Platelets Indications and Dosing

Blood platelets are currently manufactured in one of two ways. Whole blood donors may donate a unit of blood from which a platelet concentrate is manufactured. In this process, the unit of blood is subjected to two centrifugational steps. The first step is called a soft spin, which makes platelet rich plasma and a concentrated (packed) red cell. The platelet rich plasma is expressed from the bag and then subjected to a second centrifugation called a hard spin, after which the platelets are...

Delayed Blood Transfusion Reactions

The most important delayed posttransfusion reactions are shown in Table 33.1. All these reactions are very uncommon. The most common of these reactions is the occurrence of a delayed hemolytic transfusion reaction. Delayed hemolytic transfusion reactions (DHTR) are due to the technical failure to detect an antibody present in the patient's plasma or serum prior to transfusion. This is not to imply that a procedure was performed technically incorrectly, but that all techniques have limitations...

Blood Transfusion in Obstetrics

The major blood transfusion considerations in obstetrics are shown in Table 24.1. As physiologic preparation for blood loss at the time of delivery, the blood volume of a gravid woman is 60 more than that of a nonpregnant woman resulting in a dilutional anemia. It should be emphasized that patients can tolerate moderate anemia (hematocrit 18-25 , hemoglobin 6-8 g dl) if normovolemia is maintained. Blood transfusion is an uncommon event in obstetrics. Only 1 of vaginal deliveries require...

Life Threatening Acute Complications

Hemolyzed Lipemic Blood And Serum

The most serious adverse event associated with a red cell transfusion is the occurrence of acute hemolysis of the transfused red cells. This occurs when there is a pre-existing antibody in the recipient's plasma which reacts with the transfused red blood cells. Ordinarily, this is prevented by routine compatibility testing. Acute hemolytic transfusion reactions occur usually within five minutes of initiating the blood transfusion and primarily for this reason, early monitoring of vital signs...

Platelet Autoantibodies

Platelet autoantibodies are most commonly seen in idiopathic thrombocytopenic purpura ITP . It is important to appreciate that, although such patients may have low platelet counts lt 10 x 109 L , the platelets are larger in size and the hematocrit is usually normal. This differentiates these patients from other patients with thrombocytopenia, such as acute leukemia, where the platelets are normal or reduced in size and the hematocrit usually decreased. Patients with ITP may show evidence of...

Neonatal Thrombocytopenia

Polycythemia Graft For Hyperviscosity

This may result from impaired production or increased destruction of platelets. Platelet transfusion is often indicated in neonates and young infants with Table 25.2. Indications for exchange transfusion All components used for intrauterine transfusion or in neonates of 1.2 Kg or less must be irradiated and should have a reduced risk of CMV transmission such as seronegative donors, deglycerolized, leukocyte reduced by filtration. They must be cross match compatible with maternal serum. 1....

Blood Transfusion in Medicine V Acute Gastrointestinal Bleeding

Gastrointestinal bleeding as a clinical entity accounts for a significant proportion of all red blood cell transfusions and such patients require a prompt response in component availability from the Blood bank. Although acute spontaneous gastrointestinal bleeding has some similarities to transfusion problems seen in patients with massive trauma Chapter 14 , patients with trauma undergoing massive transfusion are usually hemostatically normal prior to the onset of the trauma, and hence,...

Hematological Malignancies In Adults

The major hematological malignancies requiring blood transfusions are the acute leukemias, advanced stage lymphomas, myelomas, myeloproliferative and myelodysplastic disorders. Early stage lymphomas and many of the chronic leukemia in early stages are uncommonly associated with blood transfusion. There are several important blood transfusion considerations in adults with hemato-logical malignancies. In general, it is preferable to use leukoreduced blood for all patients with he-matological...

Red Cell Autoantibodies

Blood Bank Antibody Chart

A classification of red cell autoantibodies is shown in Figure 22.1. Red cell autoantibodies are arbitrarily divided into cold and warm antibodies, but the distinction is not absolute. Cold antibodies are antibodies which preferentially agglutinate red cells at low temperatures. They characteristically agglutinate red cells at 4 C and at room temperature 22 C , but tend not to cause agglutination at 37 C. Warm antibodies on the other hand tend to be inactive at room temperature but do cause...

Informed Consent and Explanation of Blood Options

One of the most important and difficult areas in clinical transfusion medicine is the question of informed choice consent for blood transfusion and an adequate explanation to potential blood recipients of blood options All Blood Options . In understanding informed choice, it is important to appreciate the following 1 There is a need to discuss the risks, benefits, and alternatives to blood transfusion and to ensure and that the potential recipient or his her representative has an opportunity to...

Compatibility Testing and the Importance of Proper Recipient Identification

Crossmatch Technique Blood Bank

Compatibility testing is the major process which separates the transfusion of red blood cells from the administration of other types of pharmaceutical products Chapter 1 . The purpose of compatibility testing is the avoidance of a hemolytic reaction. This is of cardinal importance, since some types of hemolytic reactions can result in a fatal outcome. The technical procedures used in compatibility testing have undergone significant changes over the past few decades. The critical steps in this...