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Donation - age, temp, BP, HGB, HCT, weight?
- Age: 16+
- temp: 37.5C/99.5F
- BP: "normal limits" <180/100?)
- Hgb: 12.5g/dL+ (autologous 11)
- Hct: 38%+ (autologous 33)
- weight: 110lb/50kg
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1 RBC unit should result in __ increase to hgb and crit?
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What is the number of WBC acceptable in a leuko-reduced RBC unit? Purpose of this unit?
- <5x10^6/unit
- prevents febrile nonhemolytic rxn, CMV, HLA immunization
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Plasma donors?
Men only (no women of child-bearing age) to prevent TRALI
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Increased plt expected from plts
- 5,000-10,000 per unit
- 20,000-60,000 per APHERESIS unit
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Lewis system phenotypes
- Le gene = Lea adsorbed to RBC / Le(a+b-)
- Le and Se gene = Leb adsorbed to RBC / Le(a-b+)
- lele = no Le, regardless of Se / Le (a-b-)
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Purpose of irradiation?
Prevents GVHD
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Dolichos biflorus, Ulex europaeus are spp for what?
- DB: A1 Ag
- UE: H Ag - Bombay won't aggl (Bombay is near Europe)
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Problem with Rh null?
hemolytic anemia due to lack of RBC memb structure (Rh is crucial)
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ENHANCED/ELIMINATED by enzymes
- Enhanced: Rh, Lewis, Kidd, P1, I
- Eliminated: M, N, S, s, Duffy
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IgM Abs vs IgG Abs
- IgM: I / H / M,N / P1 / Lea, Leb
- IgG: ABO, Rh / some M / S,s / Kell, Duffy, Kidd (Jk)
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Important disease facts about anti-P, anti-Jk,
- anti-P: PCH
- anti-Jk: delayed tfxn rxn (Kids are always late)
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Dosage and cold reactive Ab pneumonics
- Kidds and Duffy the Monkey (Rh) eat M & NsLewis says H I while his Penguin eat M & Ns
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Number of units to screen?
#requested/(%Ag neg x %Ag neg...)
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Adverse tfxn rxn causes (acute, delayed, GVHD, sepsis
- acute: hemolysis, sepsis, TRALI, allergic rxn (urticarial and anaphylactic), TACO, Febrile Nonhemolytic
- delayed: extra vasc. hemolysis (Kidd ab)
- GVHD: immunocomp, HLA matched, family donor
- sepsis: bacterial contam (probably RT plts!)
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What is TRALI?
- Transfusion Related Acute Lung Injury
- donor Ab to HLA and neutrophills
- Results in resp insufficiency, pulmonary edema, hypotension, DEATH
- *Plasma from men only
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What is TACO?
- Transfusion Associated Circulatory Overload
- Hypertension -> ulmonary edema
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What is febrile nonhemolytic transfusion rxn?
- >1C raise in temp
- caused by cytokines/leukocytes from donor
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fetus bili vs newborn bili
- Mother conjugates bili for fetus (increased cbili)
- Newborns cannot conjugate (increased ubili)
- Phototreatment
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RhIg vial calc and neutralize amounts
- fetal cells/2000 x 5000mL/30mL +1
- *2000=#counted, 5000 = assumed volume
- 1 vial = 30mL whole blood (FMH) or 15mL RBCs (tfxn)
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HLA I vs HLA II (locations, genes)
- HLA I: all nucleated cells (incl plts)
- HLA-A, HLA-B, HLA-C genes
- HLA II: APCs (lymphs, dendritic, etc)
- HLA-DP, HLA-DQ, HLA-DR genes
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