Case Studies from the Transfusion Service

1/11/2016

Case Studies from the Transfusion Service Andrea McGonigle, M.D. Associate Medical Director, Transfusion Medicine UCLA Health System

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Objectives •Case 1: • Understand • Describe

natural role of IgA and define deficiency

mechanism and risk factors for IgA anaphylaxis

• Discuss management

strategies for IgA deficient patient

•Case 2: • Define

hyperhemolysis syndrome (HS)

• Describe

proposed pathophysiology of HS

• Discuss management

of HS

•Case 3: •

Understand risk of mortality in patients refusing transfusion

• Recognize

that specific products refused is variable

• Transfusion medicine

role in Jehovah’s witness patients

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McGonigle, Andrea

1

Case Studies from the Transfusion Service

1/11/2016

Objectives •Case 1: • Understand • Describe

natural role of IgA and define deficiency

mechanism and risk factors for IgA anaphylaxis

• Discuss management

strategies for IgA deficient patient

•Case 2: • Define

hyperhemolysis syndrome (HS)

• Describe

proposed pathophysiology of HS

• Discuss management

of HS

•Case 3: •

Understand risk of mortality in patients refusing transfusion

• Recognize

that specific products refused is variable

• Transfusion medicine

role in Jehovah’s witness patients

4

Case 1: Transfusion issues in an IgA “deficient” patient

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Case Background •10:15 am: Anesthesiologist call •69 yo M with interstitial lung disease •Patient undergoing single lung transplant today •Concern for risk of IgA anaphylaxis •Pre-op assessment revealed history of IgA deficiency •IgA