Presentation on theme: "Transfusion A blood transfusion is a safe, common procedure in which you receive blood through an intravenous (IV) line inserted into one of your blood."— Presentation transcript:
1 TransfusionA blood transfusion is a safe, common procedure in which you receive blood through an intravenous (IV) line inserted into one of your blood vessels.
2 TransfusionTo replace losses of: Circulating volume and Oxygen carrying capacity .To restore: Metabolic homeostasis.To replenish: Normal RBC’s (eg. Refractory anemias, Thalassemias, Sickle cell anemias etc)In cancer patients like ALL; AML; with /or after Chemothrapy drugsFor emergency surgery, heart surgery
3 ABO groupsYour blood type is established before you are BORN, by specific GENES inherited from your parents.You inherit one gene from your MOTHER and one from your FATHER.These genes determine your blood type by causing proteins called AGGLUTINOGENS to exist on the surface of all of your red blood cells.
4 Blood groupsThere are more than 20 genetically determined blood group systems known todayThe AB0 and Rhesus (Rh) systems are the most important ones used for blood transfusions.MNS, Kell , Duffy, P, Lewis are the examples of other blood group systemsNot all blood groups are compatible with each other. Mixing incompatible blood groups leads to blood clumping or agglutination, which is dangerous for individuals.
5 Blood groupingBlood group antigens are actually sugars attached to the red blood cell.Antigens are “built” onto the red cell.Individuals inherit a gene which codes for specific sugar(s) to be added to the red cell.The type of sugar added determines the blood group.
6 Blood groupingBlood group antigens are actually sugars attached to the red blood cell.Antigens are “built” onto the red cell.Individuals inherit a gene which codes for specific sugar(s) to be added to the red cell.The type of sugar added determines the blood group.
7 Landsteiner’s RuleSubstances are present in nature which are so similar to blood group antigens which result in the constant production of antibodies to blood group antigens they do not possess.Critical for understanding compatibility between ABO blood groups.
8 ABO blood groupAccording to this blood typing system there are four different kinds of blood types A,B ,AB, OBlood group A If you belong to the blood group A, you have A antigens on the surface of your RBCs and B antibodies in your blood plasma
9 AB0 grouping Blood group B If you belong to the blood group B, you have B antigens on the surface of your RBCs and A antibodies in your blood plasmaBlood group OIf you belong to the blood group O (null), you have neither A or B antigens on the surface of your RBCs but you have both A and B antibodies in your blood plasma.
10 Summary A Anti-B A or O B Anti-A B or O AB A and B none AB, A, B or O Blood GroupAntigens on cellAntibodies in plasmaTransfuse with groupAAnti-BA or OBAnti-AB or OABA and BnoneAB, A, B or OONoneAnti-A & B
11 HemolysisIf an individual is transfused with an incompatible blood group destruction of the red blood cells will occur.This may result in the death of the recipient.
12 Rh (D) Antigen Of next importance is the Rh type. Term “Rh” is a misnomer.Rh is a blood group system with many antigens, one of which is D.Rh refers to the presence or absence of the D antigen on the red blood cell.
13 Rh(D) systemUnlike the ABO blood group system, individuals who lack the D antigen do not naturally make it.A person with Rh- blood can develop Rh antibodies in the blood plasma if he or she receives blood from a person with Rh+ blood, whose Rh antigens can trigger the production of Rh antibodies.A person with Rh+ blood can receive blood from a person with Rh- blood without any problems
15 ABO groupBlood type O Rh- is the only type of blood that people of all other blood types can receive, so it is used in situations when patients need a transfusion but their blood type is unknown. People with blood type O Rh- are called Universal donor. AB blood group is universal recipient.
16 Hemolytic Disease of the Neborn – How it Occurs A child is Rh posB during pregnancy fetal Rh pos rbc’s escape into maternal circulationC Mother produces antibodies to Rh (D) antigenD Second pregnancy with Rh (D) pos child results in destruction of fetal D pos rbcs
17 Transfusion reaction Blood Transfusion is also a tissue transplant Immune reactions ( Anaphylaxis) possible, in both directions (host vs. graft, or graft vs. host)Transmission of diseases malaria, acute bacterial, HepB, HepC, , HIV, Prion mediated Creutzfeldt-Jakob (“mad cow”).Over load and cardiac failureAnd many hazards of Immunological reactions
19 Transfusion reactionTransfusions of blood products are associated with several complications, many of which can be grouped as immunological or infectiousAcute hemolytic reactionsThis is due to destruction of donor erythrocytes by preformed recipient antibodies. Most often this occurs due to clerical errors or improper typing and crossmatching.Symptoms include fever, chills, chest pain, back pain, hemorrhage, increased heart rate, shortness of breath, and rapid drop in blood pressure.
20 Transfusion reactionImmunological reactions occur when the receiver of a blood transfusion has antibodies that work against the donor blood cells.Then the red blood cells from the donated blood will clump, or agglutinate.The agglutinated red cells can clog blood vessels and stop the circulation of the blood to various parts of the body.The agglutinated red blood cells can also crack open, leaking toxic contents out in the body, which can have fatal consequences for the patient.
21 Transfusion reactionDelayed hemolytic reactions occur more frequently and are due to the same mechanism as in acute hemolytic reactions. However, the consequences are generally mild and a great proportion of patients may not have symptoms.
22 Transfusion reactionAllergic reactions may occur when the recipient has preformed antibodies to certain chemicals in the donor blood, and does not require prior exposure to transfusions. Symptoms include urticaria, pruritus, and may proceed to anaphylactic shock. Treatment is the same as for any other type 1 hypersensitivity reactions
23 Transfusion-associated acute lung injury (TRALI) It is an increasingly recognized adverse event associated with blood transfusion. TRALI is a syndrome of acute respiratory distress, often associated with fever, non-cardiogenic pulmonary edema, and hypotension, which may occur as often as 1 in 2000 transfusions.
24 InfectiousRarely, blood products are contaminated with bacteria. This can result in life-threatening infection, also known as transfusion-transmitted bacterial infection
25 Other hazardsTransfusion-associated volume overload is a common complication simply due to the fact that blood products have a certain amount of volumeHypothermiaMetabolic alkalosis can occur with massive blood transfusions due to the breakdown of citrate stored in blood into bicarbonateHypocalcemia can also occur with massive blood transfusions due to the complex of citrate with serum calcium
26 Blood donation Blood is taken ONLY from Voluntary Donors Using sterile, disposable blood bags &instrumentsDonated Blood is tested and separated intocomponents benefiting 3-4 patientsIt is safe to donate every 3 monthsIt is quick and safe.It doesn’t hurt.It saves 3 to 4 lives.
27 Age: Blood donors must be at least 17-18 years old in most countries Who can donate?Age: Blood donors must be at least years old in most countriesWeight : > 45 kgsHemoglobin level: >12 gms/dl for men and 12.5 gms/dl for womenIn good health
28 screeningBlood collected at the BDC is screened using highest quality screening testsHIV 1Hepatitis BHepatitis CVDRL (syphilis)Malaria
29 Blood is taken ONLY from Voluntary Donors Using sterile, disposable blood bags &instrumentsDonated Blood is tested and separated intocomponents benefiting 3-4 patientsIt is safe to donate every 3 monthsIt is quick and safe.It doesn’t hurt.It saves 3 to 4 lives.
30 Blood productsTransfusions are used in a variety of medical conditions to replace lost components of the blood.Early transfusions used whole blood, but modern medical practice commonly uses only components of the blood, such as red blood cells, white blood cells, plasma, clotting factors and platelets.Units of packed red blood cells are typically only recommended when a person's hemoglobin levels fall below 7g/dL
31 Measures taken in transfusion reaction . When suspected, transfusion should be stopped immediately, and blood sent for tests to evaluate for presence of hemolysis. Treatment is supportive. Kidney injury may occur due to the effects of the hemolytic reaction (pigment nephropathy
32 Autologus transfusion When a patient's own blood is salvaged and reinfused during a surgery (e.g. using a cell salvage machine such as a Cell Saver), this can be considered a form of autotransfusion
33 Benefit Regular donation (2-3 times a year….) Lowers cholesterol Lowers lipid levelsDecreases incidence of heart attacks, strokes-