transfusion medicie iv

8/7/2019 TRANSFUSION MEDICIE IV

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TRANSFUSIONTRANSFUSION

MEDICINEMEDICINE


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Indications for blood transfusionIndications for blood transfusion

Criteria for donor selectionCriteria for donor selectionScreening programScreening program

Blood transfusion reactionsBlood transfusion reactions


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Indications for blood transfusionIndications for blood transfusion

can be divided as follows:can be divided as follows: Whole blood transfusionWhole blood transfusion

Packed red cell transfusionPacked red cell transfusion

Granulocyte transfusionGranulocyte transfusion

Platelet transfusionPlatelet transfusion

Irradiated blood transfusionIrradiated blood transfusion

Cryoprecipitate transfusionCryoprecipitate transfusion


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Indications for whole blood transfusion:Indications for whole blood transfusion:

Actively bleeding patient with blood loss

Actively bleeding patient with blood lossgreater than 25%greater than 25%

Exchange transfusion ( blood


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Indications for granulocyte transfusion:Indications for granulocyte transfusion:

Bone marrow showing myeloid hypoplasia.Bone marrow showing myeloid hypoplasia.

Neutopenia


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Indications for irradiated blood transfusionIndications for irradiated blood transfusion::

Patients with congenital immunoPatients with congenital immuno--deficiencydeficiency

syndromes.syndromes.

Bone marrow transplant recipients.Bone marrow transplant recipients.

Premature new borns.Premature new borns.

Hematological malignancies.Hematological malignancies.

Indications for cryoprecipitate transfusion:Indications for cryoprecipitate transfusion:

Hemophilia AHemophilia A VonVon--Willibrands DiseaseWillibrands Disease

Congenital or acquired fibrinogen diseaseCongenital or acquired fibrinogen disease


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Donor selectionDonor selection

Age: 18Age: 18--60yrs60yrs

Sex: healthy male in every three monthsSex: healthy male in every three months

and female in every six months. Femalesand female in every six months. Femalesshould not be bled during menstruation,should not be bled during menstruation,

pregnancy and lactation.pregnancy and lactation.

Hemoglobin: >12.5gm/dl.Hemoglobin: >12.5gm/dl.

Weight: >50kg.Weight: >50kg.


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Transmission diseases: Those with a history ofTransmission diseases: Those with a history of

having suffered from or been in contact with orhaving suffered from or been in contact with or

are carriers of transmissible diseases likeare carriers of transmissible diseases likehepatitis, syphilis, malaria and HIV are to behepatitis, syphilis, malaria and HIV are to be

rejected.rejected.

Donor vaccinated against polio, yellow fever,Donor vaccinated against polio, yellow fever,measles and small pox within 3 weeks are notmeasles and small pox within 3 weeks are not

suitable.suitable.

Donor with an animal bite or antirabies vaccineDonor with an animal bite or antirabies vaccineor Hepatitis B immunoglobulinor Hepatitis B immunoglobulin deferred fordeferred for

one year.one year.


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CONDITIONSCONDITIONS PERIOD OF DEFERMENTPERIOD OF DEFERMENT

AbortionsAbortions 6 months6 months

H/o blood transfusionH/o blood transfusion 6 months6 months

AlcoholismAlcoholism Till intoxicatedTill intoxicated

Minor surgeryMinor surgery 3 months3 months

Major surgeryMajor surgery 6 months6 months

TyphoidTyphoid 6 months after recovery6 months after recovery

MalariaMalaria 3 months3 months

TattooTattoo 6 months6 months

Acute NephritisAcute Nephritis 6 months after recovery6 months after recovery


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CONDITIONSCONDITIONS PERIOD OF DEFERMENTPERIOD OF DEFERMENT

Breast feedingBreast feeding 6 months after delivery6 months after delivery

Immunization(Cholera,Typhoid,Immunization(Cholera,Typhoid,

Diphtheria, Tetanus, Plague,Diphtheria, Tetanus, Plague,

Gammaglobulin)Gammaglobulin)

24 hours after symptoms24 hours after symptoms

freefree

Rabies vaccinationRabies vaccination 1 year after bite1 year after bite

H/o hepatitis or closeH/o hepatitis or close

contactcontact

6 months6 months

immunoglobulinimmunoglobulin 12 months12 months

H/o JaundiceH/o Jaundice Not acceptedNot accepted


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No person shall donate blood and no blood bankNo person shall donate blood and no blood bankshall receive blood from persons suffering fromshall receive blood from persons suffering from

any of the diseases mentioned below:any of the diseases mentioned below:1.1. CancerCancer

2.2. Heart diseaseHeart disease

3.3. Abnormal bleeding tendenciesAbnormal bleeding tendencies

4.4. Unexplained weight lossUnexplained weight loss5.5. Diabetes controlled on insulin and oral drugsDiabetes controlled on insulin and oral drugs

6.6. Hepatitis B infectionHepatitis B infection

7.7. Chronic nephritisChronic nephritis

8.8. Signs and symptoms suggestive ofAIDSSigns and symptoms suggestive ofAIDS

9.9. Liver diseaseLiver disease


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Blood Transfusion ReactionsBlood Transfusion Reactions

Blood transfusion has undoubted benefitsBlood transfusion has undoubted benefitsbut some adverse effects do occur inbut some adverse effects do occur in

spite of all relevant tests and they arespite of all relevant tests and they are

commonly called blood transfusioncommonly called blood transfusionreactions.reactions.

Types of transfusion reactions:Types of transfusion reactions:

Hemolytic transfusion reactionHemolytic transfusion reaction NonNon--hemolytic transfusion reactionhemolytic transfusion reaction


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Signs and symptoms of hemolyticSigns and symptoms of hemolytic

transfusion reactions:transfusion reactions:

1.1. Burning sensation at the site of injectionBurning sensation at the site of injection

2.2. Flushing and feverFlushing and fever

3.3. ChillsChills

4.4. Pain in the backPain in the back

5.5. Shortness of breathShortness of breath

6.6. Hypotension/shockHypotension/shock

7.7. Disseminated Intravascular CoagulationDisseminated Intravascular Coagulation

(DIC)(DIC)

8.8. Acute renal failureAcute renal failure


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Causes of hemolytic transfusion reactionsCauses of hemolytic transfusion reactions::

Inadequate or incorrect labeling of blood.Inadequate or incorrect labeling of blood. Improper identification of the patient eitherImproper identification of the patient either

at the time of sample collection orat the time of sample collection or

transfusion of blood.transfusion of blood.

Errors in blood grouping.Errors in blood grouping.

Incompatibility not detected in crossIncompatibility not detected in cross

matching.matching.

Failure to detect weak antibodies.Failure to detect weak antibodies.


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Non hemolytic transfusionNon hemolytic transfusion

reactions can be classified as:reactions can be classified as: Febrile non hemolytic transfusion reactionFebrile non hemolytic transfusion reaction

Utricarial (allergic) transfusion reactionUtricarial (allergic) transfusion reaction

Anaphylactic transfusion reactionAnaphylactic transfusion reaction Non cardiogenic pulmonary edemaNon cardiogenic pulmonary edema

Circulatory overloadCirculatory overload

Graft versus host disease (GVHD)Graft versus host disease (GVHD)


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Measures to be taken in any suspectedMeasures to be taken in any suspected

transfusion reactions:transfusion reactions:

Stop transfusion.Stop transfusion.

Keep I.V. line open with normal saline.Keep I.V. line open with normal saline.

Inform the attending physician and bloodInform the attending physician and bloodbank.bank.

Check all the labels, forms and identity ofCheck all the labels, forms and identity of

patient to determine that the patientpatient to determine that the patientreceived correct unit of blood sent fromreceived correct unit of blood sent from

blood bank.blood bank.


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