Preparation of blood components Nada Mohamed Ahmed, MD, MT (ASCP)i.

transcript

Preparation of blood

components

Nada Mohamed Ahmed ,MD, MT (ASCP)i

Contents

• Introduction • Blood components• Processing of blood components• Whole blood• Packed red blood cells

Leukocytes-depleted blood components

Fresh frozen plasma (FFP)

Cryoprecipitate

Introduction

• Whole blood unit obtained from donors is separated inthe donor processing area of blood bank into variouscomponents.

• Blood is composed of plasma and blood cells.• Plasma contains vital proteins such as coagulation

factors, fibrinogens, albumin, and globulin (includingimmunoglobulins).

• The clinical requirement of a patient determines whichblood product should be transfused.

Blood components

• Blood components and products are obtainedby donors.

• A donated blood unit consists of around 450-

500 ml of blood mixed with anticoagulant.

• An alternative process for the collection ofblood is that of apheresis, which uses cellseparation equipment and centrifugation.

Blood components

• Blood components available from whole bloodinclude:

• Red cell concentrates (packed RBCs).• Platelets concentrates.• Fresh frozen plasma• Cryoprecipitate

• Products derived fro pooled plasma:• (human albumin, immunoglobulins, coagulation

factor concentrates)

Blood is collected as whole blood, asshown below

Processing of blood components

packed red blood cells(PRBC's) is prepared by lightcentrifugation

PRBC'sPlasma +platelets

lightcentrifugation

PRBC'sPlasma

+platelets

heavycentrifugation

PRBC's

plateletrich

plasma

freshfrozenplasma

platelets

Whole bloodCharacteristics:RBC and plasma ; WBC and platelets not viable after

24hr storage . Labile clotting factors significantly decreased after 2 days of storage .

Hct 35%(dilution by anticoagulant). Blood 450mL. CPD or CPDA-1 anticoagulant 63mL.

Approximate Volume :520mL.

Shelf-Life:ACD,CPD __21days at1-6ْC.CPDA-1 35days at 1-6ْC

clinical IndicationsMost useful in massive blood loss such as accidents

and burns .

Packed red blood cellsCharacteristics:

Packed RBC with reduced plasma volume; WBC platelets, and coagulation factors as for whole blood.

Hct 69%.

Shelf-Life:ACD,CPD __21days at1-6ْC.

CPDA-1 35days at 1-6ْC

clinical IndicationsMost useful for symptomatic anemia is present; chronic

anemia, bleeding

Washed red blood cellsCharacteristics:RBC. No plasma, minimal platelets. 70-80% WBC removed if manual wash .90% WBC removed if automated wash.Hct adjustment as per amount of saline added. 5% loss of red cells due to wash procedure.

Shelf-Life:24 hr at1-6ْC. After wash.

clinical IndicationsIncreased red cell mass as for packed red cells .Most useful for preventing febrile and allergic reactions due to leukocytes or plasma proteins and for preventing anaphylactic reaction in IgA- deficient recipients .

Frozen deglycerolized red blood cells.

Characteristics:RBC, no plasma , no platelets, removal of 95% of WBC.Hct adjustment as per amount of saline added. Up to 20% of red cells lost due to procedure.

Shelf-Life:10 years at65ْC or colder .24 hr at1-6ْC. After wash

clinical IndicationsMost useful for supply of rare blood, inventory control, and autotransfusion. Also, as per washed red blood cells.

Leukocytes-depleted blood components

• Leucocytes in the blood units may cause infections andnon-haemolytic transfusion reactions to the recipients.

• Therefore, leucocytes are removed from blood componentsby filtering through leucocytes specific filters prior totransfusions.

• This process called leucocytes depletion.

• Examples of infections transmitted by leucocytes in bloodproducts: Creutzfeldt-Jakob disease (CJD) and CMV.

platelet concentrate Characteristics:Platelets(5.5 ×10 ); some WBC (i.e., lymphocytes), 50mL of plasma , few RBC (less than 0.5% Hct).

Shelf-Life:5 Daysat room temperature (20-24ْC) constant, gentle agitation.

clinical Indications :Used for quantitative or qualitative platelet disorders. May be

used when bleeding (slow ooze) due to severe thrombocytopenia.

Fresh frozen plasma Characteristics:Plasma proteins, all coagulation factors, complement.

Approximate Volume :200 to 260 mL.

Shelf-Life:1 year at -18ْC , or colder .

clinical Indications:

1) coagulation deficiencies and haemorrhage conditions(massive blood loss, infection or surgery of the liver).

- 2) acquired coagulation factor deficiencies such as DIC.

Cryoprecipitate• Cryoprecipitate is a source of factor VIII and fibrinogen

extracted from single donor plasma.

• It is prepared by slowly thawing FFP at 4C. This processprecipitate and enrich a fraction of FFP with factor VIII.

• Cryoprecipitate is used mainly for patients with DIC andpatients with factor VIII deficiency.

CryoprecipitateCharacteristics:80 units of factor VIII, other plasma proteins, von Willebrand factors XIII, fibrinogen(200mg), fibronectin.Approximate Volume :10 to 15 mL.

Shelf-Life:1 year at -18ْC , or colder .

Clinical IndicationsMost useful for von Willebrand disease, Factor XIII deficiency, or hypofibrinogenemia. Cryoprecipitate should not be used for a newly diagnosed hemophilia A case, because there are factor concentrates available that have been modified to eliminate the AIDS virus and possibly hepatitis.

Left: Freezer filled

with FFP and Cryo.

Upper Right:Refrigerator

with RBC units.

Lower Right: Platelet

Storage.