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BLOOD GROUP ANTIGENS AND ANTIBODIES, COMPLICATIONS OF BLOOD TRANSFUSION,…

- - - - ABO and Rhesus (Rh) blood group system are of major clinical significance
        
        Naturally occurring antibodies in serum
        
        Anti – A and Anti – B antibodies usually of IgM class
        
        Immune antibodies are acquired in response to transfusion and
        transplacental passage during pregnancy. Warm antibodies of IgG class
        
        tables
- - - - Risk high in patients with chronic anaemia
        
        Onset may be immediate or delayed upto 24 hrs
    - - When volume transfused exceed patients normal blood volume
        
        Results in dilutional thrombocytopenia and coagulation factors
      - Transmission of infections
        
        Hepatitis, CMV,Syphilis, malaria, toxoplasmosis, brucellosis, infectious
        mononucleosis, AIDS
        
        Incidence increase with patients receiving multiple transfusions
        
        Every unit of blood must be screened
        
        Air embolism
        
        Debilitated person may develop air embolism with 10-40ml of air into circulation
        
        Thrombophlebitis
        
        Risk is increased if transfusion continued longer than 12 hours on a single site
        
        Transfusion haemosiderosis
        
        Iron overload and deposition
        
        Iron excretion always at 1mg per day
        
        1 more item...
- - - - Intravascular haemolysis
        
        due to
        
        ABO incompatibility.
        
        Restlessness,
        
        anxiety,
        
        flushing,
        
        chest or lumbar pain,
        
        tachypnea,
        
        tachycardia,
        
        nausea,
        
        shock,
        
        renal failure
        
        Extravascular haemolysis
        
        immune antibodies of Rh system,
        
        clinically less severe,
        
        malaise,
        
        fever
    - - Uncommon reaction from transfusion of donor plasma with high levels
        of anti-HLA antibodies which bind to leucocytes of recipient
        
        Leucocytes aggregate in pulmonary vasculature
        
        Pulmonary oedema, respiratory failure
      - Febrile reaction
        
        Due to immunologic reactions against white blood cells, platelets
        
        Anaphylactic shock
        
        Due to antibodies against IgA molecule
        
        Allergic reactions
        
        Urticaria
        
        Transfusion-related graft versus host dieases
        
        Mediated by T lymphocytes
- - - - Individuals whose blood react with Anti – D antiserum are Rh- positive and those who lack D antigen are Rh-negative
        
        table
- - - - Plasma proteins and coagulation factors
        
        Indicated for patients with coagulation failure
        
        1 unit – 2% raise in coagulation factors
      - Cryoprecipitate
        
        Source of insoluble plasma proteins, fibrinogen, factor VIII and vWF
        
        1 unit = 80 IU of factor VIII