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29 Cards in this Set

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Pre-Transfusion Testing

  1. Request for transfusion (blood order) and informed consent
  2. ID of transfusion pt and blood sample collected
  3. Testing of transfusion recipient's blood samples
  4. Donor RBC unit testing
  5. Donor RBC red cell unit selection
  6. Compatibility testing (Crossmatch)
  7. Label unit with recipients ID information
  8. Release for admin

What is done first: testing of transfusion recipient's blood sample or Donor RBC testing

Testing of transfusion recipient's blood sample

Once a Donor RBC unit is selected what testing is done

Compatibility testing (crossmatching)

Clinically significant antibodies can cause

  1. Decreased survival (or decreased lifespan) of transfused cells
  2. Hemolytic transfusion reaction (HTR) - Immediate or delayed
  3. HDFN

Informed consent

  • Physician requests for transfusion
  • Physician fully explains risks of transfusion to patient
  • Patient must give signed consent for transfusion before any blood product is administered

A request for a transfusion requires:

A prescription

WBIT

Wrong blood in tube

Pre-analytical error

  • Most common cause of mistransfusion worldwide

The most critical step in pre-transfusion testing

Positive Identification of recipient and sample is required


Proper labeling at beside

Information Minimally Required on BB Samples

  • 2 Unique Independent Identifiers: name and unique identifying number
  • Date of Sample collection

If there are no errors

the sample can be accessioned and processed

In accessioning the first step

  • Check records for prior blood bank testing results on a patient

If a patient history doesn't match

  • Patient/sample identification error
  • Sample mix-up
  • Non-ABO matched bone marrow transplant
  • Identity Fraud/Theft

Donor testing that must be done

  • Done by Collection center: Serology/virology
  • Blood Bank will reconfirm (ABO)
  • All must be completed before the unit is available for use

Weak D is not required on

recipients

Is compatibility testing required

yes

What is not routine for other products

crossmatch

If the product has >2mls of RBCs contamination what do you do

crossmatch



  • granulocyte concentrates
  • platelet only if visibly contaminated WBCs

For adults samples will be obtained w/i

3 days of scheduled transfusion if the patient was



  • transfused w/i past 3 months
  • Pregnant w/i past 3 months
  • No history available

If a person hasn't been transfused, pregnant in the past 3 months and a history has been given sample age can be

5-14 days before transfusion

How long are samples are post-transfusion

7 days

Why the 3 day limit

limits delayed transfusion reactions


Initial sample for a neonate to determine ABO and Rh


  • Use Anti-A, Anti-B, and Anti-D reagents only
  • Forward grouping only

Sample for neonate

Cord blood or venous sample

What sample is used in neonates for screening of anitbodies

Plasma from neonate or Mom



If a neonate has a negative antibody screening

Crossmatch testing is not required for the remainder of the hospital admission

Acceptable patient sample

Serum or Plasma



  • Purple- EDTA preferred for gel methods
  • Pink top tube: Spray coated K2 EDTA
  • Yellow tube top: ACD

What does ACD do

prevents detection of complement-dependent antibodies which are very rare

If Ab screen is positive

Panel ID --> Phenotype units--> full crossmatch