Components - Platelets/ HLA

Question 1

Recall travel and storage requirements for platelet and granulocyte components

Question 2

Perform visual inspection of Platelet an Granulocyte Components and labels. Recognize a platelet swirl.

Question 3

Identify the clinical indication of platelet transfusion. Determine appropriate dosage of aphereseis platelet products and whole blood derived products.

Question 4

Identify the patient population receiving granulocyte transfusions

Question 5

Compare Pre-Transfusion testing for red cell components vs platelet components

Question 6

Recognize the testing techniques performed for HLA type & Platelet Cross match testing

Question 7

Solve an HLA paternity problem utilizing antigen cross expression logic

Question 8

What is the normal value of platelets?

Answer 8

150,000 - 350,000 / uL

Question 9

What may happen when you have a platelet value of <10,000/ uL?

Answer 9

spontaneous hemorrhage may occur

Question 10

True or False: >50,000/uL minimizes hemorrhage during surgery?

Answer 10

True

Question 11

What is Platelet’s function in Hemostasis?

Answer 11

1. Platelet plug
2. Stabilize plug by fibrin formation
3. Maintenance of vascular integrity

Question 12

When are platelets transfused? State 3 reasons

Answer 12

• To increase platelet count
• Prophylactically for Oncology patients
• If a patient’s platelets are not functioning (PFA test)

On Oncology patients, we know that the chemo is going to kill the blood plts.
Chemo therapy is hard on platelets

Question 13

What is Refractory?

Answer 13

failure to achieve an acceptable platelet count following platelet transfusion.

Question 14

True or False: 1 apheresis or 6 whole blood concentrates about +30,000 - 50,000 / uL of platelets

Answer 14

True

Question 15

Plate activation occurs ______ storage

Answer 15

during

–
- ATP released
- Platelets aggregate
- Increase glucose consumption lead to Lactic acid
- Decrease in pH will cause platelets to swell (bad platelets)

Question 16

Platelet storage lesion means the _____ of quality during storage

Answer 16

loss

Question 17

What are the storage conditions for platelets?

Answer 17

• Temperature: 20-24 C
• Continuous agitation (rocker)

• Cold storage results in irreversible spherical shape change
• Facilitates oxygen transfer in the boat needed to maintain pH

Question 18

When do platelets expire?

Answer 18

• Expires 5 days post collection

– Increased chance for bacterial contamination at storage, length of time pH can be maintained in the bag

Question 19

What are the alternative storage options for platelets?

Answer 19

• Platelet Additive Solution (PAS)
• 7-platelets
• Frozen platelets
• Cold storage is still being studied

Question 20

How does Platelet Additive Solution (PAS) storage work?

Answer 20

• reduces plasma stored with platelets up to 60% (less transfusion reaction)

Question 21

How does 7 day platelets storage work?

Answer 21

Platelets must be tested for bacterial contamination on day of transfusion

Question 22

How does Frozen platelet storage work?

Answer 22

platelets can be stored frozen and kept up to 2 years with DMSO.

33% of platelets are viable from this process

Question 23

What is pathogen inactivation?

Answer 23

Pathogen inactivation impair pathogen’s ability to replicate by damaging DNA by using either ultraviolet light or Alkylating agents.

This some how inactivates bacteria DNA

Question 24

What would Pathogen Inactivation be use for?

Answer 24

• Effective for viruses, bacteria, fungi, protozoa, and leukocytes (ineffective for prions)

Question 25

What is blood products is pathogen inactivation being used on?

Answer 25

• Currently in use for platelets and plasma

Question 26

What is the donor qualification criteria for donating platelets?

Answer 26

• Must meet RBC donor qualifications
• Platelet counts need to be greater than 150,000.
• Pt is not taking the following medications (Aspirin - 2 days, Plavix - 14 days )
• Interval between random donor - 8 weeks
• Interval between apheresis donors > 2 days
• Double/ Triple bags > 7 days
• No more than 24 donations in a year.
• No more than 500 mL of fluids can be removed

Question 27

List the steps of component preparation specific to platelet components from whole blood donations

Answer 27

1. Whole bloods collected
2. Centrifuge
3. Rest 1-2 hours to unclip then place onto an agitator for storage up to 5 days
4. Sterile Docking pools of 4-6 different donors
5. Therapeutic does 5000-10,000 platelets/uL per single donation. Pools expected dose 20,000-60,000.

Question 28

List the steps of component preparation specific to platelet components from apheresis collection

Answer 28

1. Larger gauge/smaller bore size of needle than with random donor
2. 45-120 minutes. The patient is attached for the duration of the procedure and infused with saline and anticoagulants
3. Optical sensors divert the specific component to a collection bag. Multiple components can be collected at the same time
4. Variables: Centifugation speed and diameter, Dwell time of blood in the centrifuge , Types of solutions added, Cellular and Plasma content of donor or patient
5. Different ddeferalls - blood loss must be closely monitored, cannot excessed more than 500 mL or RBC deferral applies (8 weeks)