RBC PRESERVATION Flashcards
Memorization
What is the main goal of RBC preservation?
Maintain RBC viability during storage
_____% of transfused RBCs should remain viable in the bloodstream for 24 hours
> 75%
Free hemoglobin should be ________% of total hemoglobin
less than 1%
Temperature requirement for storage of liquid whole blood/RBC units:
1-6 degrees Celsius
Temperature requirement for shipping/transporting of liquid whole blood/RBC units:
1-10 degrees Celsius
Blood Units without RBCs:
- Platelet concentrate
- Granulocyte concentrate
- Fresh Frozen Plasma (FFP)
- PF 24
- Cryoprecipitate
RBC units:
- Packed RBC
- Washed RBC
- Leukocyte reduced RBC
- RBC aliquots
- Deglycerolized RBC
Temperature requirement for storage of Platelet concentrate and Granulocyte concentrate:
20-24 degrees Celsius (room temperature)
Temperature requirement for storage of FFP and PF 24:
-18 degrees Celsius (Frozen)
Consequence of incorrect temperature storage:
Bacterial contamination
Discoloration of blood unit
RBC storage lesion (loss of viability)
Increased:
RBC storage lesion
Increased:
- Plasma potassium (K+) (due to hemolysis)
- Plasma hemoglobin (due to hemolysis)
- Lactic acid (due to extensive glycolysis)
RBC storage lesion (loss of viability)
Decreased:
RBC storage lesion (loss of viability)
Decreased:
- ATP & glucose levels
- 2, 3 DPG (decreased oxygen delivery to tissues)
- pH
Approved preservative solutions:
- Acid-Citrate-Dextrose Formula A (ACD-A)
- Citrate-Phosphate-Dextrose (CPD)
- Citrate-Phosphate-Dextrose-Adenine (CPDA-1)
- Citrate-Phosphate-Double Dextrose (CP2D)
Shelf life of:
- Acid-Citrate-Dextrose Formula A (ACD-A)
- Citrate-Phosphate-Dextrose (CPD)
- Citrate-Phosphate-Dextrose-Adenine (CPDA-1)
- Citrate-Phosphate-Double Dextrose (CP2D)
- ACD-A = 21 days
- CPD = 21 days
- CPDA-1 = 35 days
- CP2D = 21 days
Remarks of:
- Acid-Citrate-Dextrose Formula A (ACD-A)
- Citrate-Phosphate-Dextrose (CPD)
- Citrate-Phosphate-Dextrose-Adenine (CPDA-1)
- Citrate-Phosphate-Double Dextrose (CP2D)
- ACD-A = has lower pH; loss of 2, 3-DPG @ 1st week
- CPD = Phosphate preserves 2, 3-DPG
- CPDA-1 = Adenine maintains ATP levels
- CP2D = 100% more glucose than CPD
Common preservative in the Philippines:
CPDA-1
Added to RBCs within the first 72 hours of storage:
Additive solution
The additive solution can extend the shelf life of a blood unit for up to:
42 days
Contents of an additive solution:t
Mannitol - prevents storage related hemolysis
Adenine - maintains ATP levels
Glucose - Source of energy
Saline - isotonic
“MAGS”
Can be used up to 3 days after expiration of red cells:
Rejuvenation solution
Rejuvenation solution can extend an expired RBC unit for:
24 hours/ 1day
Rejuvenation solution content:
Phosphate - buffer
Inosine - maintains 2, 3-DPG levels
Pyruvate - maintains 2, 3-DPG levels
Adenine - maintain ATP levels
Includes addition of a cryoprotective agent to RBCs that are <6 days old; primarily used for autologous units and storage of rare blood type:
Red cell Freezing
Red cell freezing can extend the shelf life of an RBC unit for:
10 years @ -65 degrees Celsius
Most common cryoprotective agent:
Glycerol:
(40% w/v or 20% w/v)
The FDA-approved rejuvenation solution in US
Rejuvesol
It is done prior of the transfusion of a glycerolized RBC unit
Deglycerolization
Deglycerolization process:
Washing:
1st = 12% NaCl
2nd = 1.6% NaCl
3rd = 0.9% NaCl (NSS) with 0.2% dextrose
Carry and transfer oxygen in the absence of intact RBCs:
RBC substitutes
Advantage of RBC subtitutes:
Abundant supply
Long shelf life (1-3 years)
No blood typing/crossmatching required
Platelet preservation storage:
Stored at 20-24C (room temperature) with continuous gentle agitation tp to 5 days
What happens when platelets are stored in the refrigerator?
Causes cold-induced platelet activation
What is the purpose of the continuous gentle agitation in storing platelet units?
Facilitates oxygen transfer to maintain pH
Platelet unit pH must be maintained at:
6.2 or more (>/= 6.2 pH)
Why is the platelet unit the most common blood unit that is contaminated?
Because platelet blood units are stored in room temperature, that is why it’s shelf life is only 5 days
Visual inspection of platelet units includes assessment of “_____________” (no visible aggregation)
“platelet swirl” (no visible aggregation)
The normal shape of platelets:
Discoid
Shape of platelets when expired:
Spherical (loss of swirling effect)
Platelet storage lesion
Increased:
Platelet storage lesion
Increased:
- Lactate
- Degranulation
- Platelet activation markers
Platelet storage lesion
Decreased:
Platelet storage lesion
Decreased:
- pH
- ATP
- Platelet aggregation agonists
