Retrospective evaluation of indications, transfusion protocols, and acute transfusion reactions associated with the administration of lyophilized canine albumin: 53 cases (2009-2020)

OBJECTIVES

To describe the administration of lyophilized canine albumin (LCA) and determine the increase in serum albumin concentrations post-LCA transfusion. To describe the incidence and types of acute transfusion reactions (TRs) and associated outcome in dogs presenting to a veterinary teaching hospital.

DESIGN

Retrospective and descriptive study from 2009 to 2020.

SETTING

University teaching hospital.

ANIMALS

Fifty-three client-owned dogs included in the study if they received an LCA transfusion and had vital sign monitoring recorded for at least for 4 hours after starting the LCA transfusion.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

The 53 dogs available for study inclusion received 64 LCA transfusions. Signalment; underlying disease; indications for LCA transfusion; pre- and posttransfusion serum albumin concentration; volume, concentration, and dose of LCA; duration of transfusion; administration of other blood products or synthetic colloids; occurrence, timing, and type of TR; length of hospitalization; and outcome were recorded. Serum albumin concentrations increased post-LCA transfusion, with a median dose of 0.56 g/kg and a median posttransfusion serum albumin increase of 3 g/L (0.3 g/dL) (P = 0.008). TRs occurred in 13 of 64 (20.3%) transfusion events. Volume per kilogram, dose (g/kg), concentration, duration of transfusion, and additional administration of synthetic colloids were not associated with TRs. Three (23%) TRs were classified as febrile nonhemolytic transfusion reaction, 5 (38.5%) as transfusion-associated dyspnea (development of respiratory distress and limited diagnostics), and 5 (38.5%) had clinical signs that could not be defined by any 1 TR category. Six (46.1%) of 13 events were nonsevere, 5 (38.5%) were severe, and 2 (15.4%) were life-threatening.

CONCLUSIONS

Administration of LCA can be used to increase serum albumin concentrations, although the clinical implications of this increase are unknown. Acute TRs associated with LCA are relatively frequent and can be life-threatening. Careful monitoring is vital.

Agglutination and hemolytic crossmatching to determine transfusion reaction differences between large and small breed goats

BACKGROUND

Blood transfusions are performed frequently in goats, but crossmatches are rarely performed.

HYPOTHESIS/OBJECTIVES

Determine differences in the frequency of agglutination and hemolytic crossmatch reactions between large and small breed goats.

ANIMALS

Healthy adult goats, 10 large and 10 small breed.

METHODS

Two hundred eighty major and minor agglutination and hemolytic crossmatches: 90 large breed donor to large breed recipient (L-L), 90 small breed donor to small breed recipient (S-S), 100 large breed donor to small breed recipient (L-S). A linear mixed model with treatment group (L-L, S-S, L-S) as a fixed effect and individual crossmatch as a random effect was used to identify variations in reaction frequency among groups and individuals.

RESULTS

Frequency of major agglutination reactions for L-L, S-S, and L-S were 3/90 (3.3%), 7/90 (7.8%), and 10/100 (10.0%), respectively. Frequency of major hemolytic reactions for L-L, S-S, and L-S were 27/84 (32.1%), 7/72 (9.7%), and 31/71 (43.7%). Individual pairings and groupings had no effect on agglutination reactions. Individual pairings had no effect on the frequency of hemolytic reactions. For major hemolytic crossmatches, pairwise comparisons identified higher frequencies of reactions when comparing L-L to S-S (P = .007) and L-S to S-S (P < .001).

CONCLUSION AND CLINICAL IMPORTANCE

Goats experience increased frequencies of hemolytic reactions compared to agglutination. Significant increases in hemolysis were seen between large breed donors and small breed recipients, compared to small breed pairings. Additional studies are required to determine correlations between crossmatches and transfusion reactions.

Incidence of acute haemolysis in cats receiving canine packed red blood cells (xenotransfusions)

OBJECTIVES

The aim of this study was to report the incidence of transfusion reactions in cats, including acute haemolysis (AH), occurring within 24 h of receiving a xenotransfusion. An additional aim was to determine whether cases with AH could be classified as having an acute haemolytic transfusion reaction (AHTR) as per the definition provided by the Association of Veterinary Haematology and Transfusion Medicine's Transfusion Reaction Small Animal Consensus Statement.

METHODS

Medical records of cats that received canine packed red blood cells (PRBCs) between July 2018 and September 2020 at a veterinary hospital were reviewed. The incidence of AH, AHTRs, febrile non-haemolytic transfusion reactions (FNHTRs), transfusion-associated circulatory overload and septic transfusion reactions were recorded.

RESULTS

The medical records of 53 cats were retrospectively evaluated. Twenty-three (43%) cats had transfusion reactions. Thirteen (25%) cats had AH; however, only four (8%) met the definition of an AHTR. Ten (19%) cats were determined to have FNHTRs. Survival to discharge of cats affected by AH was 50% (25% for cases that met the definition of an AHTR). Survival to discharge of cats not suffering from AHTR was 40%.

CONCLUSIONS AND RELEVANCE

This report indicates that a higher proportion of cats undergo AH (25%) when administered canine PRBCs than previously reported, although many could not be classed as having an AHTR due to an apparently adequate packed cell volume rise. Challenges with sourcing feline blood in emergency situations occasionally necessitates the use of xenotransfusion in transfusion medicine. Clinicians should be aware that haemolysis after xenotransfusion can occur within 24 h and that a repeat feline transfusion may be required sooner than anticipated in some cases.

Xenotransfusion of anemic cats with blood compatibility issues: pre- and posttransfusion laboratory diagnostic and crossmatching studies

BACKGROUND

Finding compatible feline blood donors can be challenging. Canine blood has been occasionally used when compatible feline blood was not available in emergency situations.

OBJECTIVES

The study goals were to describe the effects of xenotransfusion in 2 anemic cats receiving canine blood because of discordant blood types and acute transfusion reaction, respectively, and to report in vitro heterotyping and crossmatching results between canine and feline blood samples.

MATERIAL AND METHODS

Blood samples from patients and other cats and dogs were typed, crossmatched, and assessed for alloantibodies using gel, card, and immunochromatographic strip techniques.

RESULTS

Cat 1 was found to have type AB blood. Cat 2, which experienced an acute transfusion reaction, had type A blood. Neither had detectable alloantibodies against feline RBC. Both cats transiently improved after transfusion with canine blood; however, acute intravascular hemolysis occurred and the PCV rapidly declined. Blood typing post xenotransfusion with DEA 1 strips revealed a positive control band that was absent in feline blood, thus allowing for the identification of transfused canine RBC. Longitudinal assessment revealed that canine RBC could no longer be detected 4 days after xenotransfusion. Major crossmatching (feline plasma with canine RBC) resulted in both positive and negative reactions, depending on the cat. Minor crossmatching results showed mostly incompatibility.

CONCLUSION

While both cats survived xenotransfusion, the positive control band on the DEA 1 strip revealed that transfused canine RBC were short-lived and intravascular hemolysis occurred. Crossmatch results between cats and dogs showed varied incompatibilities and may not predict transfusion reactions.