¼±Åà - È­»ìǥŰ/¿£ÅÍŰ ´Ý±â - ESC

 

Transfusion

1. ¼öÇ÷½Ã Áõ°¡Á¤µµ

platelet 50-70 ml : 5õ-1¸¸/uL Áõ°¡

cryoprecipitate : factor VIII 80U Áõ°¡

FFP(200-250 ml) : coagulation factor 2% Áõ°¡

packed RBCs(180-200 ml) : Hb 1g/dL Áõ°¡

2. delayed hemolytic transfusion : anti-JK¶§¹®

3. ±¹³» ³óÃàÀûÇ÷±¸ ÃÖ´ë º¸°üÇã¿ë±â°£: 35ÀÏ, CPDA-1

4. cryoprecipitate(factor 1, 8, 13, vWF)ÀÌ À¯¿ëÇÑ Áúȯ

Hemophilia A, von Willebrand disease, DIC, afibrinogenemia

5. FFP transfusion Ix: coagulopathy, °áÇÌµÈ plasma protein°ø±Þ, TTPÄ¡·á

6. Ç÷¼ÒÆÇ ¼öÇ÷ȯÀÚ¿¡¼­ low platelet CCI¸¦ º¸ÀÌ´Â °æ¿ì

refractoriness : anti-HLA Ab, anti-Plt Ab

±× ¿Ü: ¹ß¿­, ÃâÇ÷, ºñÁ¾´ë, DIC, drug

cf. ºÒÀÀ¼º ¿¹¹æ¹æ¹ý: HLA- & ABO matched donor, single donor, leukocyte reduced

component

7. CCI(corrected count increment)

= (¼öÇ÷ÈÄ - ¼öÇ÷Àü Ç÷¼ÒÆÇ ¼ö)/¼öÇ÷ÇÑ Ç÷¼ÒÆÇ ¼ö(¡¿1011) ¡¿ BSA

¼öÇ÷ 1½Ã°£ÈÄ 10¡¿109/mL, 18-24½Ã°£ÈÄ 7.5 ¡¿ 109/mL°¡ Á¤»óÀÓ

8. ¼öÇ÷½Ã 2500 cGyÀÇ gamma irradiationÀÇ ÀûÀÀÁõ

BMT recipient, congenital immunodeficiency syndrome,

immunosuppressive tx¹ÞÀº malignancyȯÀÚ(neutropenic pt)

1kg¹Ì¸¸ÀÇ ¿µ¾Æ

intrauterine transfusionÀ» ¹ÞÀº ½Å»ý¾Æ

homozygous HLA_haplotypeÀ» °øÀ¯ÇÑ °¡Á·, ģô³» ¼öÇ÷

9. RBC contaminationÀÇ mc cause: Y. enterocolytica, P. aeruginosa

Ç÷¼ÒÆÇ ¿À¿°À¸·Î ÀÎÇÑ ÆÐÇ÷ÁõÀÌ RBC ¿À¿°À¸·Î ÀÎÇÑ ÆÐÇ÷Áõº¸´Ù ÀÓ»ó¾ç»óÀÌ ´õ ´Ù¾çÇÏ´Ù.

10. ¼öÇ÷ÀÇ ºÎÀÛ¿ë

delayed hemolytic transfusion reaction(DHTR) - ÀúÀý·Î ÁÁ¾ÆÁø´Ù.

acute lung injury: donor´Â ´ëü·Î multiparous woman, ÈÄÀ¯Áõ¾øÀÌ È¸º¹µÈ´Ù.

fluid overload, hypothermia, electrolyte toxicity(hyperkalemia, hypocalcemia, acidosis)

11. febrile nonhemolytic transfusion reaction

¹éÇ÷±¸¿¡ ´ëÇÑ Ç×ü°¡ ¿øÀÎÀ̸ç Àü¿¡ ¸¹Àº ¼öÇ÷À» ¹ÞÀº ȯÀÚ¿¡¼­ ¹ß»ýÇÑ´Ù.

leukocyte filter¸¦ ÀÌ¿ëÇÔÀ¸·Î½á ÀÌ·¯ÇÑ ¹ÝÀÀÀ» ´ëºÎºÐ ¿¹¹æÇÒ¼ö ÀÖ´Ù.

12. ¼öÇ÷µµÁß ¿­ÀÌ ³ª´Â °æ¿ì

hemolytic transfusion reaction

febrile non-hemolytic transfusion reaction

acute lung injury

anaphylaxis

septic transfusion

13. leukocyte filter¸¦ »ç¿ëÇÒ ¶§ ¿¹¹æÇÒ¼ö ÀÖ´Â ¼öÇ÷ºÎÀÛ¿ë 3°¡Áö

febrile non-hemolytic transfusion reaction

HLA alloimmunization

transfusion induced infection(CMV)