Rav Hemo Kaplan Transfusion

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Allergic reactions occur in 1% of transfusions and range

Back 1

Allergic reactions occur in 1% of transfusions and range from the appearance of limited wheals to the development of diffuse urticaria with or without bronchospasm.

Front 2

Mild allergic reactions typically develop when patients receive

Back 2

Mild allergic reactions typically develop when patients receive plasma-rich blood components and generally do not recur during subsequent transfusions.

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before a transfusion is reasonable for patients who have already had one or two mild allergic reactions. P

Back 3

Giving an antihistamine before a transfusion is reasonable for patients who have already had one or two mild allergic reactions.

Front 4

Patients with multiple recurrent allergic reactions should be transfused with

Back 4

Patients with multiple recurrent allergic reactions should be transfused with washed erythrocytes or platelets, although washing reduces the effectiveness of platelet transfusions.

Front 5

Anaphylaxis after transfusion occurs in 1/50,000 transfusions and is often attributable to

Back 5

Anaphylaxis after transfusion occurs in 1/50,000 transfusions and is often attributable to IgA deficiency in the recipient. If anti-IgA antibody is present in the context of severe IgA deficiency in a patient requiring a transfusion, using blood components from IgA-deficient donors may prevent anaphylaxis.

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Strategies to Minimize Allogeneic Transfusions

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Strategies to Minimize Allogeneic Transfusions * Donor Screening
* Recombinant Erythropoietin
* Autologous Blood Transfusion
* Therapeutic Apheresis

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Donor Screening

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llogeneic blood donors in the United States undergo screening to provide a history of any high-risk behaviors and to test for transfusion-transmissible diseases. Testing is done for hepatitis B and C, HIV infection, human T-lymphotropic virus (HTLV) infection, West Nile virus infection, and syphilis. The estimated risk for viral disease transmission is 1 in 2 million transfusion units for HIV, 1 in 1.5 million units for hepatitis C, and 1 in 100,000 units for hepatitis B. Donor testing for Trypanosoma cruzi (the protozoan causing Chagas disease) has also recently become available.

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Recombinant Erythropoietin

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The use of recombinant erythropoietin for patients with chronic renal failure who require dialysis has virtually eliminated the need for transfusion in these patients. Erythropoietin may also be used to treat patients in earlier stages of chronic kidney disease, who typically have less severe anemia.hemoglobin level in these patients should be maintained at no higher than 11 to 12 g/dL

Recombinant erythropoietin has also reduced the need for transfusion in cancer patients undergoing chemotherapy.

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decreased survival WIYH USING Recombinant Erythropoietin

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However, several recent randomized clinical trials have reported that patients with head and neck cancer and metastatic breast cancer who received erythropoietin had decreased survival compared with controls.

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Therapeutic Apheresis

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Therapeutic Apheresis

Therapeutic apheresis is a continuous-flow process that separates whole blood into its components, removes abnormal components, and administers an appropriate replacement fluid.

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most common therapeutic apheresis procedure i

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Plasma exchange is the most common therapeutic apheresis procedure in which plasma containing abnormal proteins and antibodies is removed and replaced with albumin solution or fresh frozen plasma.

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Plasma exchange is considered standard therapy for patients with

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Plasma exchange is considered standard therapy for patients with acute and chronic inflammatory demyelinating polyneuropathy, myasthenia gravis, Goodpasture syndrome, cryoglobulinemia, hyperviscosity in patients with monoclonal gammopathies, and thrombotic thrombocytopenic purpura.

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Adverse events associated with therapeutic apheresis

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bleeding or infection from central venous access catheters or hypocalcemia from the use of citrate anticoagulant in the extracorporeal circuit.
Using plasma as the replacement fluid, such as for treatment of thrombotic thrombocytopenic purpura, confers the additional risks associated with plasma transfusion, such as allergic reactions and transfusion-related acute lung injury.