Transfusion medicine random notes

: Coombs test: elution of cold autoantibody uses anti-complement. elution of warm autoantibodies as antiIgG


Half-life of immunoglobulin G 21 days
Immunoglobulin a monomer in serum but it dimers in secretions

Most likely bacterial contaminant In packed red blood cells Gram-negative rods particularly your Sennea because They like the cold I like iron

Transfusion reaction summary
Hepatitis B 1:220K
Hepatitis C 1:1.8 million
H I V one and 2.3 million


Red blood cell
Intravascular hemolysis: 1:250,000 to 1 in 1 million Mortality is 3.5% Clinical management: Stop transfusion intervenous hydration Maintain renal perfusion Allergic three and 1000 -Only transfusion Reaction where you can restart after pre medication Anaphylaxis one and 17,000 -Most likely etiology anti-immunoglobulin a antibiotic- Don't bother getting an IGA level just get anti-IGA because isotype variation Febrile nonhemolytic: Secondary to anti-granulocyte antibiotics. Stop the transfusion. Dear antipyretics and meperidine for severe rigors


TRALI -transfusion related acute lung injury- One in 5000 presents between three and six hours normally with ARDS picture Most likely etiology of agranulocyte antibodies from the donor-Donor must deferred Platelet Donors are mostly male now because lower risk of leukocyte allo-sensitization

Transfusion associated circulatory overload TACO One 700 presents as dyspnea cough cyanosis chf exacerbation Management is diuresis and supportive

Transfusion related sepsis one and 500,000 for red blood cells 1:12,000 for platelets Red blood cell associated sepsis higher mortality rate

Delayed hemolytic - One in 7000- anamnestic immune response to RBC antigen - Patient will require antigen negative RBC

Graft versus host:- 1:400,000
etiology Lymphocyte contamination Cellular Products the setting of immune compromised host
Presentation is normally between four and 10 days posttransfusion 90% mortality rate
Prevention is with irradiated blood products



Post transfusion Purpura: 1:200k'
Presentation is DIC picture between one and 24 days after transfusion Etiology is antiplatelet antibody Lysis of transfused and autologous platelets Treatment is intravenous immunoglobulin and plasma exchange Patient will require antigen negative platelets or washed products going forward


Iron overload: At least greater than 50 RBC transfusion