Download Free Medical Transfusion pathology PowerPoint Presentation

Transfusion pathology PowerPoint Presentation

DOWNLOAD MEDICAL POWERPOINT PRESENTATION

About This Presentation

Description : Check out this medical presentation on Pathology, which is titled "Transfusion pathology", to know about Transfusion pathology.

Tags : Pathology, Transfusion

Published on : Aug 06, 2021 | Views : 1648 | Downloads : 6

Shareable Url :

Embed Code :

Comment

Transcript

Slide 1-

Transfusion pathology Kristine Krafts, M.D. September 24, 2007
Slide 2-

Transfusion Pathology Outline • Blood groups • • • • Introduction ABO system Rh system Other systems • Blood transfusion Blood products Indications Testing Dangers
Slide 3-

intro ABO Rh other groups products indications testing dangers
Slide 4-

Transfusion Pathology Outline • Blood groups Introduction
Slide 5-

Q. What determines a blood group? intro ABO Rh other groups products indications testing dangers
Slide 6-

Q. What determines a blood group? A. The antigens on the red cell surface. intro ABO Rh other groups products indications testing dangers
Slide 7-

• • • • • Antigens are inherited (Mendelian pattern) Real function unknown Damn important during transfusion Lots of antigens exist (grouped into systems) Most important systems: ABO and Rh Red Cell Antigens intro ABO Rh other groups products indications testing dangers
Slide 8-

Transfusion Pathology Outline • Blood groups • • Introduction ABO system intro ABO Rh other groups products indications testing dangers
Slide 9-

What are the antigens? • • • • • A and B Some people have A antigen (“type A”) Some people have B antigen (“type B”) Some people have both A and B (“type AB”) Some people have neither A nor B (“type O”) intro ABO Rh other groups products indications testing dangers
Slide 10-

Type A What are the antigens? Type B intro ABO Rh other groups products indications testing dangers Type AB Type O
Slide 11-

How do you make the antigens? • • • • Start with a protein precursor Add fucose to make H antigen Add N-acetylgalactosamine to H Ag to make A Ag Add galactose to H Ag to make B Ag intro ABO Rh other groups products indications testing dangers
Slide 12-

H antigen intro ABO Rh other groups products indications testing dangers A antigen B antigen
Slide 13-

What are the genes? • H gene • • everyone* has this one codes for an enzyme that makes H Ag. • A, B, and O genes • • • • everyone has two genes. six possible genotypes: AA, BB, AB, AO, BO, OO A and B code for enzymes that make A and B antigens. O has no gene product*. * almost! intro ABO Rh other groups products indications testing dangers
Slide 14-

intro ABO Rh other groups products indications testing dangers
Slide 15-

How common is each blood type? intro ABO Rh other groups products indications testing dangers
Slide 16-

So What? • • • • We have antibodies to the antigens we don’t have! Anti-A antibodies lyse type A red cells. Anti-B antibodies lyse type B red cells. This is very important during blood transfusion. intro ABO Rh other groups products indications testing dangers
Slide 17-

Type A So what? Type B Type AB Type O intro ABO Rh other groups products indications testing dangers
Slide 18-

intro ABO Rh other groups products indications testing dangers
Slide 19-

O O AB B A Recipient blood type AB, A, B, or O B or O A or O* Donor blood type Compatible blood types * type O = universal dOnor! intro Rh ABO products other groups indications testing dangers
Slide 20-

O A B AB
Slide 21-

Transfusion Pathology Outline • Blood groups • • • Introduction ABO system Rh system intro ABO Rh other groups products indications testing dangers
Slide 22-

What are the antigens? • • • • • Most important antigen: D! “Rh” because discovered using Rhesus monkeys. “Rh factor” refers to the D antigen. Two alleles: D and d. People with the D allele make D antigen and are Rh+. intro ABO Rh other groups products indications testing dangers
Slide 23-

intro ABO Rh other groups products indications testing dangers
Slide 24-

What are the antibodies? • • • Antibodies in this system are acquired! To make anti-D you must: lack the D antigen on your red cells get exposed to D + blood Donor and recipient are tested for the D antigen. intro ABO Rh other groups products indications testing dangers
Slide 25-

Transfusion Pathology Outline • Blood groups • • • • Introduction ABO system Rh system Other systems intro ABO Rh other groups products indications testing dangers
Slide 26-

Don’t tell me there are more systems. • • • There are a almost a sh*tload of other systems.* These are not included in routine testing. Antibodies to antigens in these systems are usually acquired (like anti-D), so unless a patient has been transfused or pregnant, you don’t need to worry too much. * intro ABO Rh other groups products indications testing dangers Not quite: a sh*tload is defined as more than 42.
Slide 27-

ppt slide no 27 content not found
Slide 28-

Transfusion Pathology Outline • Blood groups • • • • Introduction ABO system Rh system Other systems • Blood transfusion Blood products intro ABO Rh other groups products indications testing dangers
Slide 29-

What do you mean, products? • • • • In olden times, there was only whole blood. Now, we separate blood into its components Better for the patient Conserves blood supply intro ABO Rh other groups products indications testing dangers
Slide 30-

What are the products? • • • Whole blood Red cells Platelets • • • Granulocytes Cryoprecipitate Fresh frozen plasma intro ABO Rh other groups products indications testing dangers
Slide 31-

Whole Blood Red Cells Granulocytes Platelet-Rich Plasma BLOOD PRODUCTS
Slide 32-

Whole Blood Red Cells Granulocytes Platelet-Rich Plasma BLOOD PRODUCTS
Slide 33-

Whole Blood Red Cells Granulocytes Platelet-Rich Plasma BLOOD PRODUCTS
Slide 34-

Whole Blood Red Cells Granulocytes Platelet-Rich Plasma Platelets BLOOD PRODUCTS Fresh Frozen Plasma
Slide 35-

Whole Blood Red Cells Granulocytes Platelet-Rich Plasma Platelets Fresh Frozen Plasma VIII Cryoprecipitate BLOOD PRODUCTS IX Albumin IgG
Slide 36-

Transfusion Pathology Outline • Blood groups • • • • Introduction ABO system Rh system Other systems • Blood transfusion Blood products Indications intro Rh ABO products other groups indications testing dangers
Slide 37-

Use: massive hemorrhage Whole Blood RBC WBC platelets plasma Contents: INDICATIONS
Slide 38-

Whole Blood Use: low hemoglobin Red Cells RBC a few WBC a few platelets a little plasma Contents: INDICATIONS
Slide 39-

Whole Blood Red Cells Granulocytes Contents: neutrophils Use: sepsis in neutropenic patients INDICATIONS
Slide 40-

Whole Blood Red Cells Granulocytes Platelet-rich plasma INDICATIONS
Slide 41-

Whole Blood Red Cells Granulocytes Platelet-Rich Plasma Platelets Contents: platelets Use: bleeding due to thrombocytopenia INDICATIONS
Slide 42-

Whole Blood Red Cells Granulocytes Platelet-Rich Plasma Platelets Use: bleeding due to multiple factor deficiencies (e.g., DIC) Fresh Frozen Plasma Plasma Contents: (including ALL coagulation factors) INDICATIONS
Slide 43-

Whole Blood Red Cells Granulocytes Platelet-Rich Plasma Platelets Fresh Frozen Plasma Uses: low fibrinogen, vW disease, hemophilia A Cryoprecipitate fibrinogen von Willebrand factor VIII Contents: INDICATIONS
Slide 44-

Whole Blood Red Cells Granulocytes Platelet-Rich Plasma Platelets Fresh Frozen Plasma Cryopr ecipitate INDICATIONS A bunch of other stuff Use: rarely used
Slide 45-

Transfusion Pathology Outline • Blood groups • • • • Introduction ABO system Rh system Other systems • Blood transfusion Blood products Indications Testing intro Rh ABO products other groups indications testing dangers
Slide 46-

ppt slide no 46 content not found
Slide 47-

patient red cells (type A) Forward typing is done using both anti-A and anti-B antibodies! FORWARD TYPE anti-A antibodies AHG
Slide 48-

patient serum (with anti-B Ab) AHG reagent red cells (type B) REVERSE TYPE Reverse typing is done using both type A and type B reagent cells!
Slide 49-

patient serum AHG donor red cells CROSSMATCH
Slide 50-

patient serum AHG reagent RBC number 1 patient serum AHG reagent RBC number 2 ANTIBODY SCREEN no agglutination (negative test) agglutination (positive test)
Slide 51-

Transfusion Pathology Outline • Blood groups • • • • Introduction ABO system Rh system Other systems • Blood transfusion Blood products Indications Testing Dangers
Slide 52-

What can go wrong? • intro ABO Rh other groups products indications testing dangers Transfusion reactions • • hemolytic non-hemolytic • Other complications • • • circulatory overload iron overload infections
Slide 53-

Acute Hemolytic Transfusion Reactions • • • • • • Happens when patient has ABO antibodies against the donor red cells. Most common reason: clerical error! Symptoms: fever, chest pain, hypotension. Hemoglobin in serum, urine. Labs:  haptoglobin,  bilirubin, DAT positive. Type and cross-match shows ABO mismatch. intro ABO Rh other groups products indications testing dangers
Slide 54-

ppt slide no 54 content not found
Slide 55-

Delayed Hemolytic Transfusion Reactions • • • • • • Hemolysis occurs days after tranfusion. Caused by antibodies to non-ABO antigens. Hemolysis usually extravascular. Presentation: falling Hgb after transfusion. Usually not severe. DAT +. Antibody screen identifies the antibody. intro ABO Rh other groups products indications testing dangers
Slide 56-

Non-Hemolytic Transfusion Reactions • • • Usually not as dangerous as hemolytic TRs. Febrile TR: Fever. Treat with Tylenol. Allergic TR: Hives. Treat with antihistamines. Rarely, may lead to anaphylaxis. intro ABO Rh other groups products indications testing dangers
Slide 57-

Circulatory Overload • • • Happens when too much blood is given too quickly Symptoms: hypertension, congestive heart failure Stop transfusion, give diuretics intro ABO Rh other groups products indications testing dangers
Slide 58-

Iron Overload • • • Too much iron can damage heart, liver Patients with chronic anemias are at biggest risk Give iron-chelating agents intro ABO Rh other groups products indications testing dangers
Slide 59-

Infections • Transfusion-related bacterial infection is rare but serious. Patients suddenly develop fever and shock. Treatment: aggressive resuscitation and antibiotic therapy. • • Scary viruses (all donors tested for these): HIV, Hepatitis. Other potential infections: EBV, malaria, Lyme disease. intro ABO Rh other groups products indications testing dangers
Slide 60-

What’s the risk of getting an infection? intro ABO Rh other groups products indications testing dangers
Slide 61-

What’s the risk of other complications? intro ABO Rh other groups products indications testing dangers