BB 18: TA-GVHD and Irradiated Blood Products

what refers to a medical condition that results when an immunocompromised patient receives:

• allogenic organ transplant

• blood transfusion where “live” donor WBCs in the blood are transfused into this patient, the donor WBCs “react” to a foreign environment and begin to attack the patient’s organs

GVHD

the pathogenesis of ____ involves transplanted immune cells recognizing patient (host) cells as foreign.

GVHD

GVHD is primarily a ____ mediated disease.

T cell

the 3 phases of ____ include:

• conditioning regimen damages and activates host tissues to secrete cytokines that upgrade MHC antigens

• donor T cell activation

• multiple inflammatory cascades

  • Th1 → TNFa, IL1 → apoptosis

GVHD

the most common preventative measure of TA-GVHD (regarding blood transfusion) is to use ____ blood products.

irradiated

the common preventative measure for GVHD regarding organ transplantation is to use ____ matched blood donors.

HLA

signs and symptoms of ____ include:

• rash and fever

• liver dysfunction/jaundice

• pancytopenia

• diarrhea

GVHD

manifestation of ____ is from 2 days to 6 weeks post transfusion.

GVHD

to prevent TA-GVHD, WBC containing products are ____ to kill donor T lymphocytes rendering them ineffective against proliferation in a foreign environment (recipient).

irradiated

the type of irradiation currently used is ____ radiation.

ionized

common radioactive sources for ____ blood products include either cesium 137 (Cs137) or cobalt 60 radioisotope.

irradiated

the _____ for irradiated blood products is 25 Gy (2500 cGy/rad) to the center of the blood container and 15 Gy to any other part of the blood container.

minimum dose

____ is a radiographic film indicator that confirms irradiation for irradiated blood products.

radsure

products that are usually ____ include:

• RBCs

• platelets

irradiated

products that are not irradiated because there are no ____ found in these products:

• FFP

• cryoprecipitate

WBCs

irradiation has no effect on platelets. true or false?

true

irradiation affects ____ by killing all nuclear material in the cells rendering them inactive.

WBCs

irradiation affects ____ by damaging the membrane and causing an increased amount of extracellular free Hb and potassium over the storage time.

RBCs

the term _____ can be used to describe the effects of increasing extracellular free Hb and potassium over time during RBC irradiation.

leaching

granulocytes should not be irradiated prior to use for transfusion of a patient with a bacterial infection. true or false?

false

the new expiration date for an irradiated RBC unit is _____ post the date of irradiation.

28 days

if the original expiration date of now-irradiated RBCs are before the 28 days, maintain the original date. true or false?

true