1. Blood Products and
Transfusions
By b conrad

2. When should you consider rbc
transfusion?
 Hb <80g/L

3. How do you treat iron
overload?
 Desferrioxamine or venesection
 Desferrioxamine mesilate is an iron chelating
compound
 Can be given with the transfusion

4. How often do you do obs whilst
giving a transfusion?
 Every ½ hour

5. 1 unit will raise an Hb by how
much?
 1-1.5g/dL

6. For red cells and platelets
which is universal donor and
reciever?
 Platelets- O= universal reciever AB= universal donor
(Abs are in the plasma)
 RBC- O= universal donor AB= universal reciever

7. What is FFP used for?
 Clotting defects
 DIC
 Warfarin overdose
 Liver disease
 Note- ffp carries all the risks of blood transfusion

8. Which product is used as
replacement in abdominal
paracentesis?
 Albumin
 Contains no coagulation factors
 Used in hypovolaemia- burns, shock, multiple organ
failure.
 Colloids are an alternative (dextrans, gelatin,
hydroxyethyl starch)
 Note- colloids have high molecular weight molecules
that largely remain in the intravascular space, so
create a greater oncotic pressure. (see colloids paper
on desktop)

9. List 6 early (<24h) reactions of
transfusion?
 Acute haemolytic reaction
 Anaphylaxis
 Bacterial contamination
 Febrile reactions
 Fluid overload
 Tranfusion-related acute lung injury (TRALI)

10. What are the clinical features
of Acute haemolytic reaction?
 ABO incompatible -> intravascular haemolysis
 Fever
 Rigors
 Hameoglobinuria
 Hypotension
 Renal failure
 Atypical antibodies from previous transfusions or
pregnancy ->intra or extravascular haemolysis with
anaemia, jaundice, splenomegaly, fever

11. How do you manage acute
haemolytic reaction?
 Stop transfusion
 Check identity and name on unit
 Tell hameatologist
 Send unit + FBC, U&E, clotting, cultures and urine
(hamoglobinuria)
 Keep IV line open with 0.9% saline
 Treat DIC

12. List delayed (>24h)
complications of transfusion?
 Infections- viruses, hepatitis, hiv, bacteria, protozoa,
prions
 Iron overload
 Graft-versus-host disease
 Post transfusion purpura

13. What is Direct Coombs test
and Indirect Coombs test?
 Direct Coombs= test for autoimmune haemolytic
anaemia
 Indirect Coombs= prenatal testing of pregnant
women, and in testing blood prior to a blood
transfusion. It detects antibodies against RBC’s that
are present unbound in the patients’s serum.

14. What type of red blood cells is
used for neonates?
 Fresh whole blood (<5 days post-collection)

15. What is Autologous donation?
 Patients donate their own blood prior to a major
surgery. Several sessions. They receive iron.
Donations are screened for infection in the usual way.

16. How many donors are needed
for one bag of platelets? Do
platelets need to be cross
matched?
 5x1010 platelets in 50-60ml
 Shelf life 4-6 days
 5 pooled units
 Group ABO and Rh compatible but not cross matched

17. When does a patient possibly
need platelets?
 <50 x 109/L if bleeding or going for surgery
 <10 x 109/L if infection or bleeding

18. Who needs irradiated
products?
 Foetuses
 Premature neonates
 Stem cell transplant recipients
 Severely immunocompromised