BLOOD AND BLOOD COMPONENTS COLLECTION TRANSFUSION AND PRESERVATION OF BLOOD

PRESENTED BY DR ABAS RASHID BHAT MVSC SCHOLAR IST YEAR

Blood Tests Transfusion Blood Biochemistry Pathogen identification

REASONS OF BLOOD COLLECTION

METHODS
Blood samples are collected by venal puncture on live animal, as cleanly as possible, using sterile equipment, and with respect for the welfare of the animal. Use new needle and syringe for each animal. Dispose needles properly, Clean the puncture area with 70% alcohol, Handle animals calmly and using appropriate restraint,

Contd Although most techniques do not require large amount of blood it is preferable to collect at least 2.5mL of blood, but ideally 10mL in large animals, and 4-6mL in small animals.

Identify the sample with a permanent method and fill the sampling form at the time of sampling.

SITES OF BLOOD COLLECTION

Jugular veins (large animals), Brachial, brachiocephalic, femoral, tarsal veins, Cranial Vena cava in pigs, Mammary veins, Ear veins in pigs: 20 gauge needle, Saphenous veins, retro-orbital veins, intracardial punction in rodents, small vertebrates, use a 23 gauge needle, Wings (brachial) in chicken, use 20 to 23 gauge needle.

Whole blood is prone to hemolysis.

PRECAUTION

Preferentially use a vacutainer instead of a syringe If you have to transfer the blood from a syringe to a sample container, remove the needle first and transfer slowly and smoothly Do not shake the blood. Do not freeze whole blood.

.BLOOD TRANSFER TRANSFERRING OF BLOOD

Whole blood samples preservation

WHOLE BLOOD means with all Constituents the blood needs to be stored properly , with an anticoagulant. Different anticoagulants are available in commercial tubes such as: EDTA (purple tubes) or Heparin (green tubes). However EDTA is often recommended. For virology antibiotics may be added. 200 units of penicillin and 200 mg of streptomycin per ml of blood.

Whole blood samples should be sent to the laboratory in an insulated container with ice at 4C.

.They should not be frozen.

->Blood samples for virology must be sent to
the laboratory within 24 to 72 hours depending on virus survivability.

PLASMA COLLECTION
Supernatent of unclotted blood Stored at -20 deg cel.

SERUM
SERUM= PLASMA CLOTTING FACTORS
PRESERVED BY REFRIGERATION

Blood Transfusion In Veterinary practice

Introduction
Significant increase in blood transfusions for over the past 20 years in small animal medicin Most commonly used products: whole blood, packed red blood cells, plasma

Whole blood

PLASMA

Blood Types
Canine:
Thirteen canine blood types Designated by DEA (Dog Erythrocyte Antigen) & a number (DEA 1, DEA 2, DEA 3, etc). Important alleles of DEA 1: 1.1 and 1.2 DEA 1.1 positive (most common type) => universal recipient DEA 1.1 and 1.2 negative => universal donor

Blood Types
Feline
AB blood type system Types: A, B, AB (very rare) Naturally occurring alloantibodies to other blood groups => no universal donor in cats Type A cats: weak anti-B alloantibodies (weak reaction if transfused w/ B blood) Type B cats: high anti-A alloantibodies (severe reaction if transfused w/ A blood)

 Predicts a transfusion recipients response to a donors RBCs and plasma Major cross-match
detects antibodies in the recipients plasma that can cause a hemolytic reaction to donor RBCs

Cross-matching

Minor cross-match
detects antibodies in the donors plasma that might react to recipients RBCs

RBC agglutination = Incompatibility

CROSSMATCH

DONOR(ml) RED CELL SERUM

RECIPIENT(ml) RED CELL SERUM

MAJOR

0.1

---

---

0.1

MINOR

---

0.1

0.1

---

DONOR CONTROL

0.1

0.1

---

---

RECIPIENT CONT.

----

---

0.1

0.1

Incubation for 15min at 37C,room temperature , and 4C

Cross-matching - Canine
Dogs lack naturally occurring alloantibodies => a cross-match does not need to be performed on a patient receiving a transfusion for the first time Sensitization takes about 3 days
No cross-match needed if transfused within the previous 72 hours Cross-match becomes necessary 72 hours after a dog receives a transfusion

Cross-matching - Feline
All cats should be cross-matched if blood type is unknown or typing card unavailable

Donors
Canine

Good general health Between 1-8 years of age Minimum weight of 25 Kg (55 lb) - allows 450 mL of blood to be collected PCV should be 40% Current on vaccinations (DALPP, Rabies) Yearly exam and full CBC/Chemistry / heartworm antigen test Infectious diseases screening: .>Donors should not have had any previous transfusions because of risk to foreign RBC antigens and the development of antibodies

TRANSFUSION IN LARGE ANIMALS

OCCASIONAL SHOULD BE Checked for compatibility Done in babesiosis,anemia,blood loss etc Biological compatibility test(10 ml blood iv) Ist transfusion no risk 2nd transfusion-risk

Canine Blood Collection

Donor in lateral recumbency Fur over the jugular vein is clipped and aseptically prepped A 16g needle is inserted into the jugular vein The bag is gently rocked back and forth as it fills, distributing the anti-coagulant(63ml CPDA) evenly; the sample is periodically weighed until the proper volume is achieved Canine units are usually 450 mL or 450 grams The hemostat is clamped back Pressure is applied to jugular vein to prevent hematoma

Dosages
ACD@15ml per 100 ml blood CPD and CPDA-1 @14ml per 100 ml blood at 2 to 6C, ACD whole blood and CPD whole blood can be used within 21 days after collection. (70% live rbc) In CPDA-1 35 DAYS Heparin less used

Administration
Blood products should be allowed to come to room temperature before administration Plasma is thawed by placing the plasma in a protective plastic bag and submerging it in a warm water bath not exceeding 98.6 F (37 C) - 30-60 minutes is generally adequate for thawing.

Administration
Several routes may be used for administering blood products
Intravenous (via 22-18g IVC) is the most common and effective, delivering blood products directly into circulation Intraosseous is also effective when vascular access is difficult or unsuccessful and often used for neonates Intraperitoneal

Plasma transfusion: for clotting factors 170-220 m in-line filter Smaller doses may be given via a 17um Hemo-nate filter Filters prevent protein debris, cellular debris, and blood clots from passing to the patient Blood products may be infused via free drip, syringe pump and fluid pump

Amount of donor whole blood (ml) required: = 90 x BW (kg) x Desired PCV- Actual PCV Donor PCV

Administration
Administration rates are variable Patients with massive hemorrhage may require a rapid transfusion Patients with chronic anemia need a slower infusion Blood components should always be infused slowly (1 mL/kg) for the initial 15-30 minutes while observing for transfusion reaction Subsequently, the rate may be increased to 5-10

mL/kg/hr

The blood product should be infused as quickly as the patient can safely tolerate, while maintaining detailed monitoring

Reactions
Immune-mediated
Hemolytic
Acute Delayed

Non-hemolytic

Non-immune-mediated

Reaction SIGNS
Chills, Fever, Urticaria, Tachycardia, Dyspnea, Nausea and vomiting, Tightness in the chest, chest , HHypotension, Bronchospasm, Angioneurotic edema, Anaphylaxis, Shock, Pulmonary edema, and Congestive failure

MANAGEMENT OF RXNS
Treatment depends on the severity Discontinuing thtransfusion

+administering drugs to stop the

hypersensitivity reaction Like CPM, coticosteriods,adrenaline. Once medications have taken effect and the patient is stabilized, the transfusion may be continued

COMPLICATIONS
Hypocalcemia Fluid OVERLOAD Disease transmission COAGULOPATHIES(HEPARIN)

THANKS Moti.