UCSF: Blood Products (Storage, Usage, Attaining) Flashcards
What are the Characteristics of Hemophilia and how is it treated?
Hemophilia A: Factor VIII deficient, with FVIII levels below 50%, but usually this is not clinically significant until they drop to 10%. When levels drop this low patients are at risk for bleeding into joints and muscles and bleeding with trauma or surgery; characterized by a prolonged PTT. Found almost exclusively in males.
Hemophilia B: “Christmas Disease” Factor IX deficient
Therapy: Cryoprecipitate (from FFP), Factor VIII Concentrate (Factor VIII concentrates from pooled plasma or recombinant FVIII, treated for potential viral contamination), Factor IX concentrates (pro-thrombin complex concentrates, factor IX concentrates, and recombinant FIX. Complex concentrate from pooled plasma by absorbing the factors out using barium sulfate or aluminum hydroxide).
Packed RBC Preservatives and Storage Lengths
ACD Acid-citrate-dextrose 21 days
CPD Citrate-phosphate-dextrose 21 days
CPDA-1 Citrate-phosphate-dextrose-adenine 35 days
CP2D Citrate-phosphate–double dextrose 21 days
Criteria for Blood Donations
Age: 17-76 years (with exceptions) Weight: >110 lbs Blood Pressure: 90-180/50-100 Pulse: 50-100 bpm Temperature: 12.5 g/dL (hgb), > 38% (hct)
Storage Conditions for Blood Components
Platelets: Stored at 20° - 24°C, with continuous agitation for up to 5 days.
Packed RBCs: Stored as a liquid state at 1° - 6°C for 21-35 days, depending on the preservative solution used.
Frozen units are stored at -65°C, with glycerol to protect the cells.
Plasma: Plasma (in a unit of whole blood) can be separated during storage and up to 5 days after the expiration date; stored at -18°C or colder and labeled as plasma with a shelf life of 5 years. As a liquid state, the product is labeled as liquid plasma and stored at 1° - 6°C and can be transfused up to 5 days after the expiration date of the whole blood.
FFP: Frozen within 8 hours of collection if the anticoagulant used was CPD, CD2D, or CPDA-1 or within 6 hours if the preservative was ACD. Stored at -18°C for 1 year or -65°C for 7 years.
Cryoprecipitate: Removed from plasma and stored at -18°C or colder. The expiration on this product is 1 year from the time of collection.
Define “Storage Lesion”
A loss of viability and function associated with certain biochemical changes that are initiated when blood is stored in vitro.
These changes include a decrease in: pH, glucose consumption, ATP levels, a buildup of lactic acid, and a reversible loss of RBC function resulting in a higher affinity for oxygen by the RBCs.
Platelets deteriorate if they are stored in lower temperatures or without rocking.
Donation Deferrals for various diseases
Cancer (Basal cell, squamous cell, cervical, melanoma): 1 year from completion of treatment
STDs: 1 year from completion of treatment
Recieving a transplant: 1 year from transplant date
HIV/AIDS exposure: 1 year from potential exposure
Exposure to persons who has hemophilia/uses clotting factor: 1 year from exposure
Exposure to Hepatitis: 1 year from exposure
Screen Cells must be…
O negative and eluted to remove any bound antibodies.
What is the waiting interval in between blood donations?
Whole blood: 8 weeks
Double Reds: 16 weeks
Platelets: 48 hrs
Plasma: 48 hrs
Calculating the amount that can be donated if below 110 lbs.
Weight must be converted to kg (divide by 2.2 lb/kg), then multiply that by the max mL you can donate per kg (10.5mL/kg). This gives the max allowable mL they can donate.
They must the anticoagulant amount so the ratio remains the same.
Can donors who have taken human growth hormone donate?
If it was recombinant, yes.
If not, no, due to the risk of Creutzfeld-Jakob Disease.
Can donors who have invested aspirin in the last 38 hours five platelets?
If they are to be taken from a whole blood unit and pooled for adults, yes.
They may not be the sole donor, and cannot be used in neonatal or pediatric patients.
Can hepatitis be transmitted through PPF?
PPF is pooled and pasteurized so it has very little risk of transmitting viruses as compared to components that are made with detergents. Those made with detergents are the next least likely to pass on viruses.
What factor is not present in cryoprecipitate?
Antithrombin III, which is instead found in FFP and commercial concentrates. Given to patients with liver disease or in DIC.
Calculating the units of FVIII in cryoprecipitate
FVIII (IU/mL) x volume (mL) = total IU FVIII
Calculating the recovery of FVIII in cryoprecipitate
[{Post FVIII (IU/mL) x volume (mL)} / {Pre FVIII (IU/mL) x volume (mL)}] x 100
% FVIII recovery
