The Red Cell Component Flashcards
LRBC
Leukoreduced RBCS, meaning that the WBCs have been mostly removed
List blood products
- RBCS
- Granulocytes
- Platelets
- Plasma
- Cryoprecipitate
- Clotting factor derivatives
- Rhogam
- Immune globulin
- Anti-sera
- Albumin
Whole blood shelf life
ACD/CPD 21 days
Whole blood volume and storage
- Volume 450-500 ml
- Store 2-6°C
Whole blood hematocrit
~38%
Uses for whole blood
- Volume expansion + oxygen carrying capacity
- Usually autologous units
- Research promoting it for emergency situations
Which components in whole blood don’t last long in storage?
Platelets, WBCS, and clotting factors
Risk of whole blood transfusion
Transfusion associated circulatory overload (TACO)
What is considered “manufacturing” blood products?
- Changing purity/potency
- Irradiating
- Aliquot
List steps of whole blood component prep from donation
- Collect in sterile closed system
- Decide what product will be used for
- Centrifuge to pack RBCs and leukoreduce overnight
- Separate components
- Test donor blood for ABO type and virus
- Label with ISBT label
- Release to inventory for distribution
How to prep platelets and plasma from whole blood donation
- Platelets: cool to RT within 24 hrs
- Plasma: cool 1-10°C within 8 hrs
How does blood collection apheresis work?
- Decide product to be collected
- Collect in apheresis system with intermmittent or continuous flow centrifugation
- Return uncollected components
- Test donor blood for ABO type and virus
- Label products with ISBT label
- Release to inventory for distribution
Different donor requirements for apheresis
Require 40% hct and 16 wk deferral
Warm auto-Ab treatment
Plasmapheresis
Leukemia treatment
Photopheresis
Erythrocytapheresis treatment is for which disease?
Sickle cell
Apheresis risks
- Citrate toxicity
- Vascular access
- Vasophagal reactions
LRBC WBC count reduced to _____
WBC < 5 X 10^6
LRBC shelf life and storage
- shelf life: 21-42 days
- storage- 2-6°C
LRBC desired hct
60-85%
LRBC risks
- Graft vs host disease
- Pathogen exposure
DRBC (DEGLYCEROLIZED RBCs) prep
Wash away plasma proteins, platelets, and WBCs
DRBC storage and shelf life
- storage: -65°C
- frozen shelf life: 10 years
- freshly washed shelf life: 24 hrs
DRBC desired hct
70-80%
DRBC uses
- Rare antigens
- Patients with allergic reactions
DRBC risks
- Cell degradation
- Leftover glycerol
- Bag degradation
LIRBC (irradiated and packed RBCs) storage and shelf life
- storage: 2-6°C
- shelf life: 28 days post irradiation or expiration date, which ever comes first
LIRBC uses
- immunocompromised patients
- babies
LIRBC risks
- HLA immunization
- RBCs higher degradation post-irradiation
What does irradiation with 25 Gy do to RBCs?
Eliminates T cell mitogenic (cell division) capacity
Blood storage in transfusion service vs transfer between sites in/outside hospital
- In transfusion service: 2-6°C
- In/outside hospital: 1-10°C
Explain 30 minute rule
Some hospitals limit blood being outside of BB to 30 min
Temp outside range will change blood product expiration date to ____
4 hrs
List when to conduct visual inspection of blood product
- on receipt
- daily
- at crossmatch
- at issue
- at return
Visual inspection
- hemolysis
- lipemia
- bacterial contamination
- particulate matter
- discoloration
Which of the following cannot be kept in the blood bank inventory/storage?
A. blood components that left BB and returned unspiked, 1-10°C
B. Washed DRBCs 25 hr from wash
C. RBC aliquot seal failure < 24h r
D. Blood components outside BB at 2-6°C in validated coolers
E. Blood components transported from vendor/taxi/helicopter/police at 1-10°C
B, because DRBCs must be less than 24 hrs old from wash
Red blood cell substitutes
- Hemoglobin-based oxygen carrier
- Perfluorocarbons - can’t actually use
- RBC engineering to make Type O from any blood type by removing sugars
Which product cannot be made from a whole blood donation processed within 24 hr?
A. LRBC
B. Platelets
C. FP24
D. Cryoprecipitate
D. Cryoprecipitate because it needs to be made in 8 hrs, not 24 hr
Which type of RBC should be given to a patient with known allergic reactions to blood products?
A. DRBC
B. LRBC
C. IRBC
D. Whole blood
A. DRBC
It was washed, so allergens in plasma are removed
