Blood Component Preparation & Therapy

Question 1

Blood collection bags

Answer 1

special plastic that allows for the proper mix of gases, nutrients, & anticoagulants
63 ml anticoagulant + 450 +/- ml whole blood

Question 2

Double bag system

Answer 2

primary bag + satellite bag
for whole blood & separation of 2 different blood components
RBCS + Plasma

Question 3

Triple bag system

Answer 3

primary bag + 2 satellite bags
whole blood collection & separation of 3 different components
RBCS+ Plasma + buffy coat

Question 4

Quad bag system

Answer 4

primary bag + 3 satellite bags
whole blood collection & separation of 4 different components
RBCs, plasma, CRYO, & platelets

Question 5

K+ during storage

Answer 5

when RBCs are old & lysed K+ is released into the unit
patients with heart problems are at risk with transfusing ‘old’ units
less than 7 days old are transfused into people with cardiac issues

Question 6

ATP during storage

Answer 6

ATP is needed to maintain membrane integrity

ATP levels decrease with the age of the unit

Question 7

2,3-DPG during storage

Answer 7

decreased with age of unit
needed for effective release of o2 in tissues
neonates require blood <7 days old bc of this

Question 8

CPD

Answer 8

citrate-phosphate-dextrose

Question 9

CP2D

Answer 9

citrate-phosphate-2x dextrose

Question 10

CPDA-1

Answer 10

citrate-phosphate-dextrose-adenine

most often used

Question 11

Dextrose purpose

Answer 11

supports ATP generation by glycolytic pathway

Question 12

Adenine purpose

Answer 12

acts as substrate for RBC ATP synthesis

Question 13

Citrate purpose

Answer 13

prevents coagulation by chelating calcium, also protects RBC membrane

Question 14

Sodium biphosphate purpose

Answer 14

prevents excessive decrease in pH

Question 15

Mannitol

Answer 15

osmotic diuretic acts as membrane stabilizer

Question 16

AS-1 or AS-5

Answer 16

dextrose, adenine, mannitol, & saline

Question 17

AS-3

Answer 17

dextrose, adenine, saline, citrate

Question 18

AS-7

Answer 18

dextrose, adenine, mannitol, sodium bicarbonate, phosphate

Question 19

Storage limit of CPD

Answer 19

21 days

Question 20

storage limit of CP2D

Answer 20

21 days

Question 21

storage limit of CPDA-1

Answer 21

35 days

Question 22

storage limit of AS-1, AS-5, AS-3 & AS-7

Answer 22

42 days

Question 23

additional functions of preservatives

Answer 23

less viscosity
easier to filter
final Hct: 55-65% vs 70-80%

Question 24

of whole blood units to = 1 unit of platelets

Answer 24

5 units of whole blood for one unit of platelets

Question 25

platelets prepared from whole blood within how many hours?

Answer 25

8 hours

Question 26

can platelets be taken from refrigerated whole blood?

Answer 26

no; unit cannot be refrigerated!

Question 27

FFP storage

Answer 27

frozen within 8 hours of collection

Question 28

CRYO

Answer 28

FFP is thawed at 1*C - 6*C | white precipitate forms & is centrifuged at a heavy spin & cryo is refrozen

Question 29

Packed RBC

Answer 29

prepared by centrifugation | RBCs, small amount of plasma, WBCs & nonviable platelets

Question 30

Leukocyte-reduced RBCs

Answer 30

<5x10^6 WBCs per unit filter by gravity, adherence & size exclusion done bc WBCs release cytokines during storage & decreases change of HLA antibodies forming in recipient & reduce CMV transmission risk

Question 31

storage/ shipping of leukocyte reduced RBCs

Answer 31

stored: 1-6*C shipping: 1-10*C

Question 32

one unit of RBCs will increase Hct & Hgb by:

Answer 32

Hct: 3% Hgb: 1 g/dL

Question 33

Washed RBCs

Answer 33

removes all plasma shelf life: 24 hours at 1-6*C given to IgA deficient

Question 34

Frozen-thawed Deglyced PRBCS

Answer 34

rbcs can be frozen in glycerol solutions & stored at -80*C for over 10 yrs people with clinically-relevant antibodies expires 24 hours after thawing & washing

Question 35

Irradiated RBCs

Answer 35

prevents T-cell proliferation by inducing DNA damage expiration date: 28 days prevents GVHD used for sibling directed donations & severely immunocompromised

Question 36

general platelet information

Answer 36

expire 5 days after donation remain at 20-24*C gently agitating to avoid clumping leukoreduced <5x10^6 WBC/unit

Question 37

apheresis platelets number

Answer 37

>3.0x10^11 plt/unit

Question 38

platelets post transfusion

Answer 38

3-4 days 1-hour post plt count will differentiate between sequestering vs immune destruction 1 pooled unit/apheresis unit should raise plt count by 20,000-40,000 /uL

Question 39

immune destruction of plts post transfusion

Answer 39

if less than 10,000/uL increase observed at 1 hour

Question 40

plts post transfusion: sequestered in spleen

Answer 40

if platelet counts rise as expected 1 hour after transfusion & then fall after 24 hrs

Question 41

what is the AABB standard for leukoreduction?

Answer 41

<5.0x10^6 residual leukocytes in at least 95% of units sampled

Question 42

fresh frozen plasma shelf life

Answer 42

<-65*C: 7 years thawed: 1-6*C: 24 hours

Question 43

CRYO shelf life

Answer 43

-18*C: 1 year thawed at room temp: unopened: 6 hours opened/pooled: 4 hours

Question 44

Granulocyte pheresis

Answer 44

1x10^10 granulocytes/unit store at RT undisturbed 24 hour expiration must be ABO compatible