PK Transfusions and Apheresis

Question 1

WHOLE BLOOD

Answer 1

Composition: RBC, plasma, WBC, platelets

No constituent has been removed

Obtained through blood donation and can be transfused directly

Storage: Refrigeration (1-6 C), 35-42 days

Indications: cardiac surgery or massive hemorrhage

Question 2

Packed (Red Blood) Cells

Answer 2

Characteristics: Contain hemoglobin, Hct -70% (slow infusion rates)

Storage: Refrigeration (1-6 C), 35-42 days

Indications:
Symptomatic anemia
Need to increase red cell mass
SYMPTOMATIC DEFICIT OF OXYGEN-CARRYING CAPACITY

Question 3

Filtered leukocyte-poor RBCs

Answer 3

Characteristics: WBC removal

LEUKOCYTES: FEBRILE REACTIONS, CMV TRANSMISSION

Indications:
H/O previous febrile transfusion reactions
Reduce immunological reactions

Question 4

Washed Red Blood Cells

Answer 4

Characteristics:
No plasma, minimal plts, 90% WBC removal

Indications:
Need to increase red cell mass -AND-
Prevent febrile or allergic reactions

Question 5

Fresh Frozen Plasma (FFP)

Answer 5

Characteristics:
Plasma proteins (e.g. complement)
All coagulation factors (except Calcium) CENTRIFUGATION FROM WHOLE BLOOD 

Storage:
Frozen (< -18 C) for one year
Thawed (1-6 C) for 24 hours

Question 6

Platelets

Answer 6

Characteristics:
centrifuge separates platelet rich plasma from donated unit of whole blood
centrifuge platelet rich plasma
obtained from donor

Indications:
Thrombocytopenia not caused by increased destruction (TTP, ITP)
Platelet function disorder
Actively bleeding or to prevent spontaneous bleeding

Question 7

FRESH FROZEN PLASMA Indications

Answer 7

TREATMENT OF STABLE CLOTTING FACTOR DEFICIENCIES FOR WHICH NO CONCENTRATES ARE AVAILABLE (other than I, VIII or vWF)
WARFARIN REVERSAL (EMERGENT/BLEEDING)
INR/PT
Immediate therapy for bleeding/surgery in the face of abnormal coagulation status (prolonged PT)

Question 8

Cryoprecipitate

Answer 8

Storage: Frozen (< -18 C) for 1 year, Thawed/pooled should be infused immediately

Indications:
vWD
Hypofibrinogenemia (DIC)
Factor XIII deficiency

Question 9

How long can Blood Components be Stored?

Answer 9

Red cells: 42 days, collected in CP2D/AS-3
35 days, collected in CPDA-1

Platelets: 5 days with continuous agitation

Cryo: 12 months at -18°C or 4 hours
after thawing

Plasma: 12 months at -18°C or 24 hours
after thawing

Question 10

Granulocyte Concentrate

Answer 10

Characteristics :Up to 1.0 X 1010 granulocytes per concentrate, Contain varying numbers of platelets and lymphocytes

Storage:
Use as soon as possible
Maximum storage: 24 hours at 20-24 C

Indications:
Febrile neutropenia which is unresponsive to broad-spectrum antimicrobial therapy

Question 11

Apheresis Platelets

Answer 11

Characteristics:
Contain at least 3.0 x 1011 platelets in 250 mL plasma
Equivalent of 6 random donor platelet concentrates

Storage:
Room temperature (20-24 C)
Five days

Indications:
Thrombocytopenia not caused by increased destruction (TTP, ITP)
Platelet function disorder