Transfusions and Adverse Reactions

What test is indicated for the detection of HLA antibodies?

lymphocyte panels

Why do liver transplant patients require plasma?

most coagulation factors produced in the liver

What is the length of time required for production of antibody in a delayed hemolytic transfusion reaction (DHTR) caused by an anamnestic immune response?

3 to 7 days

Records of a transfusion reaction must be retained for a period of:

5 years

What would be an example of an underlying cause of an immediate hemolytic transfusion reaction (IHTR)?

A patient with anti-K (or any other warm reacting, IgG antibody) in serum is transfused with K-positive red cells

Why is fresh frozen plasma (FFP) indicated for women with HELLP (hemolysis, elevated liver enzymes, low platelets)?

FFP contains an unknown substance that reverses symptoms of HELLP patients

Cryoprecipitate antihemophilic factor (AHF) contains factor VIII. What other coagulation factor is present?

Factor I (Fibrinogen)

Liquid plasma is not indicated for what factor deficiency?

Factor V

Factor IX concentrates contain which factors (otherwise known as "prothrombin complex")?

Factors II, VII, IX, X

When would transfusing non-specific blood be warranted?

If a type A individual who has been massively transfused with type O blood shows anti-A in their serum

Which of the following represent the pathophysiology of post-transfusion purpura (PTP)?

Platelet alloantibody attaches to platelet surface permitting extravascular destruction by RES

Which of the following urinalysis results represents hemolysis?

Reagent strip is positive for blood in absence of intact RBCs (microscopic)

A patient with paroxysmal cold hemoglobinuria (PCH) would require ____ in the event of a blood transfusion.

a blood warmer

What may be found in the sera of a person who is exhibiting signs of a noncardiogenic pulmonary edema reaction?

antileukocyte antibody

What is a possible mechanism for noncardiogenic pulmonary edema reactions?

antileukocyte antibody reacts in donor or patient plasma initiating complement mediated pulmonary capillary endothelial injury

Which of the following best describes a transfusion reaction?

any unfavorable transfusion-related event occuring in a patient during or after transfusion of blood components

Which of the following should be collected 5 to 7 hours after transfusion for unconjugated bilirubin determination?

clotted blood specimen

List three pathologic causes of a decreased red blood cell mass

compromised bone marrow production decreased red blood cell survival bleeding as a result of trauma

What two types of Rh-negative patients may permit transfusion of Rh-positive units when few O-negative units are available in an emergency?

elderly women/post-menopause women men

What is the most common preventable error that occurs among the nursing and medical staff that results in a transfusion-related death?

improper patient identification

What is the cause of death in graft-versus-host disease (GVHD)? How can it be prevented?

infection Pathogen Reduction treatment that involves, for example, by adding riboflavin and then exposure to UV light has been shown to be effective in inactivating pathogens like viruses, bacteria, parasites and white blood cells in blood products

A patient with two or more documented febrile nonhemolytic transfusion reactions (FNHTRs) should receive _____ blood components

leukopoor

A transfused patient has developed sepsis because of components contaminated with Escherichia coli. What contaminated components/products may have lead to this sepsis?

packed red blood cells normal saline platelets

What blood component is responsible for most allergic reactions?

plasma

Upon investigation of a delayed hemolytic transfusion reaction (DHTR), what should be included in the medical history?

previous transfusion pregnancies transfusion reactions

What is the best-tolerated form of transplantation in humans?

red blood cells

Which mechanism may play a role in fever development in a febrile nonhemolytic transfusion reaction (FNHTR)?

release of pyrogens from transfused white blood cells

What are three contributing factors towards the development of graft-versus-host disease (GVHD)?

transplantation of immunocompetent T lymphocytes HLA incompatibility between graft and recipient an immunocompromised recipient

Platelets prepared from what are referred to as random donor platelets?

whole blood units