Blood transfusion – allogenic transplant, bi most dangerous medicine

1. indication - ?

2. blood product specification check (quality)- date

3. price – 50,000-90,000 MMK

4. One blood unit – Donar, recipient screening : TTI, Hb %, Blood gp, RH

donar screening: forms, Hb assessment

Thalasaemia patients infectious disease need HBV varus

TTI transfusion transmitted infection screen : rapid test

Type and screen

Blood component preparation (rare whole blood)

Storage:
Screening: A,B,C,Syphilis

1. Hepatitis screening : Profile is the best.

Window period (seroconversion period)

B – antigen

C – antibody

Immunosilent period

***Indication***

Laboratory error: need to match with clinical, Poor quality Lab, reagents (exp

Hormone Test)
Cellular: RBC- Packed red cell, WBC, Platelet

Fluid or Plasma: Fresh Frozen Plasma, Platelet Rich Plasma, Factor Conc:, Albumin
Whole blood

Stored whole blood – no platelet , no haemostatic properties, not indicated for

blood

Store: 2-6’C

Less transmission disease, trepenema, malaria cannot survive

Fresh whole blood – 4’C , less than 4 hr

Very few indication: actively bleeding with loss>25% of blood volume

Max/day: ?

Contra: Chronic Anemia- fluid overload, cardiovascular not well (need packed cell)
Blood Components Therapy

Albumin, immunoglobulin,

Plasma component fast(frozen) > cellular

Donar – education recruitment selection

Citrate – anticoagulant

Filter WBC (leukoreduction)- febrile reaction, TRALI

Packed red cell 250

Transfusion checklist

1. guideline

2. consent patients
3. monitor – 15min -1hr

4. response

Red cell indication: complex

1. not only Hb conc:

2. but also on cause of anemia (underlying), morbidity (CKD- Potassium, Fluid

overload)

<8 have CVS disease

Hypoxia – radiosensitivity decrease

Platelet

150-250 ml/unit

Prophylactic- to minimize the risk of bleeding Platelet 2 (150-400NL)

Therapeutic- to control bleeding

Marrow failure – leukemia, aplastic anemia

Not appropriate ITP- due to antibody, give steroid,

TTP-
HUS-

HIT-

Fresh Frozen Plasma

220-250ml

Indication:

Warfarin overdose – normally vit k

Warfarin in Emergency reversal – deficient factors (vit k induce 2,7,9,10) FFP

Cryoprecipitate – FFP at 1-6’C

Contains: Factor 8, 13, Fibrinogen, vWF (20-30-40 percentage of original FFP)

No Factor 9 – no appropriate Haemophilia B

Response:
1. immediate relatives?

2. massive- citrate calcium hypo