OVERVIEW OF BLOOD TRANSFUSION

Dr.Yogesh Kumar Department of physiology

TKMC

DEFINITION

Injection of a fixed volume of blood intravenously ,which has been previously taken from a healthy person into a patient for therapeutic reasons

Common medical practice Most often life saving

What You Should Know ?

As a doctor its your responsibility to know

Indications for blood transfusions Collection and storage of blood Methods of transfusions Transfusion reactions

INDICATIONS

Acute blood loss Anemia Bone marrow failure Purpura Clotting factor deficiencies Preparation for surgery or during

surgery Burns

PURPURA

PROCEDURE

First step is “selection of appropriate donor “

Rh and ABO typing Cross matching Antibody screening of patient or

recipient

An Appropriate Donor ?

Healthy Voluntarily willing donor Free from any transmissible diseases Ideal age of 18-60yrs Hb of male -13g/dl female 12g% Donor must be screened for HIV,

Hepatitis, Malaria, filaria , lymphomas

Blood Grouping And Typing

Major systems are ABO & Rh ABO incompatibility is immediate Maybe life threatening Rh incompatibility could be delayed

Blood Groups – In a Nutshell

Blood group is determined by the type of antigen situated in the surface of RBC (glycoprotein)

Estimated over 30 blood groups with more than 400 antigens

Antigens – agglutinogens Antibodies – agglutinins Plasma contains antibodies against

antigens which are absent in RBC surface

Cont’d

Medically important blood groups are ABO system and Rh system

Which are responsible for major transfusion reactions

Due to cold antibodies other groups are not important

Some important minor blood groups MNS, Lewis , Kell, Lutheran

ABO SYSTEM

RH SYSTEM

UNIVERSAL DONOR & RECEPIENT

Universal donor O-ve Universal recipient AB+ve This method does not assure

compatibility Reaction may occur due to minor

groups Cross matching should be done However this method is useful in

emergency conditions

CROSS MATCHING

MAJOR : Donors cells are matched against recipient’s plasma

MINOR : recipient's cells are matched with donors plasma

Antibody screening of patient

BLOOD COLLECTION AND STORAGE

Vein puncture (mostly antecubital vein ) is done to collect blood

350ML of blood is collected at a time from a single donor

Blood bag contains anti-coagulent 50-70Ml Anti-coagulent used consist of citrate

phosphate and dextrose Bleeding time is 7-10 minutes BP Heart Rate are monitored before and

after bleeding

VEIN PUNCTURE

BLEEDING

Cont’d

Some degree of diaphoresis , bradycardia , hypertension and dizziness is experienced

Donors are advised not to go for work for the rest of the day

To avoid strenuous exercise And should donate blood only after a

3months interval

BLOOD BAG

BLOOD BAG

STORAGE OF BLOOD

Stored in a blood bank at 4°C Ideally for two weeks Max of three weeks Should never be used after 30days After which haemolysis occurs beyond

use

BLOOD STORAGE

RED CELL CHANGES DURING STORAGE

Changes due to reduction in metabolism

Reduced Na+ K+ pump activity Increase in intra cellular Na and

decrease K Cells swell and become spherical Leukocyte and platelets totally

disappear after 1- 2 days ATP inside the cell decreases

CHANGES IN STORED BLOOD AFTER TRANSFUSION

Within 24 hours metabolism increases Na+ K+ activity is regained 80% of RBC survival if transfusion is

done within 14 days

HAZARDS OF BLOOD TRANSFUSION

DUE TO MISMATCHED TRANSFUSION

shivering and fever jaundice haemoglobinuria ARF hyperkalemia

Due to faulty technique

Thrombophelbitis Air embolism

Due to massive transfusion

Occurs when more than 10units within 24 hours

Or total blood volume is exchanged within 24 hours

This leads to circulatory overload Cardiac arrest due to hyperkalemia

Allergic reactions

Itching Erythema Nausea Vomiting In severe cases anaphylactic shock

Transmission of disease

Hepatitis HIV Malaria Syphilis