond and start making Abs)
What is reduced in washed RBCs? When are washed RBCs indicated? Who washes the RBCs?
plasma proteins, leukocytes, platelets
Neonatal/intrauterine transfusions & ***alergic transfusion reactions (IgA deficient patients <7 Ab titer of IgA)
The reference lab
Which is more common/better to use, Platelets random or pheresis platelets? Why?
Pheresis because less risk of sensitizing the patient, equivalent to 6-8 random platelet units, increases by 30-60 x 10^9/L
What is the goal of blood bank?
provide the safest and most suitable blood product to meet the desired clinical outcome
What is Platelet refractory?
The lack of response to PLT transfusions
PLT count doesn't show improvement to expected levels based on amount transfused
How much volume is in a bag of packed red blood cells? What should the hematocrit of it be? What should 1 unit of PRBCS do to the patients Hgb and Hct?
250-300 ml
70-80% without a preservative
55-65% with AS1, AS3 or AS5
Increase Hgb by 1 g/dl and increased Hct by 3%
What is the pretransfusion testing for FFP?
Compatible with recipients RBCs
no crossmatch testing needed
What are the contraindications for FFP?
volume expander, nutritional source of protein, if more effective specific treatment is available (single factor replacements or Vit K for warfarin reversal)
What is platelet refractory caused by?
Antiplatelet abs or anti-HLA abs or other clinical conditions (DIC, fever, infection)
What is FFP? What is its shelf life and storage temperature? What volume does it normally have? What does it replace when transfused?
Fresh Frozen plasma that is removed from whole blood within 8 hours of collection
1 yr at -18 degrees
200-225 mL
labile and stable clotting factors
What are two examples of other therapies that could be used over blood component transfusions?
Crystalloid or Colloid
What are the pheresis indications and contraindications?
Indications: when you want to reduce exposure, thrombocytopenia in alloimmunized patients (HLA antibody or Anti-platelet antibody=crossmatched platelets)
Contraindications: Autoimmune idiopathic thrombocytopenic purpura, drug induced thrombocytopenia, Untreated DIC, Thrombocytopenia due to septicemia or hypersplenism, TTP (thrombotic thrombocytopenic purpura)
Increase red cell mass of symptomatic patients without overloading them with volume
increase oxygen carrying capacity in anemic patients (CHF, Chronic anemia due to renal failure/malignancy, or elderly)
What are the indications for FFP?
Management of multiple factor deficiency
Antithrombin deficiency and TTP (thrombotic thrombocytopenic purpura)
What are Deglycerolized RBCs? Who gets them? Where are they held?
RBCs frozen in cryopreservative agent which extends their shelf life to 10 years at -65 degrees
People with rare or high prevalence abs or patients who need plasma/leukocytes removed
Rare donor centers
What is the pretransfusion testing for platelets?
ABO/Rh
Match recipients RBCs if possible
No XM needed if less than 2mL RBCs present
What are the 4 major indications for a blood product transfusion?
Blood volume
O2 capacity
Hemostasis
Leukocyte reduction
What can you do to resolve platelet refractory?
Use HLA matched PLTS to resolve HLA abs
If antiplatelet abs use a PLT XM to detect abs to certain antigens
What are some contraindications of deglycerolized RBCs?
Very expensive and thought to transmit Hep B and C (not true)
What are the platelet random indications?
***Hypoproliferative thrombocytopenia from chemo/stem cell transplant or Prophylaxis when count <10,000/micro liter, Active bleeding due to thrombocytopenia of thrombocytopathy (not usually want to replace factors with plasma instead)
What are random platelets? What should they increase the plt count by? What is another term for pooled platelets?
separated from plasma during hard spin
5 day shelf life at RT
5.5x10^10 plts in 40-70ml of plasma(can be leukoreduced)
increase of 5x10^8/L
Pooled platelets
What is used to tell if a patient has Platelet refractory? What is the reference range?
CCI (Corrected count increments) (Platelet increment x BSA (m^2)/PLTs transfused(x10^11)
<7.5 CCI 1hr post transfusion
What are LR RBCs? What are the benefits of LR RBCs? What are the negatives to LR RBCs?
Reduces recurrent/ severe FNHTR (febrile non hemolytic transfusion reactions), Reduces risk of HLA alloimmunization, reduces risk of CMV (cytomegalovirus)
None it is cheap and effective
What are the platelet random contraindications?
Anything that chews up platelets because it wastes money and is not beneficial to the patient
Autoimmune idiopathic thrombocytopenic purpura, Drug-induced thrombocytopenia, Untreated DIC (treat underlying cause), Thrombocytopenia due to septicemia or hypersplenism, Thrombotic thrombocytopenic purpura
What is a contraindication for PRBCs?
Patient on EPO (Erythropoietin) which stimulates release of RBCs from BM