BLOOD COMPONENT PREPARATION Flashcards
Collection of blood in a sterile container
Close system
Collection or exposure to air through an open port that would shorten the expiration because of potential bacterial contamination
Open system
FDA requires an average ____ hours post transfusion RBC survival of more than ___%
24 hours ; 75%
Storage time (days) of ACD, CPD, CP2D
21 days
Storage time (days) of CPDA-1
35 days
Storage time (days) of CPDA-2
42 days
RBC additive solution extends the shelf-life of RBC to ___ days by adding nutrients
42 days
RBC additive solution produces an RBC concentrate of _____ that is easier to infuse
Lower viscosity
Open system : RBC must be used within ___ hours
24 hours
Open system : platelets must be used within ___ hours
4 hours
Additive solution must be added within ____ hours of whole blood collection
72 hours
Volume of additive solution added to 450 mL of blood
100 mL
Volume of additive solution added to 500 mL of blood
110 mL
Additive solution : AdsOl
AS-1
Additive solution : NuTRIcel
AS-3
Additive solution : optisol
AS-5
Additive solution : SOLX
As-7
Chelates calcium
Citrate
Maintains pH during storage
Monobasic sodium phosphate
Substrate for ATP production
Dextrose
For Production of ATP
Adenine
Protect against storage-related hemolysis
Mannitol
Regenerates ATP and 2,3-DPG
Rejuvenation solution
Red cells stored in liquid state for fewer than ___ days after their outdate are rejuvenated for __ to __ hours at __ deg c with the solution
3 days ; 1-4 hours ; 37 deg C
Rejuvenation solution components : “PIGPA”
Pyruvate inosine glucose phosphate adenine
Only FDA approved revue=venation solution
Rejuvesol
A loss of viability and function associated with certain biochemical changes that are initiated when blood is stored in vitro
RBC storage lesions
RBC storage lesions
Changed observed : percent viable cells
Decreased
RBC storage lesions
Changed observed : glucose
Decreased
RBC storage lesions
Changed observed : ATP
Decreased
RBC storage lesions
Changed observed : pH
Decreased
RBC storage lesions
Changed observed : 2,3-DPG
Decreased
RBC storage lesions
Changed observed : oxygen dissociation curve
Shift to the left ( increased oxygen affinity of the red cells)
RBC storage lesions
Changed observed : plasma potassium
Increased
RBC storage lesions
Changed observed : plasma hemoglobin
Increased
RBC storage lesions
Changed observed : lactic acid
Increased
UV irradiation and photo-sensitizers ; psoralen treatment
Pathogen reduction technology
Pathogen reduction technology : used to decrease the risk of of TTI
Psoralen treatment
Removal of white blood cells from blood or blood components prior to transfusion ; given to patient with anti-WBC antibody
Leukoreduction
Leukoreduction QC : _____ residual white blood cells per each whole blood, red cells or apheresis platelet
<5.0 x 10^6
Leukoreduction QC : _____ residual WBCs per each platelets derived from whole blood
<8.3 x 10^5
Leukoreduction QC : _____ residual WBCs per each platelets derived from whole blood
<8.3 x 10^5
Leuko reduction QC : _____ of the original component must be recovered after Leukoreduction
> 85%
Leukoreduction categories : performed shortly after collection
Pre-storage
Leukoreduction categories : at the patient’s bedside
Post-storage
Filters are multiple layers of ______ or _____ nonwoven fibers that trap leukocytes and platelets
Polyester or cellulose acetate
Causes febrile non-hemolytic transfusion reaction and transfusion-related acute lung injury (TRALI)
Anti-leukocyte antibody
Filter : removes fibrin clot
Pore size : ____
First generation ; 170 um
Filter : removes micro aggregates
Pore size : ____
Second generation ; 20-40 um
Filter : removes 99.9% of WBC
Third generation
European leukocytes quality control
<1.0 x 10^6
Historically, other methods to achieve RBC Leukoreduction
Centrifugation
Washing
Freezing
Thawing
Deglycerolyzing
Quality control : designed to count WBCs at exceptionally low levels
Nagoette chamber
Indicated to prevent the development of transfusion -associated graft-versus host disease by INACTIVATION OF T-CELLS ; indicated for recipients of components collected from a blood relative or HLA-matched donors
Irradiation
Minimum dose of gamma irradiation
25 Gy (central portion)
15 Gy (any part of the blood unit)
Radioactive source for irradiation
Cesium-137 or Cobalt-160
To confirm a product was irradiated
Darkening of the radiographic film
The process of removing extracellular solution and replacing it with normal saline ; done to prevent allergic and anaphylactic reaction or if the donor has unexpected antibody
Washing
Washed RBCs are stored at
1-6 deg C for up to 24 hrs
Washed platelets are stored at
20-24 deg C and must be transfused within 4 hours
Main indications for washing
Allergic reaction
Removal of antibody
Removal of other substances
Allow for MULTIPLE BLOOD COMPONENTS (must be of the same component) to be transfused at a single event
Pooling
Multiple unit of red cells are typically pooled together - true ba sha or false
False - no they are not, coz they are transfused individually, but other products may be pooled <333
Pooled products expiration
Within 4 hours
Produced to support neonatal exchange transfusions (removal of toxic elements in the blood)
Reconstituted whole blood
Reconstituted whole blood is a combination of
Type O RBC + type AB plasma
For long term storage of blood for 10 years
RBC freezing
Used to prevent the lysis of red cells upon freezing
Cryoprotective agent
Small molecules that cross the cell membrane into the cytoplasm
Penetrating agent
Commonly used cryoprotective agent (also a penetrating agent)
Glycerol
Large molecules that do not enter the cell but instead form a SHELL around it
Nonpenetrating agent
Example of non penetrating agent
HES, dimethylsulfoxide
High glycerol concentration (%)
40%
Low glycerol concentration (%)
20%
Most common concentration of glycerol for RBC freezing
40%
High glycerol : Initial freezing temp
-80C
High glycerol : Type of freezer
Mechanical
High glycerol : maximum storage temp
-65C
High glycerol : shipping requirements
Dry ice
Low glycerol : initial freezing
-196C
Low glycerol : type of freezer
Liquid nitrogen
Low glycerol : maximum storage temp
-120C
Low glycerol : shipping requirements
Liquid nitrogen
Low glycerol : shipping requirements
Liquid nitrogen
decreasing saline concentration for deglycerolization (1st to 3rd)
From hypertonic to isotonic solution
12% > 1.6% > 0.09% saline with 0.2% dextrose
Deglycerolization : donor with sickle cell trait, ____% is omitted - sickle cell will be lysed
2nd : 1.6% saline
Automated removal of glycerol (closed system) : expiration date
14 days at 4C suspended in AS-3
Blood component that is given if there is loss of both the red cells and plasma ; loss of 25% of blood volume
Whole blood
Component preparation : It separates platelet rich plasma and packed RBC from whole blood
Soft spin or light spin
Blood component is given if there is a problem with oxygen-carrying capacity of the blood
Whole blood or packed RBC
Blood component preparation : separates platelet poor plasma (PPP) and platelet concentrate (PC) from platelet rich plasma (PRP)
HARD SPIN or HEAVY SPIN
Duration of whole blood collection for platelet concentrate use
Not more than 12 mins
Platelet concentrate must be prepared within
8 hours of collection
Blood component given to patient with thrombocytopenia
Platelet concentrate
The platelet that is prepared through whole blood collection is called
Random donor platelet concentrate
Blood component given to patient with history of reoccurring febrile reactions due to white blood cell antibodies ;
Leukocytes poor red blood cells
Blood component given to patients with history of plasma protein antibodies, diagnosis of PNH, history of febrile reactions owing to leukoagglutinins
WASHED RBC
In adult, 1 unit of PRBC/WB will increase hemoglobin by
1g/dL
In adult, 1 unit of PRBC/WB will increase hematocrit by
3 - 5%
In pediatrics, 10 to 15 mL/mg of PRBC/WB will increase the hemoglobin by
2 to 3 g/dL
In pediatrics, 10 to 15 mL/mg of PRBC/WB will increase the hematocrit by
6 to 9%
Increase in hemoglobin and hematocrit is usually seen after __ to __ hours
24-48 hours
For random donor platelet concentrate to have a therapeutic effect, the unit must be at least
6-8 units
Random donor platelet concentrate will increase the platelet count by
5,000 to 10,000 /uL
Blood component stored at 1-6 C
Whole blood
PRBCs
Washed or deglycerolized RBCs (open system)
Irradiated
RBCs leukocyte reduced
PF24, thawed FFP
Thawed plasma
Blood components stored at -18C or less than
PF24
FFP - 1 year
Cryoprecipitated AHF
Blood components stored at -65C or less than
Frozen RBCs
FFP - 7 YEARS
Expiry date of irradiated blood
28 days
Expiry date of PF24
1 year
Expiry date of FFP stored at -18C or less
1 year
Expiry date of FFP stored at -65C or less
7 years
Expiry date of PF24 and thawed FFP
24 hours
Expiry date of thawed plasma and platelets
5 days
Expiry date of cryoprecipitated AHF
1 year
Blood component stored at 20-24 C
Pooled cryoprecipitate (After thawing)
Platelets
Pooled platelets (open system)
Apheresis platelets leukocyte reduced
Apheresis granulocytes
Expiry date of pooled cryoprecipitate (after thawing) and pooled platelets (open system)
4 hours
Expiry date of apheresis platelets leukocyte reduced in an open system
Within 4 hours
Expiry date of apheresis platelets leukocyte reduced in an closed system
5 days
Expiry date of apheresis granulocyte
24 hours
Random Donor Platelet concentrate : quality control and pH
> 5.5 x 10^10 ; pH >6.2
Used to correct thrombocytopenia who demonstrates refractories to “random” donor platelets (platelet alloantibodies)
“Single donor” platelets
Single donor platelets are collected through
Platelet apheresis
For single donor platelet concentrate to have a therapeutic effect, the unit must be
1 unit
Single donor platelet concentrate will increase the platelet count by
20,000 to 60,000 /uL
Single donor platelet concentrate : quality control and pH
> 3.0 x 10^11 ; >6.2
Buffy coat method : leukocyte and platelet rich Buffy coat is harvested from whole blood
Hard spin
Buffy coat method : harvests the platelets from pooled product
Soft spin
Buffy coat method : spin order (haha)
Hard spin followed by soft spin
Facilitates oxygen transfer into the platelet bag and consumption by the platelets
Agitation
Provides valuable information about patient response to a platelet component
Corrected count increment
Corrected count increment formula
Absolute plt increment/uL x body surface (m^2) / number of platelet transfused
Absolute platelet count increment formula
Post transfusion platelet count - pre transfusion platelet count
Contains the maximum levels of both stable and labeled clotting factors
FFP
Plasma for FFP use, must be frozen within ___ hrs of collection
8 hours
Blood component of choice for patients with multiple coagulation factor deficiency
Fresh frozen plasma
Blood component containing all stable proteins found in FFP ; plasma not frozen within 8 hours
Plasma frozen within 24 hrs (PF24)
PF24 contains normal levels of factor __, and has only slightly reduced levels of factor ___ and protein ___
Factor V ; factor VIII and protein C
FFP/PF24 not transfused within the initial 24-hour period ; treatment of stable clotting factor deficiencies
Thawed plasma
Patients undergoing massive transfusion ; contains very low levels of coagulation factors ; usually discarded
Liquid plasma
Blood components harvested from thawed FFP (at 1-6C) through hard spin
Cryoprecipitate and cryo-poor plasma
Components of cryo-precipitated antihemophilic factor
fibrinogen, fibronectin, factor VIII, factor XIII, vWF, cryoglobulin,
Cryoprecipitate : Fibrinogen QC
> 150mg
Cryoprecipitate : factor VIII QC
> 80 IU
Cryo-poor plasma contains
Residual albumin
Factors 2, 5, 7, 9, 10, 11
ADAMTS13
Treatment for thrombotic thrombocytopenic purpura
Cryo-poor plasma
Correct severe netutropenia (<500 PMN/ml) ; fever unresponsive to antibiotic therapy ; myeloid hypoplasia of bone marrow ; given to patients with CGD
Granulocyte concentrate
Granulocyte concentrate typical therapeutic dose
5 consecutive days
Granulocyte concentrate QC and volume
> 1.0 x 10^10 ; 200-600 mL
Product separated from a single unit of whole blood
Blood component
Blood product separated from a large volume of pooled plasma by a process called fractionation
Blood derivative
Can be prepared through recombinant DNA technology or monoclonal antibody purification
Blood derivative
Source plasma is collected through
Plasma apheresis
Rccovered plasma is collected through
Whole blood collection
An example of blood derivative indicated in patients who are hypovolemic and hypoproteinemic and in clinical settings for shock and burn patients
Normal serum albumin (NSA)
BLOOD DERIVATIVES: Examples of synthetic volume expanders
Crystalloid and colloid
Examples of crystalloid
Ringers lactate and NSS
Examples of colloids
Dextran and HES
Normal serum albumin, plasma protein fraction and synthetic volume expanders are examples of what blood product
Blood derivatives
