Blood Banking and Component Therapy Quiz

Blood Banking: Summary of Key Points

• ABO/Rh typing detects A, B, and D antigens using patient's RBCs and reagent RBCs. Antibodies are detected using reagent anti-A, anti-B, and anti-D or patient's serum.
• Antibody screen detects specific antibodies to BC antigens using reagent antibody screening cells and patient's serum.
• Antibody identification identifies antibodies to RBC antigens using reagent antibody panel cells and patient's serum.
• Crossmatch determines compatibility of donor RBCs with recipient's blood using donor cells and recipient's serum.
• Blood bank reagents are licensed by FDA and must meet potency and specificity standards.
• Types of reagents include reagent RBCs, antisera, antiglobulin reagents, and potentiators.
• ABO antisera are used to determine patient's blood type, and anti-A and anti-B reagents are colored with blue and yellow dye, respectively.
• D typing detects important antigens to prevent HTR and HDN. Two types of reagents are high protein and low-protein monoclonal.
• Donor selection involves registration questions, educational material, physical exam, and confidential unit exclusion.
• Autologous donation includes preoperative, intraoperative hemodilution, intraoperative collection, and postoperative collection.
• Hemotherapy uses blood or blood components to treat a disease in a patient.
• Blood components include whole blood, RBCs, plasma, platelets, and cryoprecipitated antihemophiliac factor. They have different storage temperatures and expiration dates.Blood Component Storage, Transportation, and Therapy

Storage and Transportation:

• FDA requirements and AABB Standards define calibration, maintenance, and monitoring procedures for equipment used to store blood products.
• All refrigerators, freezers, and platelet incubators must have recording devices, audible alarms, regular alarm checks, power failure, and alarm activation emergency procedures, emergency power backups, calibrated thermometers, and written procedures.
• RBCs require a temperature of 1-10°C during transport and are packed in cardboard boxes with a styrofoam box inside, with a predetermined amount of wet ice in plastic bags placed on top of the blood units to maintain the temperature for 24 hours.
• Frozen components are shipped on dry ice, and platelets are shipped at room temperature.
• When component shipments are received, the temperature and appearance of units must be observed and recorded, and any out-of-range temperatures require evaluation before transfusion.

Blood Component Therapy:

• Whole blood is used in actively bleeding patients, patients who have lost at least 25% of their blood volume, or patients requiring exchange transfusions.
• RBCs are used in oncology patients undergoing chemotherapy or radiation therapy, trauma patients, surgery patients, dialysis patients, premature infants, and patients with sickle cell anemia. One unit usually increases the patient's hemoglobin approximately 1 g/dL and the hematocrit by 3%.
• Leukocyte-reduced RBCs are used in chronically transfused patients or patients having known febrile transfusion reactions. A special filter is required for bedside filtration, and leukoreduction can also occur in the manufacturing process.
• Frozen RBCs are frozen by adding glycerol to prevent cell hydration and the formation of ice crystals that can cause cell lysis. They are stored at -65°C for 10 years.
• Deglycerolized RBCs are thawed, and then the glycerol must be removed by washing the RBCs with a series of saline solutions of decreasing osmolality. They expire in 24 hours.
• Washed RBCs are used for patients who have a reaction to plasma proteins (allergic, febrile, and/or anaphylactic) and in infant or intrauterine transfusions. 10-20% of RBCs are lost in the process of washing the RBC unit with normal saline.
• Irradiated RBCs prevent T cell proliferation and are required for cellular components if a donor is a blood relative of the intended recipient or donor unit is HLA matched for the recipient.
• Platelets are used to control or prevent bleeding and have a life span of 3 to 4 days. They can be prepared from a whole blood unit or pooled from bags. Plateletpheresis packs contain approximately 3 X 10^11 platelets per unit.
• Fresh-Frozen Plasma is used to replace coagulation factors in the patient and is indicated in bleeding patients who require factors II, V, VII, IX, and X, abnormal coagulation due to massive transfusion, patients on anticoagulants who are bleeding or require surgery, treatment of TTP and hemolytic uremic syndrome, patients with liver disease to prevent or correct bleeding, antithrombin III deficiencies, and DIC when fibrinogen is >100 mg/dL. It should be thawed in a water bath at 30-37°C for