of the indications for administering specific blood com-ponents have been published.
SELECTING DONORSBlood Type
Many transfusion reactions can be prevented simply by following appropriate transfusion medicine guide-lines (see Preventing Transfusion Reactions in Dogs) when choosing donors, collecting and preparing bloodproducts, and administering these products to patients.Several of these points warrant further discussion.
Use of nonuniversal blood increases the risk of acutehemolytic transfusion reactions in a sensitized patientand might induce antibody formation in the recipi-ent.
These antibodies will decrease survival of donor red cells and sensitize the patient to additionaltransfusions. Transfusion of nonuniversal blood to abitch might lead to neonatal isoerythrolysis in puppiesthat are subsequently born.
Unless the blood type of the recipient is known, uni-versal blood should always be used.
A quick and ac-curate card test for dog erythrocyte antigen (DEA) 1.1 isnow available. This test allows for the immediate identi-fication of the DEA 1.1 status of donor and recipient.Donor dogs can then be typed for other important anti-gens by established laboratories.
Although mostdonors should have the universal blood type, donors of other blood types may be used when the recipient
sblood type is known to be compatible (DEA 1.1
posi-tive blood may be given to a DEA 1.1
Not all DEA groups have been well characterized, soa crossmatch should be performed for all dogs receivingred blood cells
even when universal blood is used.
A full crossmatch includes a major part (which tests forantibodies in the recipient
s blood to the donor
s redcells) and a minor part (which detects antibodies in thedonor
s blood to the recipient
s red blood cells).
Controls testing reaction of the recipient
s cells with itsown serum and the donor
s cells with its own serum arealso run. Unless large quantities of plasma are trans-fused, a minor crossmatch is unnecessary.
A major crossmatch is a superb screening test for in-compatibilities that could causeserious hemolytic transfusion re-actions.
This test is especially useful for patients that have beenpreviously transfused (antibodiescan form in as few as 4 days), inpatients with natural antibodies,and in multiparous females.
The major crossmatch (see theMajor Crossmatch protocol) issimple and can be performed inany clinic with a centrifuge, aheat block, and a microscope. Antigen
antibody reactionscan be temperature dependent.Consequently, the crossmatch isrun at 37
C, and 4
Red blood cells that show a reac-tion at 37
C or 25
C should notbe given. It may also be necessary to compare the results with theself-controls (especially in cases of immune-mediated hemolyticanemia) and determine a
transfusion.The incidence of hemolytictransfusion reactions will be re-duced by performing crossmatch-es when red cells are given. Even when blood showing a compati-
Type all donors—at least forDEA 1.1.
Screen for metabolic andinfectious diseases.
Use sterile technique whencollecting blood.
Use appropriate separationmethods, and store bloodproducts at suggestedtemperatures.
Perform a major crossmatch.
Use universal blood (unless thepatient
s blood type is known).
Consider the patient
s underlyingdiseases when choosingcomponents and administrationrate.
Administer diphenhydramine(0.5 mg/kg subcutaneously orintramuscularly).
use outdated or hemolyzedproducts.
Use only isotonic saline to dilutepacked red cells.
Warm blood products toappropriate temperatures.
Avoid mechanical damage tocellular components by usingappropriate pumps, filters, needlesizes, and administration rates.
Use warmed or open units within24 hours.
Complete each transfusion within4 hours.
Monitor transfusions carefully.
Preventing Transfusion Reactions in Dogs
*Screened and typed canine blood products can also be obtained from an establishedblood bank.