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Chapter 16
Transfusion medicine
Red cell transfusion
ABO system
The ABO system is a group of carbohydrate antigens in which the individual alleles are defined by the terminal saccharide moiety. Specifically, addition of N-acetylgalactosamine or galactose to the subterminal galactose yields red cells of group A or group B, respectively. Individuals who express neither of these sugars on the subterminal galactose are group O, and individuals who express both sugars are group AB. The subterminal galactose, in association with a constitutively expressed fucose moiety, defines the so-called H antigen. As such, some authors refer to the ABO antigen system as the ABH system. For reasons that are still Rh system Other protein antigen systems Other carbohydrate antigen systems Collection and storage of red cells Clinical transfusion of red cells
Platelet transfusion
The human leukocyte antigen system Human platelet antigens Collection and storage of platelets Clinical transfusion of platelets Prophylactic platelet transfusion Choice of platelet product Platelet transfusion dose Diagnosis and management of platelet transfusion refractoriness Prevention of alloimmunization to HLA antigens
Granulocyte transfusion
Granulocyte antigen systems Collection and storage of granulocytes Clinical transfusion of granulocytes
Transfusion of plasma products
Fresh frozen plasma Cryoprecipitate Immunoglobulin
Pretransfusion testing
ABO/Rh(D) typing Antibody screen and specificity identification Crossmatching
Apheresis
Plasma exchange and plasmapheresis Exchange transfusion Hematopoietic stem cell harvesting
Transfusion support in special clinical settings
Candidates for hematopoietic stem cell transplantation Hematopoietic stem cell collection Hematopoietic stem cell infusion Hematopoietic stem cell transplantation Pediatric transfusion issues In utero transfusion Neonatal transfusion Other special considerations in pediatric patients Exchange transfusion in the pediatric population Component therapy Neonatal thrombocytopenia Transfusion in older children Pediatric immune disorders Autoimmune hemolytic anemia Autoimmune thrombocytopenia Sickle cell disease Massive transfusion Cardiopulmonary bypass Aplastic anemia
Transfusion risks
Acute hemolytic reactions Delayed hemolytic reactions Febrile reactions Allergic reactions Transfusion-related acute lung injury Infectious complications Bacterial and protozoal transmission by transfusion Hepatitis AIDS-related retroviruses Human T-cell lymphotrophic viruses West Nile virus Parvovirus B19 Cytomegalovirus Transfusion-associated graft-versus-host disease Strategies to reduce transfusion risks in general Blood substitutes | |||||||||||||||||||||||||||||||||||||||||||||||||||