TRANSFUSION MEDICINE II TRANSFUSION RISKS
Dr. Remedios Magkasi MD, FPSP -Transfusion of diseases during transfusion (HIV,
Transcribed by: Leoluis Nathaniel R. Uy, RN Hepa), window heap- presence of virus,
absence of antibody
DECISION TO TRANSFUSE BLOOD -Sensitization/ Immunization –test RBC not WBC
-Is it really indicated? -Transfusion reactons *safest blood > One’s
-Is the benefit greater than the risks? own blood, filter should be used
-What (Blood product) do you decide to give?
-When? SCOPE OF TRANSFUSION MEDICINE
-What precautions should you observe? 1. Blood Collection
-After transfusion? 2. Blood Processing
-If a transfusion reaction occurs, what type of 3. Preparation & Selection of Blood
reaction is it? What are the signs and 4. Components & Derivatives
symptoms? Prevention? (For Management) 5. Special Situations
-Artificial Blood… what is it? 6. Patient transfusion testing
7. Infusion of blood components
As a physician ordering a blood transfusion, one 8. Artificial blood
must be able to answer the above mentioned
questions otherwise there is ignorance and BLOOD COLLECTION
incompetence. Donor: increasing number of volunteer donors,
decrease the number of paid donors.
Transfusion Medicine
(Multidisciplinary Specialty)
A. REGISTRATION
-Used to register donors for future
Appropriate Blood Removal of existence
collection unqualified blood
B. SELECTION
-Assess donor’s state of health
USE -Determine if procedure is harmful to
Treatment the donor
Blood Components & -Identify if donor blood will be harmful
Derivatives to the patient
Disease Prevention
BLOOD COMPONENTS & DERIVATIVES C. MEDICAL HISTORY TAKING / MINI PE
-on the day of donation/ done in private
WHOLE -basic qualification is good health
-others:
PACKED RBC Platelet Rich Plasma 1) 18 -65 years old
Six years old should have parents
Platelet Concentrate Platelet Poor Plasma consent.
(FFP) 2) 50kg above : 450 ml
(No weight loss greater than 10 pounds)
CRYOPRECIPITATE CRYOSUPERNATE 40kg: 250ml
Factor VIII Concentrate 3) Temperature: 37.0-37.5 deg Celsius
Factor IX Concentrate 4) Pulse rate:
Systolic: 50-100
90-160 bpm regular
Diastolic 60-100
Other Coag Factors rhythm
PLASMA Fractionation
Albumin 5) BP:Female
6)HGB <180/100>12g/dl Male>12.5g/dl
Immune Globulins HCT Female>36 %
Rh Immune Globulin Male >38%
Anti-Thrombin III Concentrate
Leukocytes
D. Deferrals – from history taking d E. Phlebotomy
PERMANENT DEFERALS s Materials:
1)Cancer -Labeled donor bags
2)CHF/ Arrythmias -Tubes
3)Hepatitis/ Jaundice (+)HBsAg &anti-HBs -Record
4)Severe lung disease -Cotton balls
5)Use of prohibited drugs -Alcohol
6)High risk sexual behavior Tourniquet
7)High risk behavior
-STD exposure, hepa, HIV Donor in supine position
8)Past/Present STD Venipuncture: aseptic; closed
9)Prolonged bleeding container system
10)Sudden Weight loss -450ml +/- 10% 405-495ml
11)Chronic Alcoholism +63ml CDPA-1 or CPD
-30ml in test tube
TEMPORARY DEFERRAL
1)Previous blood donation
450ml: 3 mos
250ml: after 1 ½ mos
2)Acute febrile Illness
2-3weeks after recovery
3)Pregnancy
9mos. After delivery
3mos After weaning
4)Major Surgery
After 2 mos
5)Alcohol intake
After 12 hours
6)Skin lesion at the venipuncture site
2mos until healed
7)Unhygienic skin piercing/ tattoo
After 1 year
8)Malaria
After 3 years after cessation of S/Sx
9)Vaccines
CAT. 1 LIVE ATTENUATED (2wks after)
Measles, Polio, BCG, Yellow Fever,
Mumps
CAT2 Rubella (1mo.)
CAT 3 Rabies (1year)
10) Medications
-Antibiotics, OCT (Ok Anytime)
-Anti-TB (Until cured)
-Aspirin/ pyroxicam (Ok Anytime)
*not for platelate concentrate
-Anti-acne / retinoic acid (2mos after cessation)
