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qestions and answers in blood transfusion
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in this document I tried to make a short overview of what a medical student needs to know in transfusion in the form of questions and answers
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blood transfusion( questions and answers)ABO testing
• what are the reaction condition of the ABO testing?
*tempreture has to 20c *antigen-antibody ratio→ 10% suspension * medium of the reaction
has to be physiological saline *and the reaction time in the case of the reverse reaction(the
presence of anti-A or anti-B)→ 10 minutes and in the case of the forward(suggest the presence
or the absence of the A or B antibody) reaction→ 5 mins
• What type of the antibody are antiA or antiB?
They are IgM
• What is forward testing?
In the forward testing we try to see if there is there presence of the A and B antigen on the
surface of the RBC and the test plate contains anti A and anti B
• what is the reverse blood typing?
Investigating to see if anti A or anti B are present in the plasma and this might or might not react
with the antigen on the test plate→ so the reverse typing detects the presence of anti A or anti B
in the patient’s plasma
• what are the reaction requirement for the Rh testing?
Tempreture 20c *antigen – antibody ratio→ 50 % suspension of the RBCs *medium of the
reaction→ serum *reaction time→ 5 mins
• what types are anti Rh antibodies?
They are IgG
,• what is the general rule for transfusion of the plasma?
That we have to use a plasma for transfusion that doesn’t have the antibodies against the
RBCs→ for example: we can use the plasma of someone with A for someone who has type O
blood and we can use the plasma of someone with type B blood for someone with type O blood
and also we can use plasma of AB for someone with O B or A type blood
• how does the blood changes during storage
Lactate concentration increases
extracellular potassium increases
ammonia concentration increases
glucose concentration decreases
PH decreases
2.3-DPG decreases
ATP decreases
• what substance starts to pile up outside of the RBC?
K efflux from red blood cell→ if we transfuse this blood to the patient the there is risk of
potassium intoxication and kidney insufficiency
• which substance starts to increase rapidly from 7 days?
Ammonia level increases and again we have the risk of intoxication → which can cause severe
liver damage
• what are the unstable blood components?
Red blood cell concentrates
platelet concentrates
white blood cell concentrate
some plasma product→ FFP
• what are the stable blood components?
Albumin solutions
immunglobulins
clotting factor
other isolated plasma fractions or their combinations
, haemopoietic growth factor
• how many different types of the exchange transfusion do we have?
Adult exchange transfusion
neonatal exchange transfusion
• what do we have to know about the adult exchange transfusion?
We do it in the case of the
1)severe acute liver failure
2)poinsoning eg(mushroom, CO,chemicals)
• how many types of neonatal exchange transfusion we have?
*partial
*total
• when do we use partial neonatal exchange transfusion?
Rapid correction of severe anaemia
hyperviscosity induced polycythemia
• when do we use total exchange transfusion?
Haemolytic disease of the newborn
severe RDS
harmful substances transferred from the maternal circulation to the fetus
haemolytic crisis of sickle cell anemia
• what kind of blood products can we use in the case of the exchange transfusion?
RBC under 7 days old
the blood’s crossmatch has to be performed on the mother’s serum also up to 4 months
• what is the amount of the exchange blood product?
180-200 ml/kgBW
• how do we make sure that we removed the white blood cells?
Spinning and buffy coat removing will remove about 80 % of the WBC
washing→ with physiological saline will remove 70-90%
filtration→ we use special filter and this removes almost all of the WBCs
• what are the use of the blood preservative ?
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