:

(pRBCs)

-

. .
-
2011


, :
1.
2.
3.
4.
5.





:
1.
2.
3.

4.



:



10
RBCs
:
1. (18.2%)
2. (13.8%)
3. (8.8%)
 ;

:







 ;

1.

2.


:
1. 2
2.

:
1.
2.
3.
4. (TRALI)


(HIV, HBV, HCV)

HIV




1.

2.

3.

/






TRALI HLA HPA
TA-GvHD

ACE

1/1.000.000
1/30.000-1/250.000
C 1/30.000-1/150.000
HIV 1/200.000-1/2.000.000
HTLV I/II 1/250.000-1/2.000.000
B19 1/10.000

1/500.000
1/12.000
Creutzfeldt-Jacob
1/250.000-1/1.000.000
1/1.000
1/5.000
TRALI
 - SHOT
(Serious Hazards of Transfusion)
1996/7 1997/8 1998/9 1999/2000 2000/01

81 110 144 201 213

27 28 34 34 37

27 24 31 28 40

11 11 10 5 3

TA-GvHD 4 4 4 0 1

TRALI 11 16 16 19 15

8 3 9 6 6

7 0 0
169 196 255 293 315

()
 ()

Hb

,
2

 O2

2,

2/ 2
20%-25%, 50%

(50%)
Hb 3.5-4 gr/dl,
Hb 6-7 gr/dl

1. ,
2/ 2, Hb,

2.


,

 ;

1. 16

RBCs,
1.404
1.4%

2.



1. ,
,

2.

,
Hb 8 gr/dl
30, 90



1. , 418
Hb < 7 gr/dl
Hb 7-9 gr/dl, 420
Hb < 10 gr/dl
Hb 10-12 gr/dl

2.
30 2 , ,
7
gr/dl
10 gr/dl
 ;
1.

2. 257
(p >0.30)

3.

4.



1.
-

2.
,
,
2


 ;
30

, Hb
2
2.
:
1. ,
2.
3.
Hb
.


1. American College of Physiciants 1992

2. National Institutes of Health Consensus Conference
on perioperative transfusion of red cells, 1998
3. Society of Anesthesiologists 1996
4. Canadian Medical Association 1997
5. British Committee for Standards in Haematology,
Blood Transfusion Task Force (2001)
6. International Society of Blood Transfusion (ISBT)
2008
7. American Association of Blood Banks (AABB) 2009
 ;

1. RBCs

2.
RBCs Hb 6-8 gr/dl

3. RBCs
Hb 8 gr/dl,

Hb 10 gr/dl

4.
Hb 11 gr/dl



Hb > 10g/dl

Hb 7- 10g/dl

Hb <7 g/dl


15% :
-

15-30% :
,
-

30- 40% :
,

>40% :



(Fe,
B12, )

Hb

Hb =8 g/dl

1.

Hb 9-
11g/dl

2.
Hb<7 g/dl

3.



1.
2.
3.
4.
5. Hb>8g/dl
6. >75x 109/l ( >100 x 109/l
, )
7. PT APTT<1.5
8. >1g/l
9.


1.

(.. , )

2.

(.. , )

3. (.. , )


1.

2. -


3.
-

4.


 FFP




1. ( ,
, )

,
,
> 10 x 109 /l

20 x 109 /l
2. ( []):
> 38 C
10 / 5 x 109 /l
3. :
> 20 x
109 /l.

4.
( , )

10 5 x 109 /l

5. :

,
,

.

:

, ,
, ,
, ,
,
50 x 109 /l

(.. , )
100 x 109 /l

1. ,
(.. ibuprofen),
ADP, .

2.
,

3. Ht > 30%
rhEPO

4. DDAVP
,


:
2 50
x 109 /l

< 50 x 109 /l

, 100 x 109 /l

():
()
, > 50 x
109 /l.
,



:

(
Glanzmann )
,

()

, ,
,
IV IV

1. (),

2.
(HIT-)

1.

2. -

3. -

4. -

5.
,
- -


1. Rh (-) Rh (-)

2. Rh (+)
anti-D

1.
(HBV,HCV,HIV)
,
(1:3000 )
1:25000
2. HLA
HLA I


3.
4. TA-GVHD
5. TRALI

Fresh Frozen Plasma
 (Fresh Frozen Plasma)

1. FFP 1

<-300 C 6

2. 1

FV FVIII

3.
2 .

1. FFP



2. FFP

,
12-15 ml/kg
3. FFP
PT
aPTT
 FFP

1.

2.

3.

4.

5.
 FFP

1. --
II, VII, IX
X, ,
C S, 4-6

2.
,
FFP 1 Lt
 FFP
1.
shock, , ,
V, VIII, ,
,

2. ,
, FFP

3.
FFP

 FFP

1. PT/aPTT
1.5 , (PT
>18 sec aPTT >55-60 sec) FFP

2.

(
<50 x 109/l)

 FFP
1.

2.
,

,
3. FFP
,
,

4.

,
II, VII, IX, X 40%
 FFP
FFP > 1 L
PT 1.6-1.8 ,
,


(PCCs)

,

,

 FFP
1.

2.

3. , ,
,
FFP

4.
 FFP

1. ,

2.
- -

3.

4. RHESUS,
(10 )

 FFP
1.
1-3%
< 1:100.000

2.

3.
, ,
TRALI (Transfusion-Related Acute Lung Injury)

 FFP

1.

2.

3. ,

4. (HAV,HBV,HCV,HIV1+2,Parvo B19)

5. variant Creutzfeldt- Jakob

 ()
1. ) (18%-20%):


ARDS

) (4.5%-5%):
(>30%)


shock
2. (fibrin glue or fibrin sealant)
3.
 ()
4. FVIII:
5. FIX:
6. FvonWillebrand: vonWillebrand
7.
8.
9. FVII
10.
11. C
12. C1-
13. -1- ()
14. annan-binding (MBL)
 ()
15.
16.
17.
18. 1
19. ADAMTS-13 ( von
Willebrand)
20. (
)

1. ,
,

2.
,





(85ml/kg , 100
ml/kg )




(CMV)

,


(TAGVHD)
(, ).