Blood- Component- Preparation PDF

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Summary

BLOOD COMPONENT PREPARATION Blood Collection Bags Anticoagulant/Preservative Solutions • Anticoagulants prevent blood clotting • Preservatives provide nutrients for cells Anticoagulant/Preservative Solutions • Adenine - Substrate for ATP synthesis • Dextrose - Supports ATP generation by glycolytic p...

Description

BLOOD COMPONENT PREPARATION Blood Collection Bags

Anticoagulant/Preservative Solutions • Anticoagulants prevent blood clotting • Preservatives provide nutrients for cells

Anticoagulant/Preservative Solutions • Adenine - Substrate for ATP synthesis • Dextrose - Supports ATP generation by glycolytic pathway • Citrate - Prevents coagulation by binding calcium • Phosphate – supports red cell stability • A bag with 63 ml of anticoagulant will support the collection of 450 +/- 45 ml of blood. • A bag with 70 ml of anticoagulant will support the collection of 500 +/- 50 ml of blood. Additive Solutions • A mixture of glucose, adenine, and normal saline • Provide nutrients to stabilize the red cell membrane, maintain the level of 2,3 DPG, and increase the storage time for the unit of red blood cells. • Extends storage to 42 days • Remove platelet rich plasma within 72 hours • Add additive solution to RBCs

Lesion of Storage • Decrease in pH • Decrease in glucose consumption • Build up of lactic acid • Decrease of ATP levels • Reversible loss of RBC function

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This decrease in the level of 2,3 DPG impacts the ability of red cells to release oxygen to the tissues.

Shelf-life/Storage • Red cells being stored prior to transfusion must meet several criteria. These criteria include: – Sterility – Viability during storage – In vivo survival after storage: greater than 75% of transfused cells remain in circulation 24 hours AFTER transfusion – 24 hours post-transfusion – Hemolysis of ≤1%

Components Available for Transfusion • Whole blood • Packed red cells • Leukocyte reduced red cells • Irradiated red cells • Washed red cells • Deglycerolized red cells • Autologous storage • Fresh frozen plasma • Cryoprecipitate • Platelet concentrate • Leukocyte concentrate • Factor Concentrates • Granulocyte Concentrate Instruments

Component Preparation • Collect unit within 15 minutes to prevent activation of coagulation system • Draw into closed system – primary bag with satellite bags with hermetic seal between. • If hermetic seal broken transfuse within 24 hours if stored at 1-4C, 4 hours if stored at 20-24C • Centrifuge – light spin, platelets suspended • Remove platelet rich plasma (PRP) • Centrifuge PRP heavy spin • Remove platelet poor plasma • Freeze plasma solid within 8 hours • Thaw plasma at 1-4C – precipitate forms • Centrifuge, express plasma leaving cryoprecipitate. Store both at -18C • RBCs – CPD – 21 days, ADSOL – 42 days – 1-6C Whole Blood • Contains RBCs and plasma • Hct of approximately 38% • When the cryoprecipitate antihemophilic factor has been removed from the unit of whole blood, whole blood is referred to as whole blood modified • Storage temperature is 1 to 6C, and the shelf-life is dependent on the preservative

Equipments

Shelf-life: Storage Temp.: Quality Control: Volume: Indications for use: Contents: Dosage:

Same as anticoagulant used 1-6oC Hct. Approx. 40% 450-500 mL Volume expansion RBC, Platelets, Plasma, WBCs Hgb 1g/dl, hct 3%

Irradiated RBCs • Whole blood that has been irradiated to inhibit T-cell proliferation in the recipient – GVHD • Px who are immunocompromised, receiving stem or bone marrow, directed blood coming from a relative, fetuses undergoing intrauterine transfusion • Has an expiration date of 28 days from the date of irradiation • Cesium-137, Cobalt-60

Centrifugation Heavy Spin • 5000g for 5 minutes – Packed RBC, Platelet Concentrate • 5000g for 7 minutes – Cryoprecipitate, Cell free plasma Light Spin • 2000g for 3 minutes – Platelet-rich plasma

Shelf-life: Storage Temp.: Quality Control: Volume: Indications for use: Contents: Dosage:

28 days 1-6oC Hct. Approx. 40% 25 Gy to center of Canister 450-500 mL Volume expansion, Prevent GVHD, increase O2 RBC, Platelets, Plasma Hgb 1g/dl, hct 3%

Packed RBC • Used to treat symptomatic anemia and routine blood loss during surgery • Hematocrit is approximately 80% for non-additive (CPD), 60% for additive (ADSOL). • Allow WB to sediment or centrifuge WB, remove supernatant plasma. Shelf-life: Storage Temp.: Quality Control: Volume: Indications for use: Contents: Dosage:

Pre-storage Leukoreduction • 1st method, in-line filter can be attached to whole blood unit and filter via-gravity • 2nd method, plasma initially removed from WB then RBC passed through an in-line reduction filter • 3rd method, sterile docking device can be used to attach a leukocyte reduction filter

Same as anticoagulant used, If open system (24 hours) 1-6oC 3 x 1011 (SD) pH 6.2 50-70 mL Thrombocytopenia, DIC, Bleeding Platelet 5k-10k/uL (RD), 30k-60k/uL (SD)

Platelet Concentrate Random Donor • Used to prevent spontaneous bleeding or stop established bleeding in thrombocytopenic patients. • Prepared from a single unit of whole blood. • Due to storage at RT it is the most likely component to be contaminated with bacteria. • Therapeutic dose for adults is 6 to 10 units. • Some patients become "refractory" to platelet therapy. • Expiration is 5 days as a single unit, 4 hours if pooled. • Store at 20-24 C (RT) with constant agitation. • D negative patients should be transfused with D negative platelets due to the presence of a small number of RBCs. Pooling Platelets • 6-10 units transferred into one bag • Expiration = 4 hours

Platelet Concentrate Single Donor • Used to decrease donor exposure, obtain HLA matched platelets for patients who are refractory to RD-PC or prevent platelet refractoriness from occurring. • Prepared by hemapheresis, stored in two connected bags to maintain viability. • One pheresed unit is equivalent to 6-8 RD-PC. • Store at 20-24 C (RT) with agitation for 5 days, after combining, 24 hours • D negative patients should be transfused with D negative platelets due to the presence of a small number of RBCs Platelet Concentrate Fresh Frozen Plasma

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Used to replace labile and non-labile coagulation factors in massively bleeding patients OR treat bleeding associated with clotting factor deficiencies when factor concentrate is not available. Must be frozen within 8 hours of collection. Expiration – frozen - 1 year stored at...