ABPath Blood Banking/Transfusion Medicine flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

RBC storage shelf life

RBC units in additive solution (AS-1, AS-3, AS-5) are stored at 1-6 C for up to 42 days; whole blood and non-additive RBCs have shorter dating of 21-35 days.

Leukoreduced unit threshold

A prestorage leukoreduced blood component contains fewer than 5 x 10^6 residual white blood cells per unit, reducing febrile nonhemolytic reactions and CMV transmission.

Platelet storage conditions

Platelets are stored at 20-24 C with continuous agitation for up to 5 days (7 with pathogen reduction); pH must remain at least 6.2 throughout storage.

Cryoprecipitate content requirements

Each unit of cryoprecipitated AHF must contain at least 80 IU factor VIII and at least 150 mg fibrinogen; it is stored frozen at -18 C or colder for up to 12 months.

Irradiated component expiration

Cellular blood components irradiated at 25 Gy expire 28 days after irradiation or on the original outdate, whichever comes first, because irradiation accelerates storage lesion.

Thawed plasma shelf life

Plasma thawed at 1-6 C may be relabeled as thawed plasma and used for up to 5 days for patients needing factor replacement without strict labile factor requirements.

ABO reverse grouping

Reverse grouping tests the patient's serum against A1 and B reagent red cells; a discrepancy between forward and reverse typing requires resolution before transfusion.

Weak D testing

Weak D testing is performed when the initial D typing is negative or weak; donors with weak D are managed as D-positive while patients may receive D-positive or D-negative units per policy.

Antibody screen phases

Antibody detection testing includes immediate spin to detect IgM antibodies, 37 C incubation, and antihuman globulin phase to detect clinically significant IgG antibodies.

Clinically significant antibody

An antibody is clinically significant if it is reactive at 37 C or the AHG phase and can cause hemolytic transfusion reactions or hemolytic disease of the fetus and newborn.

Direct antiglobulin test

The DAT detects in vivo coating of red cells with IgG or complement using polyspecific AHG; monospecific anti-IgG and anti-C3 reagents differentiate the cause.

Universal donor plasma

Group AB plasma lacks anti-A and anti-B and is the universal donor plasma; group O red cells are the universal donor red cells because they lack A and B antigens.

Restrictive RBC threshold

A hemoglobin threshold of 7 g/dL is recommended for most stable hospitalized adults, while 8 g/dL applies to cardiac and orthopedic surgery and stable cardiovascular disease.

Prophylactic platelet threshold

Prophylactic platelet transfusion is indicated at a platelet count below 10 x 10^9/L for stable patients and below 20 x 10^9/L before minor procedures.

FFP dosing

Therapeutic plasma dose is 10-15 mL/kg; it is indicated for bleeding or invasive procedures with an INR above 1.5 or for multiple factor deficiencies.

Massive transfusion definition

Massive transfusion is defined as more than 10 units of red cells in 24 hours or replacement of one blood volume; balanced plasma-to-RBC ratios improve outcomes.

TRALI presentation

Transfusion-related acute lung injury presents as noncardiogenic pulmonary edema within 6 hours of transfusion, often due to donor anti-HLA or anti-HNA antibodies.

TACO presentation

Transfusion-associated circulatory overload causes hydrostatic pulmonary edema within 6 hours, with elevated BNP and response to diuretics and slower infusion rates.

Acute hemolytic reaction

An acute hemolytic transfusion reaction presents with fever, chills, flank pain, and hemoglobinuria; management includes stopping the transfusion and maintaining urine output.

Compatible IV fluids

Only 0.9% sodium chloride is compatible with red cell transfusion; dextrose causes hemolysis and lactated Ringer's contains calcium that can clot citrated blood.

Transfusion time limit

Red cell units should be infused within 4 hours of issue; platelets and plasma are infused as rapidly as tolerated, and standard filters are 170-260 microns.

Febrile nonhemolytic reaction

A febrile nonhemolytic reaction is a temperature rise of at least 1 C to 38 C or higher; it is the most common reaction and is reduced by leukoreduction.

Patient blood management

Patient blood management uses preoperative anemia treatment, reduced phlebotomy, cell salvage, antifibrinolytics, and restrictive thresholds to reduce transfusion exposure.

Whole blood donor criteria

Donors must be at least 17 years old (16 with consent), weigh at least 50 kg, have hemoglobin of 12.5 g/dL (female) or 13.0 g/dL (male), and be afebrile.

Donation interval

Whole blood donors may donate every 56 days; platelet apheresis donors may donate up to 24 times per year, and plasma donors every 28 days.

TPE replacement fluid

Plasma exchange for thrombotic thrombocytopenic purpura uses plasma replacement, while most other indications use 5% albumin; 1-1.5 plasma volumes are exchanged.

Citrate toxicity

Citrate anticoagulant used in apheresis binds calcium, causing perioral tingling, tetany, and hypotension; treatment is calcium supplementation or slowing the procedure.

HLA class I and II

HLA class I antigens (A, B, C) are on all nucleated cells; class II antigens (DR, DQ, DP) are on antigen-presenting cells and are key for transplant matching.

GVHD prevention

Cellular blood components are irradiated with 25 Gy to prevent transfusion-associated graft-versus-host disease in immunocompromised recipients and directed donations from relatives.

CD34+ progenitor dose

A minimum CD34-positive cell dose of about 2 x 10^6/kg is targeted for peripheral blood stem cell transplantation to ensure engraftment.

Biological product deviation report

Under 21 CFR 606.171, blood establishments must report deviations affecting the safety, purity, or potency of a distributed product to the FDA.

FACT accreditation scope

FACT accredits hematopoietic cellular therapy programs including bone marrow transplant, apheresis, and cord blood banks, requiring quality management and outcomes analysis.