Blood Components Flashcards
Storage Temp
RBCs
1-6 C
Storage Temp
Frozen RBCs
< -65 C
Storage Temp
FFP
< -18 C
Storage Temp
Cryo
< -18 C
Storage Temp
Thawed FFP
1-6 C
Storage Temp
Thawed cryo
20-24 C
Storage Temp
Platelets
20-24 C
Storage Temp
Granulocytes
20-24 C
Expiration
RBCs CPDA-1
35 days
Expiration
RBCs AS-
42 days
Expiration
Frozen RBCs
10 years
Expiration
Deglycerized RBCs
Open system: 24 hr
Closed system: 14 days
Expiration
RBC open system
24 hours
Expiration
FFP (-18)
12 months
Expiration
FFP
7 years
Expiration
Thawed plasma
5 days from begin of thaw
Expiration
Liquid plasma
5 days after expiration of whole blood
Expiration
Frozen Cryo
12 months
Expiration
Thawed cryo
6 hours
4 hours if pooled (open system)
Expiration
Platelets
5 days
Product QC
RBC
Hct < 80%
Frozen RBC considerations
Freeze within 6 days of collection if no additive
Additive: freeze before expiration
Rejuvenated RBCs
Rejuvisol limits
CPD , CPDA- rejuvenate up to 3 days after expiration
AS-1 rejuvenate up to 42 days then freeze up to 3 hrs
Not approved for AS-3 or AS-5
Purpose of rejuvenating RBCs
Restores 2,3-DPG and ATP levels
Deglycerolized RBC QC
Mean cell recovery >80%
Adequate removal of glycerol (<1 g remaining)
Minimum free hemoglobin determined by visual inspection of last wash(<3%), refractometor, or osmolality (<400 mOsm/kg H2O)
RBC leukoreduced QC
Retain >85% of original RBC mass
<5 x10^6 leukocytes per unit
FFP must be separated from whole blood and frozen
8 hours of collection
PF24 must be separated from whole blood and frozen within
24 hours of collection
PF24 has reduced levels of … compared to FFP
Factor V, VIII, and protein C
Liquid plasma considerations
Contain viable lymphocytes that can cause GVHD
Cryo AHF preparation
FFP is thawed to 1-6 and the insoluble portion is removed and suspended in approx 15 ml of plasma
Refrozen w/in 1 hr
Factors in cryo
Fibrinogen Von Willebrand factor Factor VIII Factor XIII fibronectin
Minimum factor requirements for cryo
150 mg fibrinogen
80 IU factor VIII
Cryo reduced plasma
Refrozen within 24 hrs of cryo removal
Used for TTP plasma exchange
Platelet prep from whole blood
Whole blood not cooled below 20C
PRP Method: soft spin followed by hard spin
Resuspended in 40-70ml plasma
Platelet QC
90% tested:
>5.5 x 10^10 platelets
> 6.2 pH at end of storage
Platelet leukoreduced
75% tested:
>5.5 x 10^10 platelets
90% tested:
>6.2 pH at end of storage
95% tested:
< 8.3 x 10^5 leukocytes
Apheresis platelet leukoreduced QC
90% tested:
>3 x 10^11 platelets
> 6.2 pH at end of storage
95% tested:
<5 x 10^6 leukocytes
Apheresis granulocytes QC
75% tested:
>1 x 10^10 granulocytes
Transfusion Indications
RBCs
Treatment of symptomatic anemia in normovolemic patients to increase oxygen carrying capacity and cell mass
Generally Hgb < 7, maybe be higher depending on patient factors
Transfusion Indications
Platelets
Thrombocytopenia
Abnormal platelet function
Prophylactic (plt <10)
Transfusion Indications
FFP
Bleeding or preop patient who need multiple coag factors
Warfarin reversal
Therapeutic exchange in TTP
Replacement of single factor deficiency when concentrates unavailable
Rare plasma protein deficiency to which concentrates or recombinant products are unavailable
Transfusion Indications
Cryo
Control of bleeding associated with fibrinogen deficiency (<100)
Treat factor XIII deficiency when recombinant protein unavailable
Transfusion Contraindications
RBCs
Anemia that can be corrected with medication (B12, iron, erythropoietin)
Transfusion contraindications
Platelets
Rapid platelet destruction (ITP, DIC)
TTP or HIT
Transfusion contraindications
FFP
Coagulopathy correctable with specific concentrate or vitamin K
Volume expansion
Dosing
RBCs
One unit increases Hgb 1g In nonbleeding patient
Pediatric: 10-15 ml/kg
Dosing
Platelets
1 unit random plt will increase platelet count approx 5000/ ul
Dosing
FFP
1 ml plasma contains 1 unit coag activity
10-20 ml/kg should increase coag factors by 20%
Dosing
Cryo
1 unit raises fibrinogen 5-10 mg/dL
Number of bags needed: 0.2x kg body weight
Expiration
RBCs CPD or CP2D or ACD
21 days
Platelet red cell content
Generally <1.0 x10^9
If >2 ml of RBCs present, unit must be ABO compatible with recipient plasma and XMd
Irradiation
Irradiation sources
Gamma rays: cesium-137 or cobalt-60
X-rays
Required radiation dose for irradiated products
At least 25 gray to the mid plane (no more than 50)
Minimum to any portion 15 Gy
Post irradiation expiration
28 days or original (whichever is first)
platelet storage lesion (3)
platelet activation- become spherical shape
increase H+ concentration (decrease pH)
glycoprotein Ib levels decrease
Cryo is not produced from
Apheresis FFP
Refreezing of deglyced units
refreeze for 10 years
once thawed expiration is however long the unit had left before refreezing (like a pause, not a restart on the 24 hr expiration)
most common glycerol concentration used
high concentration: 40%
20% may be used but requires rapid freezing and storage
inadequate glycerol removal
hemolysis
cause of the formation of a semi solid gel mass when deglycing a unit of rbcs
sickle cell trait