transfusion intro to transfusion part 2 2 of 2 week 18 students.pptx

Introduction to transfusion part 2 aka ‘Red Cell Immunohaematology’ The Transfusion Journey - Stages From Donor to Patient Donor Selection & Assessment  Donated Blood Collection Testing Donor Samples Processing the Donation Storage & Transport to the Hospital ‘Blood Bank’ Compatibility Testing Admi...

Introduction to transfusion part 2 aka ‘Red Cell Immunohaematology’ The Transfusion Journey - Stages From Donor to Patient Donor Selection & Assessment  Donated Blood Collection Testing Donor Samples Processing the Donation Storage & Transport to the Hospital ‘Blood Bank’ Compatibility Testing Administration to the Right Patient Strict procedures & quality measures must be followed at all Stages - to protect safety of donors and recipients Selecting Suitable Donors types of blood donor:  whole blood: new or regular (known)  apheresis rationale for blood donor selection  must be safe for recipient  must not do the donor harm achieved by  ‘voluntary unpaid donors’  self-exclusion  donor assessment strict criteria followed for donor selection or exclusion  e.g Hb check would you like to be a blood donor sir? Selection and Exclusion Criteria Exclusion Criteria High risk occupation or hobby Health risk Infection risk Disease Risk group  Travel abroad, tattoos, peircings Potential Infection incident Self exclusion due to ‘ high risk’ lifestyle Protects against window of infectivity. Donor Assessment Donor Assessment  complete a Donor Health Questionnaire  interviewed by a Healthcare Professional  new donors have a physical assessment  sign a consent form  complete a Haemoglobin check Collecting the Whole Blood Donation Whole Blood 450mls of donor blood is withdrawn and collected into the special ‘Blood Collection System’ this contains citrate anticoagulant can donate every 12-16 weeks  Apheresis allows direct collection of specific blood component Testing the Donation Sample  three donation samples are taken for lab testing mandatory Tests performed on ALL donations  Blood Typing  Red Cell Antibody Screening  Microbiology Testing  ‘Window of Infectivity’   Additional Tests are performed on some donations  e.g. Sickle Cell Trait Processing Whole Blood Donations donated whole blood is processed into three main components for therapeutic use Red cell Concentrates, Fresh Frozen Plasma (FFP) and Platelet Concentrates    patient is only transfused with deficient component more than one patient benefits from each donation individual components can be stored under optimal conditions to maintain viability and function Storage and Transport Storage Red Cells   in SAGM for 35 days at 4oC in CPD for 28 days  Platelets Concentrates  at 22oC for 7 days with continuous agitation  reduced to 5 days without bacterial screening  FFP  at < -25oC for 3 years  Transport  components are always placed in special insulated containers with temperature insets  these are validated to maintain their temperature for 4 hours Compatibility Testing - performed by BMS in the Hospital ‘Blood Bank’ Aim - to provide the recipient with a transfusion which is both beneficial and safe  Standard procedures must be carried out prior to administration of red cell transfusions to patients  Crossmatch performed in the laboratory  only ‘Issue’ if donor red cells are compatible with any patient red cell antibodies must comply with Guidelines and Regulations Transfusion Practice: at the Bedside Identifying the Patient  strict procedures are followed to ensure the Right Patient receives the Right Treatment  errors in Patient Identification can cause Haemolytic Transfusion Reactions leading to severe morbidity or mortality  SPOTs! Therapeutic Use of Blood Components 12 Early Therapeutic Remedies ? Based on scientific evidence Transfusion Therapy - Red Cell Concentrates Red Cell Concentrates  used to treat acute or chronic anaemia  a transfusion of red cells will improve the oxygen carrying capacity of the patient’s blood Platelet Concentrates  transfused in cases of thrombocytopenia  as a prophylactic measure to prevent microvascular bleeding or to treat bleeding episodes Fresh Frozen Plasma  to prevent microvascular bleeding due to abnormal coagulation Paediatric units Solid Organ and Stem Cell Transplantation Transplantation defined as ‘transfer of tissues or organs within one or between two individuals’ types of transplantation  autogeneic (autologous graft)  allogeneic (allogeneic graft) clinical transplantation  aims to exchange diseased organ with a healthy donor replacement  first successful kidney transplant in 1954  first heart transplant performed in 1967 Organ & Tissue Transplantation Organ transplants  lung, heart or heart/lung, Kidneys, liver, small bowel, pancreas  Tissue transplants  cornea, skin, bone, heart valves, tendon Stem cell  sources include peripheral blood, bone marrow, cord blood  NHS Organ Donor Register (2015)  21.1 million people joined (in total)  2014-15: 429 patients died waiting for a transplant   2932 kidney transplants 5417 waiting for kidney transplant Pictures courtesy NHS BT Allogeneic Stem Cell Transplantation Donor Peripheral Stem Cells collected and frozen in LN2 Patient BM ablated   re-infused with stem cell transplant transfusion support vital