Plus-Hex CLINICAL
FWB must be used within 24 hours of collection, as it cannot be stored longer under refrigeration. Strict aseptic techniques are essential to maintain sterility of the blood, equipment and all personnel involved in the transfusion process. In practice, this includes working in a closed system, whereby the blood remains within sealed, sterile collection and administration sets that are not open to the environment, alongside appropriate hand and skin preparation, use of sterile consumables and adherence to infection control protocols as part of the veterinary nurse ' s( VN ' s) role in transfusion medicine. FWB is most beneficial in cases of trauma and active bleeding, as it contains RBCs to increase oxygencarrying capacity, and proteins and platelets, which are essential for coagulation. Once FWB has been collected, the platelets become non-viable 4 – 6 hours after collection, resulting in reduced coagulation [ 12 ].
pRBCs are most useful when patients have a normal circulating volume but low RBC count, and are beneficial for increasing oxygen delivery while avoiding fluid overload [ 13 ]. The main indications for the use of pRBCs are primary or secondary anaemia. Conditions that can lead to secondary anaemia include chronic kidney disease, neoplasia, infections with FIV or FeLV, and immune-mediated diseases [ 14 ]. pRBCs do not contain plasma, which avoids the risk of fluid overload. They also carry lower risks of transfusion reactions, as they do not contain plasma antibodies; this means they are especially beneficial for patients with type AB( C) blood receiving a transfusion of type A pRBCs.
Fresh frozen plasma( FFP) is used mainly for coagulopathies caused by deficiencies in clotting factors and hypotension. Examples include rodenticide toxicity or disseminated intravascular coagulation( DIC) [ 12 ].
In cases of neonatal isoerythrolysis or orphaned neonates that did not receive adequate colostrum, plasma from a healthy, vaccinated donor, administered intraosseously, can provide antibodies to the young kitten. This is especially beneficial for pedigree kittens from incompatible blood-typed parents, which may be unable to receive colostrum from the queen. The aim of transfusing matched plasma to neonatal kittens is to provide additional support to their immune system [ 9 ].
Cross-matching
Cross-matching is an important aspect of testing the suitability of the donor blood for the recipient. A cross-matching test is done using samples of both the donor ' s and recipient ' s blood to identify any potential incompatibilities or alloantibodies between the two. These may be identifiable by visible agglutination( Figure 1), whereby the donor ' s RBCs separate( and aggregate) from the prospective recipient ' s serum. Haemolysis, which is the destruction of RBCs, may also be seen. Either reaction indicates that the donor blood is incompatible for the patient [ 15 ].
Figure 1. The left tube shows agglutination of red blood cells. The contents of the right tube are not agglutinated, indicating a compatible match between the donor and recipient.
Cross-matching is split into two parts: major and minor cross-matching. In major cross-matching, the patient ' s plasma is mixed with the donor ' s RBCs. It detects antibodies in the recipient that would destroy the newly transfused donor RBCs. This cross-match is most important for ensuring the survival of the transfused RBCs and reducing potential transfusion reactions [ 12 ]. In minor cross-matching, the donor ' s plasma is mixed with the patient ' s RBCs [ 12 ]. It detects antibodies in the donor ' s plasma that could attack the recipient ' s RBCs.
Due to the presence of naturally occurring circulating antibodies, it is recommended that cats receive all tests, including agglutination testing, cross-matching and blood typing, before any transfusion procedure. Failure to undertake any of the recommended testing can result in acute haemolytic transfusion reactions, even at a first transfusion, due to incompatibilities between the donor and recipient. Although testing is important for all feline patients, it is a particularly important consideration for patients with an unknown transfusion history or those that have had a previous transfusion reaction, especially if recent [ 11 ].
Volume 41( 3) • June 2026
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