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TRANSFUSION
Indication & Reaction
Sub Topics
I.
II.
III.
IV.
Introduction
Safety Blood Transfusion
Type & Indication
Transfusion Reaction
I. Introduction
I. Introduction
(1)
I. Introduction
Tahun
1818,
James Blundell
transfusi darah
dengan syringe
donor ke resipien.
Reaksi
I. Introduction
(2)
Blood transfusion :
Transfer of blood or blood product
Why blood
component ?
1. Efficient (1 donor for 3
recipients)
2. Effective (give only recipients
need)
3. Safer (avoid unnecessary
component)
4. Prevention of longterm reaction
Examples :
To increase patients
hb/hematocrite
give only Packed Red Cells
To increase patients platelet
give only Platelet Concentrate
To restore patients coagulation
factors
give only Cryoprecipitate or
Fresh Frozen Plasma
Compatibility Test
abad 20
era transfusi
modern.
Awal
Tahun
1901, Karl
Landsteiner
identifikasi grup
Compatibility Test
Between donors blood and
recipient
Must be done before give the blood
!
Blood antigens : vary
What are must be tested ?
1. Blood Type Compatibility
(A,B,O,AB)
2. Rhesus factor Compatibility
DONOR
Cara aferesis
Cara
konvensional
III.
TYPE OF TRANSFUSION
& INDICATION
a. Whole Blood
Very limited indication:
1. Open heart surgery
2. Large volume blood loss
in relatively short time
3. Remote area (no facilities)
Whole Blood
Darah Lengkap/ Whole Blood (WB)
1 unit = 300 ml
2/3 ( 200 ml ) consist of RBC
Usually for patient with anemia
(to increase hematocrit )
1 unit PRC ht increased by 4 %
( Hb increased by 1,3 1,4 g% )
3. Frozen Blood
Useful in :
1. Stock for very rare blood group
2. Severe Leukoaglutinin reaction
3. Anaphylactic rx to plasma
protein
4. Leuko-poor Blood
Made by centrifugation or washing
Leucocyte (-), platelet (-)
Useful in :
patient w/ severe Leuco-aglutinine
rx
to donors erythrocyte
5. Platelet
Concentrate
Platelet Concentrate
Trombosit Pekat/ Platelet Concentrates (PC)
Plasma Component
6. Fresh Frozen Plasma (FFP)
Volume : 200 cc
Contain all of coagulation factor
Useful in :
- correction of coagulation factor
deficiency
- Thrombotic Thrombocytopenic Purpura
(TTP)
7. Cryoprecipitate
Cryoprecipitate
Kriopresipitat/ Cryopresipitate (CRYO)
8. Granulocyte
Transfusion
Indication :
- Severe Neutropenia (<100 /uL), with
sepsis
cause by gram negative bacteria
- Progressive Soft Tissue Infection
IV. Transfusion
Reaction
Based on time of onset
A. Acute Complication
(during or soon after
transfusion
/ within 24 hrs)
B. Late Complication
A. Acute Complication :
1. Mild reaction : fever, chills,
itchy
2. Moderate reaction:
- Moderate hypersensitivity
- Non-hemolytic fever
- Bacterial contamination
- Pyrogenic reaction
Pyrogen Reaction/Fever
Transfusi Darah
Terkontaminasi Bakteri
Pyrogen Reaction/Fever
- Chills, nervousness
- Stop transfusion symptoms
(-)
Hemolytic Reaction
1.
2.
B. LATE COMPLICATION
1. Transmission of disease :
( HIV, Hepatitis, Syphilis,
Malaria, Cytomegalovirus, etc)
2. Other Late Complication
Late hemolytic reaction
GVHD (graft versus host
disease)
Iron overload
Complication (based on
location) :
a. Local Complication
1. Failure in accessing the
vein
2. Poor vein fixation
3. On site infection
b. Systemic Complication
1.
2.
3.
4.
Transfusion Reactions
Transmission of diseases
Immunologic sensitivity
Hemochromatosis
Thank You