4th Pediatric Infectious Diseases Conference
 
 
Home  Back   ISSN 0973 - 0958
 
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Pedi Poll
Today's Poll
Should teicoplannin, colistin be used in case of neonatal sepsis where culture does not reveal any organism_?
No, it should be used only after drug sensitivity report
Yes, under guidance of an infectious disease expert
ADMINISTRATION OF BLOOD
Administration of Blood
Dr. Mukesh Desai
Consultant Pediatric Hematologist-H.N. Hospital,
Consultant Pediatric Hematologist-Nanavati Hospital.


Continued...

ADVERSE REACTIONS TO BLOOD TRANSFUSION :


POST TRANSFUSION PURPURA :

Incidence :
 
Uncommon
Presentation:
-
Acute severe thrombocytopenia 5 - 10 days after transfusion in a previously pregnant female or multiple-transfused individual.
  - Typically perimenopausal or menopausal women
  - Rare in males.
Pathophysiology:
-
Patients platelet lack HPA -1a (PLA1)
  - 2 % of population
  - Antibodies destroy both HPA-A1 positive and HPA -A1negative platelet..
Course :
 
Self-limited, recovery in 21 days
Treatment :
-
Steroids controversial
  - Plasma exchange
  - IV IgG
  - HPA-A1 antigen negative platelet of benefit but difficult to arrange.
Prognosis :
 
Good
    Recurrence rare.
Prevention :   Washed PC
 
Blood from HPA-A1 negative patients.

PLATELET REFRACTORINESS :

Incidence:
  20 to 70 % requiring multiple platelet transfusion
Criteria :
  Lack of accepted CCI of two platelet transfusion
    Poor response to three platelets in 2 weeks
Causes :
  Platelet alloimmunization
    Non-immune causes
Immune causes:
  ABO mismatch
    Anti HLA antibodies
    Platelet specific allo and autoantibodies
    Drug dependent antibodies
Most common cause:
  Anti HLA antibodies
    Produced by passenger lymphocytes
    May disappear
Strategies for prevention:
  ABO matched Single donor apheresis platelets
  - Leucodepletion using leukocyte filters
  - HLA matched platelets difficult - Need a donor pool of 2000 to 3000 donor
  - Irradiation of HLA matched platelets must

Last created on 01-05-2005
Last submitted on 01-07-2006


 
 
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