Finals: BLOOD PRESERVATION, COMPONENT PREPARATION AND STORAGE, ISSUANCE OF BLOOD, AND TRANSFUSION THERAPY Flashcards
Indications of Washed RBcs
Increase mass RBCs of symptomatic anemic px with transfusion history of
Allergic reaction, Urticarial reaction
Anaphylactic reaction
Febrile non hemolytic reaction
This is not a substitute for leukocyte reduced rbcs
Washed RBcs
May also be used in infant or intrauterine transfusion
Washed Rbcs
How many percent of rbcs lost in the process after washing with saline?
10-20%
Storage and shelf life of Washed RBcs
Storage: 1-6 *C
Shelflife: 24 hrs open system
Indications of Platelet Concentrate
Active bleeding px who are thrombocytopenic (<20,000 /uL)
Cancer px dueto chemotheraphy and radiation
Thrombocytopenic pre operative px (<50,000/uL)
Dengue hemorrhagic fever
Preparation of RDP
Prepared from whole blood (1 unit)
• Prepared within 6 hours after collection
• Whole blood at room temp→ 1st step: light spin (3200 rpm),
2-3min→ produce platelet rich plasma separated from red
cells→ 2nd step: heavy spin (3600 rpm), 5 min→ platelets
separate from plasma→ remove plasma into another bag,
leaving 50 – 70 mL for the platelets.
How many platelets must contain in RDP?
> 5.5x10^10
How many plasma must contain in RDP and pH
40-70 mL plasma, pH >6.2
RDP may be pooled for how many units?
4-6/8 units
RDP new method is also called
Buffy Coat Method
In RDP, 1 unit should increase platelet by
5,000-10,000/ uL
Interpretation of the Increment for Platelet should be done:
After 1 hour of post transfusion
Good increment is =
> 10,000/uL
Refractoriness=
<5,000/uL
Reason why refractoriness <5,000/uL
Unresponsive of platelet transfusion due to HLA/HPA, DIC, Sepsis and fever
Preparation of SDP
Apheresis
SDP must contain how many platelets
3x10^11 equivalent to 4-6 units
SDP must contain how many mL of plasma?
200-400mL
Indications of SDP
Indicated for patients with Idiopathic Thrombocytopenic Purpura
In SDP, 1 unit should increase platelets by
30,000-60,000/uL in 75 kg px
Storage and Shelflife of SDP
Storage: 20-24 *C
Shelf Life: 5days with constant agitation
Leukocyte Reduce RBcs indications
Can be use for ITP
In Leukocyte Reduced RBCs, how many leukocytes must contain in a whole blood
<8.3x10^5
In Leukocyte Reduced RBCs, how many leukocytes must contain in a pheresis
<5x10^6
Storage and Shelflife of LRP
Storage: 20-24 *C
Shelf life:
Open System: 4hrs
Apheresis: 5 days with constant agitation
Preparation of Pre Storage pooled Platelets
4-6 ABO identical platelet pooled using closed system
Indications of Pre Storage Pooled Platelets
Severe thrombocytopenia and Abnormal Platelet Function
Storage and Shelflife of Pre Storage Pooled Platelets
Storage: 20-24 *C
Shelflife: Extend outdate due to close system
Preparation of Apheresis Granulocytes
Uses hydroxyethyl starch as a sedimenting agent, with the administration of Corticosteroids to the donor 12-24hrs before donation
In Apheresis Granulocytes,
1 unit must contain; how many mL of RBCs
> 1.0x10^10 ; 20-50mL
In Apheresis Granulocytes, donor should have how many uL of WBCs
4x10^9 /uL WBCs
Indications of Apheresis Granulocytes
Px with absolute granulocyte count of <350-500/ uL
Px with granulocyte dysfunction
Myeloid hypoplasia
Px who are unresponsive to antibiotic
Severe neutropenia
Storage & Shelflife of Apheresis Granulocytes
Storage: 20-24 *C without agitation
Shelf life: 24 hours
In Fresh Frozen Plasma preparation
WB in CPD > process within 8 hours
WB in ACD > process within 6 hours
FFP- thaw in waterbath for 30-37*C in 30-45mins
Thawed plasma should be transfused immediately
In Fresh Frozen Plasma, for labile factors store it at
1-6*C for 6 hours
In Fresh Frozen Plasma, when Factor V is not needed store it at
4*C for up to 24hours
Fresh Frozen Plasma contains
All coagulation factors
Indications for PT
> 16secs
Indications for aPTT
> 60secs
FFP is need for bleeding px who requires factors
2,5,7,9,10
Indication of FFP
Px with liver disease
Treatment of TTP
Antithrombin III deficiencies
Reverse effect of warfarin
FFP storage and shelflife
Storage:
-18C for 1year
-65C for 7 years
Plasma Frozen 24 hr–PF/FP24 is frozen within?
8-24 hours of collection
Plasma Frozen 24 hr–PF/FP24 is stored at
-18*C
Plasma Frozen 24 hr–PF/FP24 contains all
Stable proteins found in FFP
Recovered Plasma and Liquid Plasma
Can be prepared directly from WB
By product of platelet concentrate
Cryoprecipitate production (Cryosupernate)
Use of Recovered Plasma & Liquid Plasma
Use as volume expander
For the manufacturer of plasma fractionation products such as:
Plasma Protein Fraction
Normal Serum Albumin
Immune serum globulin
Recovered Plasma and Liquid Plasma, storage and shelflife
-18*C or Colder for 5years
Recovered Plasma and Liquid Plasma is labelled as
Plasma
Recovered Plasma and Liquid Plasma, in liquid state, the product is labeled as and stored at
Liquid Plasma; 1-6*C
Recovered Plasma and Liquid Plasma, can be transfused up to
5days after expiration of WB
S/D-Pooled Plasma consist of pools not more than
25 units of ABO type-specific plasma
S/D- Pooled Plasma, is treated with solvent/detergent, wherein solvent is? And Detergent is?
Solvent- Tri-n-butyl Alcohol
Detergent- Triton
S/D- Pooled Plasma is treated with solvent and detergent in the thawing process to?
Inactivate lipid-enveloped viruses such as HIV and Hepatitis B
S/D- Pooled Plasma contains
Stable and Labile clotting factors
S/D- Pooled Plasma lacks
Willebrand’s factor multimers
S/D- Pooled Plasma volume is
200mL
It is the cooled precipitated concentration of Factor VIII
Cryoprecipitate
Preparation of Cryoprecipitate
FFP thawed @1-6 *C from single WB (CPD/CPDA-1), by heavy spin centrifugation (5,000xg for 7mins)
Cryoprecipitated anti hemophilic factor contains
Fibrinogen 150-250 mg
AHF VIII -120 IU
vWF 40-70%
F VIII 20-30%
Fibronectin
Cryoprecipitated Anti hemophilic Factor
Before infusion: Frozen cryoprecipitate→ thaw at 30-37 Degrees
Celsius→ thawed cryoprecipitate
• Store at room temp and transfuse immediately or transfuse
within 6 hours
Pooled cryoprecipitate: Transfuse within
4hrs (open system)
Cryoprecipitated Anti-hemophilic Factor (AHF)
Indications:
Px with fibrinogen deficiency
Hemophilia A
Von Willebrand Disease
Factor XIII deficiency
Cryoprecipitated Anti-hemophilic Factor (AHF)
is not indicated with TTP must use:
FFP OR CRYOSUPERNATE
Cryoprecipitated Anti-hemophilic Factor (AHF)
Storage & Shelf life
Frozen -18*C for 1year
After thawing: RT
Shelf life: 1 year if frozen or
After thawing: Single units: 6 hours
Pooled units: 6 hours if closed system, if open: 4 hours
Treatment for classic hemophilia and hemophilia A, and in deficiency of FVIII
Factor VIII Concentrate
Factor VIII, When prepared from pooled plasma→3 techniques to destroy viral contaminants:
Pasteurization
• Solvent and detergent technique
• Monoclonal purification
Forms:
• Porcine Factor VIII
• Recombinant Factor VIII using D
