>=16 yo >=8wks single unit whole blood >=16 wks double unit blood temp: =12.5g/dL/38% W; >=13g/dL/39% M

blood bank Flashcards by Doug Thompson

Donor requirements

> =16 yo
=8wks single unit whole blood
=16 wks double unit blood
temp: <=99.5
BP: 90-180/50-100 mmHg
pulse: 50-100bpm
110lbs
H/H: >=12.5g/dL/38% W; >=13g/dL/39% M

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Autologous donorreqs

physicians order
H/H: >=11g/dL/33%
collection >72H before surgery
no risk of bacteremia
Confirm ABO/Rh

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Directed donation

Good for low incidence antigens

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Drug deferals
Tegison

Permenant

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drug deferals
Erivedge
odomzo
aubagio
arava

24 months

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Drug deferals
proscar, propecia
accutane
avodart, Jalyn
soriatane
Cellcept

1 mo
1mo
6 mo
3 y
6 w

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Dru deferal
Aspirin

2 days

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Drug deferal
plavix

14 days

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Drug deferal
Warfarin

For plasma, 7d

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drug deferal
HIV prevention

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drug deferal
HIV prevention (injectable!)

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Apheresis Donor Req

Plasma:
once every 4 wks OR <= 2/wk at least 2 days apart
>=50kg
Platelets:
2 day donation interval
once a wk for double/tripple donation
<= 24 donation in 12 mo
count >= 150 X10^9

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Donation collection

Aseptic technique
NO green soap
iodione or iodine and iso alc
10-40 ml diverted to avoid contamination
MAX: 10.5 mL/kg of donor weight

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donor adverse reactions

most occur at the site
Vasovagal (pass out)
injury from needle insertion
Citrate toxicity, air embolism, hypovolemia
allergic reactions (usually iodine)

Post-donation Fe deficiency

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Donor serological testing

ABO
Rh
Weak D testing if Rh =

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Donor disease testing

Every donation screened every time, except Cruzi which is a 1 time
Babesia dependant on location

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donor plt testing

10-40mL diverted for testing, can contain contaminated skin
Cultures maintained for the shelf life of the unit
issued after the first 12 h of incubation

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Blood component manufacture

WB to plateletes: cooled to 20-24C or units to 1-10C
cetrifuged for shortest time and lowest speed. reduces dmg

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red blood cell products

42 day shelf life
2,3 DPG declines rapidly after 1-2wks storage,
transfusion for babies usually less that a week old because of 2,3 DPG

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FFP product

placed in freeze <=-18C within 8hrs
PF24 is not frozen w/in 8 hrs but before 24 h. 1-6C w/in 8 hrs

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Cryoprecipitate product

FFP that is thawed @1-6C
white material that is suspended in thawed plasma
resuspended in 10-15 mL plasma and frozen
pooled: 4-10 units into single unit, then frozen

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plateletes products

low spin to seperate RBC from PRP
hard spin to seperate plateletes from plasma
plasma removed and pellet resuspended
Pooled: 5 day expiration from oldest unit
pooled before transfusion 4h expiration
adult transfusion 4-6 units

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expiration of bacterial risk control
Pathogen reduction

5 days

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Expiration for bacterial control
LVDS 36h

5days

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Expiration for bacterial control LVDS 48h

7days

Expiration for bacterial control pri culture 24h; 2nd culture 3 days

5 days

Expiration for bacterial control pri culture 36h; 2nd culture 4 days

7 days

Expiration for bacterial control pri culture 36h; 2nd culture rapid detection

7 days

Expiration for bacterial control rapid bacterial testing

WBD platelets: 5 days post storage pools WBDP: 4 h

Expiration for bacterial control Single culture sampling 36h after collection

5 days

Expiration for bacterial control single culture sample 24h after collection

5 days

Pathogen reduction technology

Amonosalen+UVA light: prevents nucleic acid replication platelets that undergo are not required to be cultured alternative for babesia questioning inactivate WBCs, removing risk of GVHD and negating irradiation

Sterile connection device

closed system maintains original expiration date uses: prestorage pooled platelete/pooled cryo AHF Splitting units for fetal use, attachment for LR filters, culture sampling

storage and transport

temp recorded and logged every 4h at least RBC: 1-6C/transport 1-10C frozen RBC:<= -65C/transport maintain frozen platelete: 20-24C w/ agitation/transport 20-24C, <=30h w/o agitation cold store platelets: 1-6C, optional agitation/transport 1-10C FFP/Cryo: <=-18C/transport maintain frozen thawed plasma:1-6C/ transport 1-10C Thawed cryo: 20-24C/same Aphoresis gran: 20-24C/same

shelf life LRWB and WB

CPD/CP2D: 21d CPDA-1: 35D Open system 24h

Shelf life RBC

42d

Shelf life LRBC

42d

Shelf life Apheresis RBC

42d

Shelf life Frozen RBCs

10y

Shelf life deglycerolyzed RBCs

open system: 24h Closed system: 14d

Shelf life Plateletes

shelf life pooled platelets

5d, up to 7d with rapid bacterial testing

shelf life apheresis platelets

5d-7d

shelf life apheresis platelets (patho reduced)

shelf life aphoresis platelets additive solution

shelf life cold store platelets

14d at 1-6C

shelf life aphoreseis granulocytes

24h

shelf life FFP

<= -18C: 12m <=-65C: 7y

shelf life PF24 plasma

<= -18C: 12m

shelf life Thawed plasma

4d after initial 24h thaw period

shelf life Cryo

<= -18C: 12m non-pooled: 6h thawed Pooled: 4h thawed

blood product QC RBC

RBC: HCT >= 80% LRBC: <5x10^6 Leuk Apheresis RBC: >= 60g Hb LRBC apheresis: >=51g Hb, <5x10^6 Leuk

Blood product QC Plateletes

Plateletes: 5.5x10^10 plts, PH >=6.2 LR plateletes: 5.5x10^10, <8.2x10^5 leuks, PH >=6.2 pooled plts: <5.5x10^5 Leuks, >=6.2 PH Apheresis plts: >=3x10^11

Blood product QC Apheresis gran

>= 1x10^10 granulocytes

blood product QC Cryo

>=150 mg Fibrinogen & min of 80 IU of FVIII

Blood group systems carbohydrate antigens

ABO, H, LE, I, P1PK, GLOB Naturally occuring usually IgM, can be IgG React best at RT Usually direct agglutination Can react with complement

Blood group systems Protein antigens

FY, JK, KEL, Rh, MNS immunogenic usually IgG react best at 37C Attach to respective antigens, failing to demonstrate direct agglutination AHG reagent used to demonstrate agg. (IAT)

Hardy-Weinberg equation and work

p^2+2pq+q^2=1 p+q=1 if K+ is in 9% of the population, determine KK, Kk, kk p^2+2pq+q^2 =1 q^2=1-(p^2+1pq) (p^2=2pq) - K+ = .09 q^2=.91 q=sqrt .91=.95 p+q=1, p=1-.95 p=.05 Therefore p^2 = .05^2 = .0025 is the frequency of KK 2pq = 2(.05x.95) = .0950 is the frequency of Kk q^2 = .95^2 = .9025 is the frequency of kk

ABO

Most important non-immunogenic Ch.9 A/B genes co-dominate, or dominant in the presence of O A terminal sugar: N-acetylegalactoseamine B terminalk sugar: Galactose

H antigen

FUT1 Gene Ch. 19 H terminal sugar: Fucose H expression most to least : O>A2>b>A2B>A1>A1B