Blood Bank

RBC storage temp & shelf life?

1–6 °C; 35–42 days depending on additive

Platelet storage temp, conditions, & shelf life?

20–24 °C, continuous agitation, 5–7 days

FFP storage temp & shelf life?

≤ −18 °C for 1 year

ACD, CPD expiration

21 days

CPDA-1 expiration

35 days

AS-1/3/5 expiration

42 days

What does irradiating units change the expiration date to?

28 days max or original expiration, whichever is sooner

QC requirement for platelets?

≥ 5.5 × 10¹⁰ platelets per unit

QC requirement for cryo?

Each unit must contain ≥ 80 IU Factor VIII

What do washed RBCs prevent?

IgA deficiency, prevents severe allergic/IgE reactions

What do irradiated RBCs prevent?

prevents GVHD

What do leukoreduced RBCs prevent?

prevents febrile non-hemolytic reactions & CMV transmission

ABO system antibodies & reaction risk?

Naturally occurring IgM → immediate hemolytic transfusion reaction

Rh (D antigen) antibodies & risk?

IgG → HDFN + hemolytic transfusion reactions.

Clinically significant antibodies to note?

Kidd, Kell, Duffy

Kidd antibodies: type, reaction, memory aid?

IgG, delayed HTR, may disappear from plasma

“Little Kidds are always late.”

Kell antibodies: type & clinical importance?

IgG, highly immunogenic → severe transfusion reactions, HDFN

Duffy antibodies: significance? What phenotype is resistant to Plasmodium vivax malaria?

IgG, cause transfusion reactions

Duffy-negative (Fy[a−b−])

IgM vs IgG — cold vs warm?

IgM = cold
IgG = warm

Complement activation → intravascular vs extravascular hemolysis?

Full activation = intravascular (severe)

Partial activation = extravascular (splenic clearance)

What causes HDFN?

Maternal IgG anti-D crosses placenta → fetal RBC hemolysis

Which HDFN is less severe?

ABO incompatibility (mom O, baby A/B)

Warm AIHA key features: name the antibody, type of hemolysis, morphology associated, and test?

• IgG antibody

• extravascular hemolysis

• spherocytes

• DAT+ for IgG

Cold AIHA key features: name the antibody, pathway it activates, morphology associated, and test?

• IgM antibody

• activates complement

• agglutination in cold temps, acrocyanosis

• DAT+ for C3

Main concern in HPC (stem cell) transplant & prevention?

GVHD; prevented by irradiating blood products

Forward vs reverse grouping?

Forward = patient RBCs with known anti-sera → detects antigens

Reverse = patient plasma with known cells → detects antibodies

Crossmatch: IS vs AHG?

IS = checks ABO incompatibility only

AHG = detects clinically significant IgG antibodies

Antibody screen & ID purpose?

Detects unexpected antibodies; ID panel determines specificity

DAT (Coombs) detects what?

In vivo coating of RBCs (HDFN, AIHA, transfusion reaction)

Enzymes (ficin, papain): what do they enhance, but also destroy?

Enhances antibody reactions Rh, Kidd, and Lewis

Destroys duffy and MNS antibodies

LISS: speeds up what?

antibody binding

PEG: what does it enhance and how?

enhances IgG detection by reducing zeta potential

Gel/solid phase are modern methods (replace tube testing) for what type of antibody detection?

easier weak antibody detection

Indications for RBCs, platelets, plasma?

RBCs = anemia/acute blood loss.

Platelets = thrombocytopenia/PLT dysfunction.

Plasma (FFP) = coagulation factor deficiencies/coagulopathy.

Febrile non-hemolytic reaction cause & prevention?

Anti-WBC/cytokines; prevent with leukoreduced products

Febrile non-hemolytic reaction symptoms?

Fever, chills during/after transfusion

Allergic transfusion reaction cause & prevention?

IgE to donor plasma proteins; prevent with washed RBCs for IgA deficiency

Allergic transfusion reaction symptoms?

Urticaria (hives), itching; SEVERE: anaphylaxis

TRALI cause & key sign?

Donor anti-HLA/neutrophil antibodies → acute respiratory distress, pulmonary edema (BP normal/low)

Normal BP: 90-120 / 60-80 mmHg

TACO cause & key sign?

Volume overload → dyspnea, hypertension (high BP), pulmonary edema.

Who is at risk for TACO?

Risked in elderly, infants, and heart failure patients

Acute hemolytic transfusion reaction cause & symptoms?

ABO mismatch (IgM/complement) → fever, chills, back pain, hemoglobinuria, shock, DIC.

Which transfusion reaction is most dangerous?

Acute hemolytic transfusion reaction

What transfusion-transmitted infections are tested for?

HIV, HBV, HCV, syphilis, West Nile, Zika (very low residual risk still exists)