Alvedia

Transfusion therapy refers to the safe and effective replacement of blood or one of its components offering support for many critically ill, anemic and bleeding patients. Thereby, blood transfusions have become pivotal in any emergency and critical care setting which led to the large increase of blood product usage over the past two decades. The Transfusion Medicine Academic Awards, given by the NIH to 5 veterinary schools around 1990, have spurred research and greater emphasis on comparative transfusion medicine. Many novel blood banking techniques have recently been developed for use in companion animals.

While much of this year's IVECCS conference is focusing on transfusion medicine and covers some topics in specific lectures, this expert panel will discuss many practical issues and highlight the recent advancements and controversies in canine and feline transfusion medicine. Moreover, audience participation on topics discussed is encouraged.

Several general points on transfusion medicine in companion animals are listed below and some will be addressed during this panel discussion.

• The indications for transfusions need to be clearly determined, and ideally only the deficient blood component is replaced at the appropriate dose to avoid incompatibility reactions and other untoward events.
• While red blood cells and plasma clotting factors are crucial, the indications and efficacy of transfusing platelets, leukocyte, as well as other plasma proteins are limited and controversial.
• Collection techniques and storage conditions have been optimized to assure safer and better products, and many clinic and >12 canine and few feline commercial blood banks ensure the availability of blood products.
• Blood products, however, remain a limited resource and have a short expiration date; hence they should only be given when indicated, at the minimal dose required and after carefully considering all alternatives.
• While the availability of the ultrapurified bovine hemoglobin solution has become scares, other novel products are being introduced such as lyophilized canine albumin, globulin, and platelets and recombinant factors.
• Standardized laboratory and in-practice blood typing and crossmatching tests/kits have become available to assure blood compatibility. Still true autoagglutination prevents the performance of compatibility studies.
• All blood donors need to be typed for DEA 1.1 and the feline AB blood groups, respectively, and regularly screened for their health including testing for infectious diseases appropriate for the area.
• All recipients should be typed for DEA 1.1 and feline AB and any previously transfused (>4days) animals should also be crossmatched prior to the next red cell transfusion as they may be sensitized.
• Although over a dozen blood group systems have been described in dogs, blood incompatibilities are rarely associated with them. Additional common red cell antigens are being recognized in dogs, such as dal.
• While in cats the AB system is of greatest importance due to the presence of naturally occurring alloantibodies, additional common red cell antigens are being recognized that are responsible for incompatibilities.
• While acute hemolytic transfusion reactions are feared most and can be avoided, other adverse transfusion reactions may not be difficult to predict, but may be prevented by proper blood banking techniques.
• The efficacy of transfused blood cells and plasma proteins and untoward occurrence of transfusion reactions.

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