Blood Components

Blood Bags

Single blood bag:Whole blood

Double bags:Packed red cellsplasma

Triple bags:Backed cellsPlasmaplatelets

Quarterly bags:Backed cellsPlasmaPlateletsPlasma factors

Whole Blood (WB)

• Collected directly from donors into blood transfusion bag containing anticoagulant

• 500 ml transfusion bag is used (contains 63 ml of anticoagulant + 450 ml blood)

Anticoagulant ratio is 1.4 ml:10ml blood (63ml / 450ml)

Whole Blood (WB)

• Consists of RBCs, WBCs, platelets and plasma (with anticoagulant).

• 1 unit increases Hb 1 g/dl & Hct 3%

• When is it used?– Patients who are actively bleeding and lost

> 25% of blood volume.– Exchange transfusion

Blood ComponentsSeparating WB into components of blood

is necessary to avoid wasting of units.

Goals

• Decrease harmful effects of blood

transfusion.

• Giving patients specific component

needed.

• Allow a longer survival for components.

• More than one patient will use the unit.

What are the Blood Components?

► Packed Red Blood Cells (PRBCs)

► Fresh Frozen Plasma (FFP)

► Platelet Concentrates (PC)

► Cryoprecipitate (CRYO)

► Leukoreduced Red Blood Cells

Centrifugation Types

There are two types of centrifugation

• Light/soft spin; (2000 rpm- 20ºC)

• Heavy spin; (3500 rpm- 20ºC)

Centrifuged blood

Buffy Coat (WBCs & Platelets)

Red Blood Cells

Plasma

PRBCs

How to prepare (PRBCs)?

RBCs have higher specific gravity than plasma, it moves to lower portion of the bag by centrifugation.

Whole Blood :(Light spin): Two products:

1) PRBCs

2) Platelet Rich Plasma (PRP)

Whole Blood Unit

After centrifugation

WB separates into

PR Plasma &

PRBCs

PRBCs A PRBC unit contains ~ 200 ml RBCs & 50 ml

Plasma.

– HCT of the unit should be ≤ 80%– One unit increases hematocrit 3%

RBC units must by stored at 2-6ºC

PRBC are indicated for: Patients with anemia

Surgery

Newborn exchange transfusion

Fresh Frozen Plasma (FFP)

Platelet Rich Plasma (PRP) centrifuged using (heavy spin), this will produce:

1) Fresh Frozen Plasma (FFP)2) Platelets Concentrate (PC)FFP is the fluid portion of blood that is separated and frozen at -18ºC within 8 hrs of WB donation.

Contains all the coagulation factors, including FVIII (factor 8) & Fibrinogen.

Whole blood unitWhole blood unit

Centrifuge using Centrifuge using LIGHTLIGHT spin spin

Express Platelets Rich Plasma (PRP) into satellite bagExpress Platelets Rich Plasma (PRP) into satellite bag

Take PRP and centrifuge again now using Take PRP and centrifuge again now using HEAVYHEAVY spin spin

Express PPP into satellite bag & freeze at -18ºCExpress PPP into satellite bag & freeze at -18ºC

Final products :PRBCs, Platelets concentrate & FFPFinal products :PRBCs, Platelets concentrate & FFP

FFPFreeze/store it at

- 18ºC for 1 year from collection date.

• - 70ºC for up to 8 years

Cross match is not required, but should be ABO compatible.

Indications of FFP

• Liver disease• Severe burns• Provides coagulation factors for

– Bleeding– Abnormal clotting due to massive transfusion– Patients on warfarin who are bleeding– Treatment of TTP – Coagulation factors deficiency– ATIII deficiency– DIC when fibrinogen is <100 mg/dl.

FFP

Platelets Concentrate (PC)

How to prepare PC?

Platelet Rich Plasma (PRP) centrifuged using (heavy spin), this will produce:

1) Platelets Poor Plasma (PPP)

2) Platelets concentrate (PC)• PC are stored at room temperature on

platelet agitator (prevent platelets clumping)• PC stored for 5 days at 20-24°C.• Each unit should elevate the platelet count by

5000/µL

P.C; Indications 1.To prevent bleeding due to

thrombocytopenia or platelet dysfunction.

2. For patients undergoing an operation, if the platelets count < 20,000/µl.

Platelet concentrate

Pooling Platelets6-10 units transferred into one bagExpiration = 4 hours

Cryoprecipitate (Cryo.)• Cryo-precipitated (Cryo.) or anti-hemophilic

factor (AHF) is the precipitated protein portion that results after thawing FFP at cold.

• Contains– von Willebrand’s Factor (vWF); (platelets adhesion

factor).– Fibrinogen

• 150 mg in each unit.

– Factor VIII• About 80 IU in each unit.

Cryoprecipitate (Cryo.)How to prepare Cryo.?

WB is centrifuged special heavy spin (3500 rpm at 4ºC for 11 min.)

• PRBCs• Plasma store until frozen > -18ºC (FFP)

FFP allowed to thaw at 4ºC overnight.

Centrifuge plasma heavy spin to separate plasma from Cryo……..

Express supernatant plasma & Cryo. will remain in bag.

what the supernatant plasma is called?

The supernatant plasma is called cryoprecipitate reduced or plasma cryo.Good for Thrombotic

Thrombocytopenic Purpura (TTP).

Cryo…..Indications

Hemophilia-A

von Willebrand Disease (vWD).

Congenital or acquired fibrinogen defects (dysfibrinogenemia).

Storage and Expiration of CRYO:• Must be stored at -18ºC, preferably - 30ºC.

• Expires 1 year from original WB donation date, not from

the date the Cryo., was prepared.

Special Procedures

AphaeresisAPHERESIS, Greek pheresis = ″to take away″;

involves the selective removal of blood constituents from blood donors or patients.

Selective removal of a pathologic materials has a theoretical advantage over the removal of all plasma constituents.

In most aphaeresis instruments, centrifugal force separates blood into components on the basis of differences in density.

Apheresis

PlateletsphaeresisTo obtain platelets at least 3 × 1011 platelets/unit

from:Random volunteer donors (5 Random

donors=1 apharesis donor)Patients’ family membersDonors with matched HLA or platelet antigen

phenotypes.

-The most common platelets collection systems (Trima-right side & Baxter-left side)

Irradiation of Blood ComponentsCellular blood components are irradiated to

destroy viable T- lymphocytes which may cause Graft Versus Host Disease (GVHD).

GVHD is a disease that results when immunocompetent, viable lymphocytes in donor blood engraft in an immunocompromised host, recognize the patient tissues as foreign and produce antibodies against patient tissues, primarily skin, liver and GI tract. The resulting disease has serious consequences including death.

GVHD may be chronic or acute

Irradiation of Blood ComponentsPatients at greatest risk are:

severely immunosuppressed,immunocompromised, receive blood donated by relatives, or fetuses receiving intrauterine transfusions

Irradiation inactivates lymphocytes, leaving platelets, RBCs and granulocytes relatively undamaged.

Must be labeled "irradiated".Expiration date of Red Blood Cell donor unit

changes to 28 days.May be transfused to "normal" patients if not

used by intended recipient.

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