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Transfusion Science > Lecture 3 - Blood Components > Flashcards

Lecture 3 - Blood Components Flashcards

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1
Q

what is the storage temperature of red blood cells?

A

2-6 degrees

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2
Q

what is the storage time for red blood cells?

A

28 to 49 days

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3
Q

what is the difference in storage time for irradiated red cells?

A

14 days post irradiation

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4
Q

what is the storage time for washed red cells?

A

14 days

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5
Q

in what situation are granulocytes used?

A

life-threatening soft tissue damage, bacterial infection, prolonged neutropenia after chemotherapy

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6
Q

why must granulocytes always be irradiated?

A

due to high risk of white cell engraftment and graft vs host disease

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7
Q

why does a granulocyte component contain a lot of platelets?

A

because they are made from the Buffy coat

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8
Q

what is the storage for granulocytes?

A

20-24 degrees

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9
Q

what type of component must not be agitated?

A

granulocytes

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10
Q

what situations are platelets used in?

A

prevention of bleeding in patients with low count or dysfunction of platelets

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11
Q

how long are platelets stored for?

A

5-7 days

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12
Q

why do platelets need to be agitated?

A

ensures constant oxygenation and removal of CO2 which prevents granule release and lysis

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13
Q

in what situations does FFP need to be used?

A

prevention of bleeding due to clotting factor deficiencies e.g. due to massive haemorrhage or liver disease

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14
Q

why can’t FFP be used as a volume expander?

A

due to risk of allergic reaction

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15
Q

what is cryoprecipitate?

A

made by thawing fresh frozen plasma at 4 degrees

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16
Q

what is cryoprecipitate rich in?

A

cryoglobulins, rich in fibrinogen, factor VIII and VWf

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17
Q

what is recommended dose of cryo?

A

two pools of five units which raises fibrinogen by 1g/L

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18
Q

what is cryoprecipitate used for?

A

hypofibrinogenemia or acquired dysfibrinogenaemia

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19
Q

what is DIC?

A

disseminated intravascular coagulation which is blood clotting through the body

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20
Q

what is the maximum storage of FFP and cryoprecipitate?

A

36 months

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21
Q

how long can cryoprecipitate be stored after thawing?

A

24 hours

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22
Q

how long should FFP be used after leaving storage?

A

4 hours

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23
Q

if whole blood was to be used, what would it be used for?

A

rapid transfusion of plasma and platelets as well as cells

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24
Q

what is the difference between blood components and blood products?

A

components are made from whole blood donation yet products are made from the plasma component

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25
Q

what are plasma derivatives?

A

licensed medicinal products made from plasma donations

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26
Q

how are plasma derivatives further processed to avoid infection?

A

undergo pathogen inactivation steps

27
Q

what is solvent detergent FFP?

A

prepared from pools of large donations, the solvent detergent step inactivates bacteria and encapsulated viruses

28
Q

what is octoplas?

A

the licenced medicinal product of solvent detergent FFP

29
Q

what is octoplas LG?

A

a prion reduced version of octoplas

30
Q

what is an advantage of the pooling process?

A

gives a more standardised concentration of clotting factors, lowers risk of allergic reaction

31
Q

where is solvent detergent FFP used?

A

in those who have clotting factor deficiency

32
Q

what is human albumin solutions?

A

a solution containing proteins derived from plasma yet no clotting factors or blood group antibodies

33
Q

what is 4.5%/5% HAS used for?

A

subacute plasma volume loss caused by burns, pancreatitis or trauma and as a replacement in plasma exchange

34
Q

what is 20% HAS used for?

A

hypoalbuminaemic patients with liver cirrhosis or nephrotic syndrome

35
Q

what factors does clotting factor concentrates are not covered?

A

factor V and factor II

36
Q

what is riastap?

A

fibrinogen factor I concentrate and treats congenital hypofibrinogenaemia

37
Q

in what situations are clotting factors more effective?

A

in situations of acquired hypofibrinogenaemia

38
Q

what is octaplex?

A

prothrombin complex concentrate

39
Q

what factors does octaplex contain?

A

factor II, VII, IX and X

40
Q

what is octaplex extremely useful for?

A

rapid reversal of warfarin overdose

41
Q

in what way are red cells damaged by being in storage?

A

the sodium potassium pump in the red cell membrane is immobilised casing a decrease in intracellular potassium and an increase in cytoplasmic sodium levels

42
Q

how is acidosis caused as a result of storage?

A

due to decline of glucose levels due to immobilisation of NA/K pump and low pH levels occur as a result

43
Q

what causes morphological changes of the red blood cells?

A

lipid per oxidation and oxidative stress causes formation of sphereochinocytes and osmotic fragility

44
Q

how does irradiation cause shorter shelf life?

A

gamma radiation exacerbates storage lesions

45
Q

what issues can transfusing newborns with stored blood cause?

A

the stored blood has increased levels of potassium and so has been associated with myocardial hyperkalaemia and neonatal arrhythmia

46
Q

how can heart complications in newborns be reduced?

A

transfuse with blood less than 5 days old

47
Q

what are blood bags manufactured with to prevent coagulation?

A

citrate phosphate dextrose

48
Q

what does citrate do in a blood bag?

A

is the coagulant, removed calcium ions prevents the clotting cascade

49
Q

what does phosphate do in a blood bag?

A

counteracts the loss of phosphate lost during storage and improve viability

50
Q

what does dextrose do in a blood bag?

A

prevents loss of ATP

51
Q

what is saline adenine glucose?

A

an additive that is added to the red blood cells to combat effects of storage

52
Q

what does saline do as an additive?

A

maintaining volume and prevents uptake of glucose that occurs when cells packed together

53
Q

what does adenine do as an additive?

A

restoration of cell shape, ATP concentration and viability

54
Q

what does glucose do as an additive?

A

prevent loss of ATP and enable longer storage

55
Q

what does mannitol do?

A

protects the red blood cell membrane and reduces haemolytic by acting as a free radical scavenger

56
Q

why might blood be leucodepleted?

A

transfused leucocytes induce immunosuppressive changes so leucodepletion reduces the incidence of transfusion reactions

57
Q

what is the negative effects of leucodepletion?

A

may induce the incidence of postoperative infection and recurrence of cancer

58
Q

how is leucodepletion carried out?

A

filtration of multiple layers of synthetic polyester non-woven fibres that selectively retain white cells

59
Q

how can leukocytes cause infection in the host?

A

in immunosuppressed patients, white cells can engraft and detect the host as foreign, aka graft vs host disease

60
Q

what type of patients should receive phenotyped blood?

A

women of childbearing age, those with alloantibodies, need to be Kell and Rhd negative

61
Q

what patients are seen as transfusion dependant?

A

those with sickle cell anaemia or beta thalassaemia

62
Q

what is the Coombs test?

A

use a sample of patient serum against donor red cells which form complexes, anti-human Ig’s are added which join to the recipients Ig’s and therefore join the red cells together causing agglutination

63
Q

what is the advantages of electronic issue?

A

quicker, avoid potential delays, reduce waste, virtually limitless supply

64
Q

what are the disadvantages of electronic issue?

A

must have a reliable and validated lab, cannot perform electronic issue if no IT, some rare antibodies are not detected

Transfusion Science (8 decks)

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