Blood Components (RBCs-Platelets) Flashcards
Component rich in Hemoglobin and RBC to increase the mass of the circulating red cell in situations where tissue oxygenation may be impaired
Packed Red Blood Cells
Indication of Packed RBC (1)
Restore oxygen carrying capacity (anemia)
Patients that commonly require RBC transfusion: (5)
- Oncology patients (Undergoes chemotherapy)
- End-stage renal disease patients
- Dialysis patients
- Chronic kidney disease
- Infants and neonates
Content/QC of Packed RBC:
Hematocrit must be 80% or less
Storage temp of Packed RBC:
1-6°C
Immediate effect of one unit packed RBC:
Increase in 3% Hct. Increase of 1 g/dL in Hgb
Red blood cell component in which the white blood cells have been removed/reduced
LEUKODEPLETED/ LEUKOREDUCED RED BLOOD CELLS
How much RBCs are left in Leukoreduced RBCs
85%
Indication of Leukoreduced RBCs: (2)
- Anemia with history of febrile reactions
- decrease alloimmunization to WBC or HLA antigens or CMV transmission
Shelf life of Packed RBCs:
Open System:
Closed System:
Open System: 24 hours
Closed System: Depends on the anticoagulant used
Means of Leukocyte removal: (3)
- Means of centrifugation
- Washing procedures (using saline or glycerol)
- Mechanical separation (use of leukoreduction
filters)
Filter sized of Leukoreduction Filters:
1st generation filter:
2nd generation filter:
3rd generation filter:
1st generation filter – 170 µm
2nd generation filter – 20-40 µm
3rd generation filter – 3-log filter
Preparation of Leukoreduced RBCs: (2)
- Pre-storage - can be separated during or
immediately after collection - Post-storage - can be separated at the time of
transfusion
Blood component with the addition of Rejuvenation solution.
Rejuvenated RBCs
Components revived in rejuvenating RBCs: (2)
ATP and 2,3 Diphosphoglyceric acid
Components used in RBC rejuvenation: (5)
- Phosphate
- Inosine
- Pyruvate
- Adenosine
- Glucose – also used for rejuvenating RBCs but is now removed
FDA Approved Rejuvenating Solution
Rejuvesol
Shelf life of Rejuvenated RBCs
Can be prepared 3 days after expiration of blood. The addition of rejuvenating solution alters the shelf life of the blood component. Only valid 24 hours prior to transfusion.
RBCs washed with sterile saline for the removal of plasma proteins, platelets, leukocytes and cellular debris.
Washed RBCs
Shelf life of Washed RBCs
Open System: 24 hours at 1-6°C
Indications of Washed RBCs: (3)
- Anemia with history of febrile reactions
- Paroxysmal nocturnal hemoglobinuria
- For patients with plasma proteins antibodies to reduced allergic reactions (for IgA-deficient patients). For patients at risk of developing anti-IgA antibody
Quality control requirement for washed RBCs
Plasma must be removed
prepared for those with rare units such as AB (-) individuals, Bombay phenotype, Rh phenotype and patients that undergoes autologous donation
Frozen RBCs
Cryoprotective agent used in Frozen RBCs
Glycerol
What is the use of glycerol in Frozen RBCs
Keeps the RBC components from being destroyed when stored in low temperatures
Give the three concentrations of Glycerol and its temperature requirement: (3)
- High Concentration: 40% glycerol. Freezer requirement: Mechanical
freezer (- 65°C) (Preferred) - Low Concentration: 20% glycerol. Requirement: Liquid Nitrogen (- 100°C)
- 79 % Glycerol + Dextrose, Fructose and EDTA: -65°C
Why is high concentration of glycerol is preferred than the low concentration?
Low concentration glycerol uses liquid nitrogen that is prone to formation of ice crystals. These ice crystals lead to cell lysis.
Shelf life of Frozen RBCs
Frozen – 10 years provided that cryoprotective agent is added
Deglycerolized – 24 hours (thawed)
What is the temperature requirement in thawing frozen RBCs?
1-6°C
Important requirement in deglycerolization process:
Use decreasing concentration of saline or NaCl (Hypertonic to Isotonic Sol’n)
Explain deglycerolization washing process
1st washing process – wash thawed RBC to 12% NaCl (Hypertonic sol’n) –
2nd washing process – wash RC at 1.6% NaCl
3rd wash – 0.9 or 0.85% NaCl (isotonic sol’n)
given to patient with impaired normal platelet function and impaired number of circulating platelet
Platelet components
Purpose of giving platelet component
Control/prevent bleeding associated with critically decreased or functionally abnormal platelet
Platelet Concentrates are done via: (2)
- Random Donor Platelets
- Single Donor Platelets
Indications of Random Donor Platelets: (4)
- Thrombocytopenia
- DIC
- Platelet disorders
- Bleeding
Shelf life of RDP:
5 days with the need of constant agitation
What is the purpose of constant agitation of platelets?
Agitation facilitate oxygen transfer and oxygen consumption by the platelets. Also to prevent clumping of platelets. Oxygen consumption of platelets is associated with maintaining the pH of platelets (key parameter in maintaining platelet viability in vitro)
Storage temp:
Random Donor Platelet:
Single Donor Platelet
Both are stored in 20-24°C
Contraindications of RDP:
- Triggers Immune Thrombocytopenia
- Heparin induced thrombocytopenia
Quality Control of RDP:
5.5 x 1010 and 50-65mL of plasma sample
Immediate effect of RDP:
Increase platelet count by 5,000 – 10,000 per unit
How is Single Donor Platelet prepared?
Prepared from apheresis procedure
Indications of SDP: (2)
- Thrombocytopenia
- For patients refractory to RDP due to platelet antibodies
Considerations of SDP: (2)
- If platelets are necessary to transfuse
- Indication for the use of RDP are given to those actively bleeding patients
Shelf life of SDP:
Closed system:
Open system:
- Closed system – 5 days
- Open system – 24 hours
Contents of SDP:
3.0 x 1011 platelets in approx. 300 mL plasma
Other platelet components: (4)
- Pooled Aliquot
- Irradiated Platelets
- Leukoreduced Platelets
- Pooled Platelets
for platelet transfusion for neonates (< 50,000 mL per unit)
Pooled Aliquot
Platelet component that is used to prevent development of TA-GVHD
Irradiated Platelets
Platelet component that must be < 8.3 x 105 of residual WBCs for platelet derived from whole blood
Leukoreduced Platelets
6 pooled RDPs is
combined into 1 bag
Pooled Platelets
Pooled platelets must be transfused within _____ of pooling?
4 hours
