Red Cell and Platelet Preservation: Review of Metabolism and Current Trends (Chapter 1 | P) Flashcards
What are the exs of anticoagulant preservatives?
1) ACD
2) CPD
3) CP2D
4) CDPA-1
If ACD is used, how long can blood be stored?
21 days
If CPD is used, how long can blood be stored?
21 days
If CP2D is used, how long can blood be stored?
21 days
If CPDA-1 is used, how long can blood be stored?
35 days
What phenomenon can still occur even if anticoagulant preservatives are used?
Reduction in 2,3-DPG
When does the phenomenon occur (even if anticoagulant preservatives are used)?
It is observed in the 2nd wk
What are the components of CPDA-1 (w/ corresponding concentrations / values)?
1) 0.25 mM of adenine
2) 25% more glucose compared to CPD
3) 60% less glucose compared to CP2D
After transfusion, normal lvls of 2,3-DPG are reached after what time duration?
24 hrs
What are the goals of RBC preservation?
To provide viable and functional blood components for pts requiring blood transfusion
What aspect of RBCs must be maintained during storage time?
Viability of RBCs
Accdg to FDA, after transfusion (post transfusion), the survival of RBCs after 24 hrs is what?
More than 75%
Accdg to FDA, the percentage of free hgb from total hgb is what?
Less than 1%
What is the meaning of AS?
Preservative / additive solutions
What are the fxns of AS?
1) To maintains viable, functional RBCs from time of collection to time of transfusion
2) It extends the shelf life of blood to 42 days
What are the AS that are currently in use?
1) Adsol
2) Nutricel
3) Optisol
What is the manufacturer of Adsol?
Baxter Healthcare
What is the manufacturer of Nutricel?
Pall Corporation
What is the manufacturer of Optisol?
Terumo Corporation
What is the storage abbreviation of Adsol?
AS-1
What is the storage abbreviation of Nutricel?
AS-3
What is the storage abbreviation of Optisol>?
AS-5
How long can blood be stored if Adsol is used as AS?
42 days
How long can blood be stored if Nutricel is used as AS?
42 days
How long can blood be stored if Optisol is used as AS?
42 days
Why did the manufacturers produced the 3 diff AS?
For use in extending the shelf life in blood
If Adsol, Nutricel, and Optisol are not used, blood can only be stored for up to what?
35 days
Based on the type of preservative used
What is the volume? (mode of administration?) of Adsol, Nutricel, and Optisol?
mg/100mL
What are the components of Adsol?
1) Dextrose
2) Adenine
3) Mannitol
4) NaCl
What is the concentration / value of dextrose in Adsol?
2,200
What is the concentration / value of adenine in Adsol?
27
What is the concentration / value of monobasic Na phosphate in Adsol?
0
What is the concentration / value of mannitol in Adsol?
750
What is the concentration / value of NaCl in Adsol?
900
What is the concentration / value of Na citrate in Adsol?
0
What is the concentration / value of citric acid in Adsol?
0
What are the components of Nutricel?
1) Dextose
2) Adenine
3) Monobasic Na phosphate
4) NaCl
5) Na citrate
6) Citric acid
What is the concentration / value of dextrose in Nutricel?
1,100
What is the concentration / value of adenine in Nutricel?
30
What is the concentration / value of monobasic Na phosphate in Nutricel?
276
What is the concentration / value of mannitol in Nutricel?
0
What is the concentration / value of NaCl in Nutricel?
410
What is the concentration / value of Na citrate in Nutricel?
588
What is the concentration / value of citric acid in Nutricel?
42
What are the components of Optisol?
1) Dextrose
2) Adenine
3) Mannitol
4) NaCl
What is the concentration / value of dextrose in Optisol?
900
What is the concentration / value of adenine in Optisol?
30
What is the concentration / value of monobasic Na phosphate in Optisol?
0
What is the concentration / value of mannitol in Optisol?
525
What is the concentration / value of NaCl in Optisol?
877
What is the concentration / value of Na citrate in Optisol?
0
What is the concentration / value of citric acid in Optisol?
0
What are the AS that contains mannitol among the 3?
1) Adsol
2) Optisol
Mannitol are added to bags containing what preservative?
CPD
What is the only AS that contains Na citrate and citric acid among the 3?
Nutricel
Na citrate and citric acid are used in bags containing what preservative?
CP2D
What is the fxn of mannitol (purpose of it being added)?
It decreases cell lysis
What is the fxn of adenine and glucose?
These increases ATP lvls
What is the other term for glucose?
Dextrose
What are the 3 areas in RBC biology w/c are crucial for normal survival and fxn?
1) RBC membrane
2) Hgb structure and fxn
3) RBC metabolism
If defects in any or all of the areas of RBC biology that are crucial for normal survival and fxn of RBC are present, what will happen?
RBC survival of fewer than the normal 120 days in circulation
Where are integral proteins located in the plasma membrane?
These are located w/ the 2 layers of plasma membrane
Where are peripheral proteins found in the plasma membrane?
These are found on either side of the layers of the plasma membrane
How are glycoproteins derived?
When carbohydrate molecules bind to protein
How are glycolipids derived?
When carbohydrate molecules bind to lipids
What are the components of the plasma membrane?
1) Protein
2) Lipid
3) CHO
What is the value of proteins (as a component of plasma membrane)?
52%
What is the value of lipids (as a component of plasma membrane)?
40%
What is the value of CHO (as a component of plasma membrane)?
8%
What is the characteristic of the plasma membrane?
It is a semipermeable lipid bilayer
What are the types of membrane lipids?
1) Phospholipids
2) Glycolipids
3) Chole
What is the value of phospholipids (as a type of membrane lipids)?
75%
What is the value of glycolipids (as a type of membrane lipids)?
5%
What is the value of chole (as a type of membrane lipids)?
20%
Integral proteins fxns as what?
1) Channels
2) Transporters
3) Receptors
4) Intercellular junctions
5) Enzymes
6) Cytoskeleton anchors
7) Cell identity markers
What are the fxns of peripheral proteins?
Same w/ the fxns of integral proteins
How many volunteers donate blood?
8 M
What is the volume of blood in 63 mL of anticoagulant?
450 mL +/- 10%
405 - 495 mL
Recently, the blood:anticoagulant ratio changed, in 70 mL of anticoagulant, what is the volume of blood?
500 mL +/- 10%
450 - 550 mL
What is the max amt of blood?
10.5 mL/kg of the donor’s wt
If the donor is 110 lbs, what is the max volume of blood that he/she can donate?
525 mL of blood
1 kg = 2.20462 lbs
110 lbs -> 50 kg
10.5 mL/kg = 525 mL
If the donor is 110 lbs, a max of 525 mL of blood can be drawn every what?
Every 8 wks
What is the total blood volume of adults?
10 - 12 pints
If fluid is lost (due to transfusion), it can be replaced in what time duration?
24 hrs
What is the time duration for RBCs to be replaced after transfusion?
Within 1 - 2 mos
After a successful transfusion (after 24 hrs), what is the percentage of cells that should be viable?
A min of 75% cells
What is the temp needed for storage of blood?
Ref temp: 1 - 6 DC
How long can a unit of blood may be stored?
21 - 42 days
Preservation of blood depends on what?
1) Type of anticoagulant-preservative used
2) Whether a preservative is added to separated RBCs
What is the result as storage time increases?
Viability decreases
What are the biochemical changes that accompanies the loss of viability of blood?
1) Decrease in pH
2) Build-up of lactic acid
3) Decrease in glucose consumption
4) Decrease in ATP lvls
5) Reversible loss of RC fxn (increase in O2 affinity or shift to the left)
The RBC’s metabolic pathways that produce ATP are mainly what?
Anaerobic
What are the characteristics of RBCs in connection to metabolism?
They are 1) anucleated and 2) have no mitochondrial apparatus for oxidative metabolism
The 3 ancillary pathways serve to maintain the what?
The structure and fxn of hgb
What are the diff metabolic pathways for RBCs?
1) Glycolysis
2) Pentose-phosphate pathway
3) Methemoglobin reductase pathway
4) Luebering-Rapaport pathway
What is the purpose of glycolysis?
To produce 90% of ATP needed
What is the purpose of pentose-phosphate pathway?
To produce 10% of energy
What is the result if defects in pentose-phosphate pathway are present?
It results to the production of Heinz bodies
What are the purposes of Luebering-Rapaport pathway?
1) Generates 2,3 DPG
2) Regulates affinity of hgb to O2
What is O2 affinity?
It is the ability of hgb to bind or release O2, expressed in terms of O2 tension
What are the allosteric changes that occur as the hgb loads and unloads O2 (specifically when decrease in 2,3 DPG is present)?
1) Increase in hgb O2 affinity
2) Less O2 delivered to tissues (shift to the left)
What are the results if blood w/ low 2,3 DPG was transfused?
1) Increase in cardiac output
2) Decrease in PO2
What are the concepts / situations present if shift to the left / left shifted is present (present in the O2 dissociation curve)?
1) Increased Abn Hb
2) Increase in pH
3) Decreased DPG
4) Decreased temp
5) Decreased P50
What are the concepts / situations present if shift to the right / right shifted is present (present in the O2 dissociation curve)?
1) Decreased pH
2) Increased DPG
3) Increased temp
4) Increased P50
Percent hgb saturation depends on what?
1) pH
2) Temp
3) P50
4) DPG