RBC and Platelet Preservation Flashcards
What are the naturally occurring antibodies?
anti-a and anti-b
Name the 4 metabolic pathways.
EMP
Pentose Phosphate Pathway (Hexose Monophosphate Shunt)
Methemoglobin Reductase Pathway
Luebering-Rapaport Shunt Pathway
Which metabolic pathway produces 90-95% of a cell’s energy?
EMP
What does the Hexose Monophosphate Shunt do?
Protects the cell from oxidative damage
G6PD deficiency affects which metabolic pathway?
Pentose Phosphate pathway
Hexose Monophosphate shunt
Which metabolic pathway is responsible for maintaining iron in the ferrous state?
Methemoglobin Reductase Pathway
The Leubering-Rapaport Shunt Pathway regulates
2,3-DPG (which in turn regulates oxygen transport)
What is the function of hemoglobin?
carry oxygen to the tissues and carry CO2 back to be expelled
What molecules on the RBC surface help maintain the cell’s shape?
Antigens
After collection, what needs to be maintained for RBC viability?
ion pumps, hemoglobin, and RBC integrity and deformability
How many pints of blood does a normal adult have?
10-12 pints
A standard unit of blood contains what volume of blood?
450 mL (1 pint)
Low volume units can only be used for
Packed RBCs
How many mL of anticoagulant is needed per 1 unit of blood?
63 mL
After processing, what is the shelf life for a normal unit of blood?
21-24 days
How is RBC viability measured?
via the amount of hemolysis that has occured
What percentage of cell survival is needed in order for a unit of blood to be considered viable?
75% survival after 24 hours
At what temperature is collected blood stored at?
1-6 degrees C
Which factors are decreased during storage lesion (biochemical changes)?
pH
glucose consumption
ATP
Na
Which factors are increased during storage lesion (biochemical changes)?
lactic acid
Hemoglobin-oxygen affinity
K and ammonia
What increases hgb-oxygen affinity during storage lesion?
decrease in 2,3-DPG
Which RBC enhancement additive supports ATP generation by glycolytic pathways?
Dextrose
Which RBC enhancement additive provides substrate from which ATP can be synthesized?
Adenine
Which RBC enhancement additive prevents coagulation by chelating calcium?
citrate
Name additives that enhance RBC survival and function
Dextrose, adenine, citrate, phosphate, mannitol
Which RBC enhancement additive prevents pH from falling excessively?
phosphate
Which RBC enhancement additive is a carbohydrate that reduces hemolysis by acting as an osmotic diuretic?
Mannitol
Name 4 whole blood anticoagulants and preservatives
ACD (Acid-citrate-dextrose)
CPD (citrate-phosphate-dextrose)
CP2D (citrate-phosphate-dextrose x2)
CPDA-1 (citrate-phosphate-dextrose-adenine)
How long can whole blood be stored when ACD, CPD, or CP2D are used?
What about CPDA-1?
ACD, CPD, CP2D 21 days
CPDA-1 35 days
What are the additives for Packed RBCs?
AS-1 (Adsol): glucose-adenine-mannitol-sodium chloride
AS-3 (Nutricel): glucose-adenine-phosphate-sodium chloride
AS-5 (Optisol): glucose-adenine-mannitol-sodium chloride
What is the storage life of PRBCs when AS-1 (Adsol), AS-3 (Nutricel), or AS-5 (Optisol) are used as additives?
42 days
What is an autologous donor?
An individual who donates blood for themselves before a procedure
PIPA solution contains what and is used in which process?
Pyruvate, Inosine, Phosphate, Adenine
Used during rejuvenation of RBCs
Adding PIPA during the rejuvenation process of RBCs restores…
2,3-DPG and ATP
RBCs preserved in which solutions can be rejuvenated within 3 days of outdating?
CPD, CPDA-1, or AS-1
How is RBC rejuvenation performed?
Incubate the cells with PIPA solution and then wash the cells before administration.
How long after rejuvenation can the RBCs be used?
Must be administered within 24 hours
How long can RBCs be stored when frozen?
10 years
Freezing RBCs lowers WBCs/platelets and removes most plasma proteins. Why is this advantageous?
Lower WBCs and platelets decreases HLAs
Antibodies are plasma proteins and when removed, won’t cause a transfusion reaction.
How old can RBCs be in order to be frozen?
less than 6 days
Which cryoprotective agent is used when freezing RBCs?
glycerol
What is the initial temp and storage temp when a high concentration (40% w/v) is used in the freezing procedure?
Initial temp: -80 degrees C
Storage temp: -65 degrees C
What is the initial temp and storage temp when a low concentration (20% w/v) is used in the freezing procedure?
Initial temp: -196 degrees C
Storage temp: -120 degrees C
What is an advantage and disadvantage to using a low concentration of glycerol when freezing RBCs?
Advantage: thaws more rapidly
Disadvantage: more expensive
How do you deglycerolize frozen RBCs?
Replace the glycerol with decreasing concentrations of saline.
Initial wash: 12% NaCl
2nd wash: 1.6% NaCl
3rd wash: 0.2% dextrose in normal NaCl
