Component Prep and Therapy

Question 1

Anticoagulant Preservation Solutions

Answer 1

Sodium citrate: anticoag
Citric acid: creates an acidic environment to slow down glycolysis that occurs through cell metabolism
Dextrose: ATP generation via glycolytic pathway
Adenine: substrate for RBC synthesis of ATP during cell metabolism
Monobasic sodium phosphate: buffer to maintain pH

Question 2

RBC Component Storage Lesion

Answer 2

Biochemical changes that occur during storage of RBC components
In RBC bag: decreased 2,3-DPG/K+/ATP, increased Na+
In Plasma bag: decreased pH, increaed K+/hemolysis

Question 3

RBC Transfusion Catagories

Answer 3

Iatrogenic
Decreased bone marrow production
Decreased RBC survival
Surgical/Trauma

Question 4

Fresh RBCs

Answer 4

Less than 7 days old

For neonatal transfusion and massive transfusions

Question 5

Indications for Txn Leukocyte Reduced RBCs

Answer 5

Febrile non hemolytic TxRx
HLA allo immunization
TRALI
Transfusion related immune suppression

Question 6

Washed RBCs

Answer 6

Indicated for rare patient with IgA deficiency

Washing the RBC unit removes enough plasma to reduce the risk of anaphylactic reaction

Question 7

Random Donor Platelet Prep

Answer 7

Prepared from whole blood component

1. Centrifuge using a soft spin
2. Seperate plt rich plasma from RBCs and centrifuge using a hard spin

Question 8

Indications for Transfusion of Platelet Products

Answer 8

Thrombocytopenia

Platelet refractoriness

Question 9

Fresh Frozen Plasma (FFP)

Answer 9

Frozen at -18C for 1 year
Frozen at -65C for 7 years
Thawed good for 24 hours
Contains all clotting factors, treat multiple coagulation factor deficiencies, need to be ABO compatible
Contraindicated for volume expansion and protein replacement

Question 10

Cryo

Answer 10

Cryoprecipitated antihemophilic factor
Primary use: IV supplementation of Factor XIII and fibrinogen
Topical use: fibrin sealant in surgery
Lyophilized factor concentrates have replaced cryo because of reduced risk of transmission of disease

Question 11

Granulocyte Concentrates

Answer 11

Prepared by apheresis
Store at 20 to 24C
Good for 24 hours

Question 12

Indications for Transfusion of Granulocyte Pheresis

Answer 12

Patient sould have neutropenia, fever for 20 to 48 hrs, positive bacterial or fungal cultures, progressive parenchymal disease unresponsive to antibiotic therapy, myeloid hypoplasia
Reasonable chance for recovery of marrow functions
Component should be irradiated and CMV seronegative

Question 13

Irradiated Blood Components

Answer 13

Purpose: inactivate donor lymphocytes to prevent Graft vs Host Disease
Good for 28 days from irradiation or original outdate (what ever is first)

Question 14

Indications for Irradiated Blood Components

Answer 14

Bone marrow transplant
Intrauterine transfusion of fetus
Exchange transfusion (neonate)
Congenital immunodeficiency’s (SCID, DiGeorge syndrome, Hodgkin’s lymphoma)