TOPIC 1 - P2 Flashcards
added to the RBCs after removal of the plasma with or without platelets
ADDITIVE SOLUTION
In Additive solutions, Removal of the _______ during the preparation of RBC concentrates removed much of the ______ needed to maintain RBCs during storage
plasma component ; nutrients
In Additive solutions, RBC concentrates can be relatively void of plasma with _______, which causes the units to be ______ and _______ , especially in emergency situations
high hematocrits ; more viscous and difficult to infuse
In Additive solutions, _____ to the RBC concentrate prepared from a _____ blood collection
100 mL ; 450-mL
In Additive solutions, contained in a _____ and is added to the RBCs after most of the plasma has been expressed
satellite bag
(AS) All three additives contain ______, ______ and ______.
saline, adenine, and glucose.
____ and _____ also contain mannitol, which protects against storage-related hemolysis
AS-1 and AS-5
AS-1 and AS-5 also contain _______, which protects against storage-related hemolysis
mannitol
____ contains citrate and phosphate for the same purpose
AS-3
(AS) As with RBCs stored only with primary anticoagulant preservatives, _____ is depleted by the ______ week of storage
2,3-DPG ; second
3 ADDITIVE SOLUTIONS IN USE IN NORTH AMERICA
- Adsol (Baxter Healthcare) = AS-1 with 42 days storage time
- Nutricel (Pall Corporation) = AS-3 with 42 days storage time
- Optisol = AS-5 with 42 days storage time
autologous units and the storage of rare blood types
(RBC FREEZING)
(RBC FREEZING) allows individuals to donate blood for their own use in meeting their needs for blood transfusion
Autologous transfusion
(RBC FREEZING) RBCs that are less than _____
6 days old
(RBC FREEZING) cryoprotective agent used most commonly
Glycerol
(RBC FREEZING) added to the RBCs slowly with _____ then rapidly frozen and stored in a freezer.
vigorous shaking
(RBC FREEZING) usual storage temperature is _____; __ years from the date of freezing
below –65°C ; 10
2 concentrations of glycerol
- high concentration glycerol = 40% weight in volume [w/v]
- low-concentration glycerol 20% weight in volume [w/v]
ADVANTAGES OF HIGH CONCENTRATION GLYCEROL TECHNIQUE USED BY MOST BLOOD BANKS OVER LOW CONCENTRATION GLYCEROL TECHNIQUE
- Initial Freezing Temperature
High Glycerol: -80°C
Low Glycerol: -196°C
ADVANTAGES OF HIGH CONCENTRATION GLYCEROL TECHNIQUE USED BY MOST BLOOD BANKS OVER LOW CONCENTRATION GLYCEROL TECHNIQUE
- Need to control freezing rate
High Glycerol: NO
Low Glycerol: YES
ADVANTAGES OF HIGH CONCENTRATION GLYCEROL TECHNIQUE USED BY MOST BLOOD BANKS OVER LOW CONCENTRATION GLYCEROL TECHNIQUE
- Type of Freezer
High Glycerol: Mechanical
Low Glycerol: Liquid Nitrogen
ADVANTAGES OF HIGH CONCENTRATION GLYCEROL TECHNIQUE USED BY MOST BLOOD BANKS OVER LOW CONCENTRATION GLYCEROL TECHNIQUE
- Maximum storage temperature
High Glycerol: -65°C
Low Glycerol: -120°C
ADVANTAGES OF HIGH CONCENTRATION GLYCEROL TECHNIQUE USED BY MOST BLOOD BANKS OVER LOW CONCENTRATION GLYCEROL TECHNIQUE
- Shipping Requirements
High Glycerol: Dry Ice
Low Glycerol: Liquid Nitrogen
ADVANTAGES OF HIGH CONCENTRATION GLYCEROL TECHNIQUE USED BY MOST BLOOD BANKS OVER LOW CONCENTRATION GLYCEROL TECHNIQUE
- Effect of changes in storage temperature
High Glycerol: Can be thawed and refrozen
Low Glycerol: Critical
Replacing glycerol with decreasing concentrations of saline
Deglycerolization process
In Deglycerolization process, the saline are:
____ saline, followed by ____ saline, with a final wash of _______________
12% saline ; 1.6% saline; 0.2% dextrose in normal saline
In Deglycerolization process, ____ of the unit should also be monitored to ensure adequate deglycerolization
Osmolality
In Deglycerolization process, thawed RBCs: stored at _____ for ___ hours (open system)
1°C to 6°C ; 24
ADVANTAGES OF RBC FREEZING
Long Term Storage (10 years)
Maintenance of RBC viability and function
Low residual leukocytes and platelets
Removal of significant amounts of plasma proteins
DISADVANTAGES OF RBC FREEZING
A time consuming process
Higher cost of equipment and materials
Storage requirements (-65°C)
Higher cost of products
ATP and 2,3-DPG levels are restored or enhanced by metabolic alterations
RBC Rejuvenation
only FDA-approved rejuvenation solution
Rejuvesol
Rejuvesol contains ____, _____, ____ and _____
contains phosphate, inosine, pyruvate, and adenine
In RBC rejuvenation, RBCs (liquid state) can be rejuvenated at outdate or up to _____ after outdate
3 days
incubating the RBC unit with _____ of the rejuvenating solution for ____ at ____ then washed to remove the rejuvenation solution and transfused within _____
50 mL ; 1 hour ; 37°C ; 24 hours
Current Trends in RBC Preservation Research
- Improved Additive Solutions
- Procedures to Reduce and Inactivate Pathogens
- Formation of O-Type RBCs
- Blood Pharming
- RBC substitutes
procedures that would reduce the level of or inactivate residual viruses, bacteria, and parasites in RBC units
Procedures to Reduce and Inactivate Pathogens
inadequate supply of O-type RBC units
Formation of O-Type RBCs
In Formation of O-Type RBCs, O-type RBCs manufactured from B-type RBCs were effective when transfused to ____ and ____ type patients in need of RBCs.
O- and A-
Creating RBCs in the laboratory(O-negative RBCs)
Blood Pharming
In Blood Pharming, bioengineering company (______) uses proprietary technology (____) to turn hematopoietic stem cells (HSC) from umbilical cord
Arteriocyte ; NANEX
_______ is a search for a safe and effective oxygen carrier that could eliminate many of the problems associated with blood transfusion, such as the need for refrigeration, limited shelf-life, compatibility, immunogenicity, transmission of infectious agents, and shortages.
RBC substitutes
Hemoglobin-Based Oxygen Carriers
Bovine hemoglobin
Bovine hemoglobin advantage
Lower oxygen affinity and better oxygen uploading in ischemic tissues
Bovine hemoglobin disadvantage
potential immunogenicity and transmission of prions
synthetic hydrocarbon structures in which all the hydrogen atoms have been replaced with fluorine, chemically inert, excellent gas solvents, and carry O2 and CO2 by dissolving them
Perfluorocarbons
Perfluorocarbons, Bcoz of small size (about 0.2 microns in diameter), they are able to pass through areas of _____ and deliver ____ to tissues that are inaccessible to RBCs
vasoconstriction ; oxygen
Normal platelet function in vivo requires more than _____
100,000 platelets per microliter
Spontaneous hemorrhage may occur when the platelet count falls below ______
10,000 platelets per microliter
loss of platelet quality during storage
Platelet Storage Lesion
In Platelet Storage Lesion, varying degree of platelet activation occurs that results in release of some _____ and a decline in ____ and ____
intracellular granules ; ATP and ADP
In Platelet Storage Lesion, Also results in temporary aggregation of platelets into large sheets that must be allowed to rest for the aggregation to be reversed, especially when the platelet concentrates (PCs) are prepared with the _______ method.
platelet-rich-plasma (PRP) method
In Platelet Storage Lesion, ___ days and ____ temperature associated with bacterial contamination
5 days and 22 degree celsius
In Platelet Storage Lesion, the storage of PCs in plasma, the principal buffer is _____
bicarbonate
In Platelet Storage Lesion, the normal platelet concentrates pH is
6.2
In Platelet Storage Lesion, when the PC pH is below 6.2 it is associated with a _____; platelets ____ and there is a ____ transformation in morphology that is associated with a loss of ______
loss of platelet viability ; swell ; disk-to-sphere ; membrane integrity
In Platelet Storage Lesion, loss of membrane integrity using _____ (binding of _____ with anionic phospholipids)
flow cytometry ; annexin V
flow cytometry can also be used to measure the platelet ______
degranulation process
Immediately before distribution to hospitals, a visual inspection is made that often includes an assessment of ______
platelet swirl
absence of platelet swirl is associated with the _____ during storage, resulting in the loss of _________
loss of membrane integrity ; discoid shape with irreversible sphering
Since the 1970s, platelets have been prepared from whole blood as concentrates in which the volume per unit is near ____ in contrast to the ______ volume of platelet-rich plasma units
50 mL ; 250- to 300-mL
Today, platelets are prepared as concentrates from _____ and increasingly by ______
whole blood ; apheresis
In platelet preservation, the platelets are stored at _____, with continuous agitation for up to __ days and the expiration time is the midnight of day __
20°C to 24°C ; 5 ; 5
(History of Platelet Storage)
_____ has been shown to facilitate oxygen transfer into the platelet bag and oxygen consumption by the platelets; maintenance of platelet component pH
agitation
(History of Platelet Storage)
The gas transport properties of a container are known to reflect _______, ________, ________, and ________.
the container material, the gas permeability of the wall of the plastic container, the surface area of the container available for gas exchange, and the thickness of the container.
Storage in Second-Generation Containers was developed in
1982
Containers with increased gas transport properties (allowing increased oxygen transport and carbon dioxide escape)
Second-Generation Containers
In Storage in Second-Generation Containers, polyvinyl chloride (PVC) plastic containing a _______; other cases with _____ plastic.
phthalate plasticizer ; polyolefin
Storage in Second-Generation Containers is ___ days
5
In Storage in Second-Generation Containers, the nominal volumes of the containers are _____ and _____for WBD platelet concentrates and apheresis components, respectively
300 to 400 mL ; 1 to 1.5 L
Measurement of Viability and Functional Properties of Stored Platelets…
_____ indicates the capacity of platelets to circulate after infusion without premature removal or destruction
Viability
Measurement of Viability and Functional Properties of Stored Platelets…
observation of the _____ when placed in front of a light source: used to obtain a semiqualitative evaluation of the retention of platelet viability properties in stored units
swirling phenomenon
Measurement of Viability and Functional Properties of Stored Platelets…
_______: ability of viable platelets to respond to vascular damage in promoting hemostasis.
Function
Measurement of Viability and Functional Properties of Stored Platelets…
_______: have reflected an undesirable activation of platelet processes at a temperature range of 1°C to 6°C.
cold-stored platelets
Platelet Storage and Bacterial Contamination…
major concern storage of platelets at 20°C to 24°C is the potential for ______
bacterial growth
Platelet Storage and Bacterial Contamination
______ due to contaminated platelets is the most common infectious complication
Sepsis
Platelet Storage and Bacterial Contamination
three commercial systems approved by the FDA for screening platelets for bacterial contamination:
BacT/ALERT (bioMérieux)
eBDS (Pall Corp.), and
Scansystem (Hemosystem).
Platelet Storage and Bacterial Contamination
1st rapid test
Pan Genera Detection (PGD) test (Verax Biomedical)
Platelet Storage and Bacterial Contamination
Eighty percent of the septic reactions were due to _____ (2004 to 2006 culture neg products)
Staphylococcus spp.
Platelet Storage and Bacterial Contamination
- recent precaution is the _____ of the first aliquot (about _____) of collected blood into a separate but connected diversion pouch
- minimizes the placement of ____, the most common source of bacterial contamination, into the ______
diversion ; 20 to 30 mL
skin plugs ; platelet products
Current Trends in Platelet Preservation Research
1 Storage for 7 Days at 20°C to 24°C
2. Storage with Additive Solutions
3 Procedures to Reduce and Inactivate Pathogens
4 Development of Platelet Substitutes
5 New Approaches for Storage of Platelets at 1°C to 6°C
6 Frozen Platelets
first platelet additive solution
(PAS-C)
_____: Reports of septic transfusion reactions increased following this change (___ to ____ days)
1984 ; 5 to 7
