Therapeutic Use of Blood Components

Therapeutic Use of Blood Components

• Red cell concentrates are used to treat acute or chronic anaemia, improving the oxygen-carrying capacity of the patient's blood.
• Platelet concentrates are transfused in cases of thrombocytopenia, as a prophylactic measure to prevent microvascular bleeding, or to treat bleeding episodes.
• Fresh frozen plasma is used to prevent microvascular bleeding due to abnormal coagulation.

Solid Organ and Stem Cell Transplantation

• Transplantation is defined as the transfer of tissues or organs within one or between two individuals.
• Types of transplantation include autogenic (autologous graft) and allogeneic (allogeneic graft) transplantations.
• Clinical transplantation aims to exchange diseased organs with healthy donor replacements.
• The first successful kidney transplant was performed in 1954, and the first heart transplant was performed in 1967.

Organ and Tissue Transplantation

• Organ transplants include lung, heart, or heart/lung, kidneys, liver, small bowel, and pancreas transplants.
• Tissue transplants include cornea, skin, bone, heart valves, and tendon transplants.
• Stem cell sources include peripheral blood, bone marrow, and cord blood.

Allogeneic Stem Cell Transplantation

• Donor peripheral stem cells are collected and frozen in liquid nitrogen.
• The patient's bone marrow is ablated, and the stem cell transplant is re-infused with transfusion support.

Transfusion Therapy

• The transfusion journey involves stages from donor to patient, including donor selection and assessment, donated blood collection, testing, processing, storage, and transport to the hospital "blood bank", compatibility testing, and administration to the right patient.
• Strict procedures and quality measures must be followed at all stages to protect the safety of donors and recipients.

Testing the Donation Sample

• Three donation samples are taken for lab testing, including mandatory tests for blood typing, red cell antibody screening, and microbiology testing.
• Additional tests are performed on some donations, such as sickle cell trait testing.

Selecting Suitable Donors

• Types of blood donors include whole blood and apheresis donors.
• The rationale for blood donor selection is to ensure the safety of both the recipient and the donor.
• Strict criteria are followed for donor selection or exclusion, including exclusion criteria for high-risk occupation or hobby, health risk, infection risk, disease, and risk group.

Donor Assessment

• Donors complete a health questionnaire, undergo an interview with a healthcare professional, and have a physical assessment.
• New donors undergo a hemoglobin check and sign a consent form.

Collecting the Whole Blood Donation

• Whole blood donation involves collecting 450mls of donor blood into a special "blood collection system" containing citrate anticoagulant.
• Apheresis allows direct collection of specific blood components.

Historical Aspects of Blood Transfusion

• The first known record of blood transfusion was in 1494, followed by the discovery of blood circulation in 1628.
• The 19th century saw the development of transfusions, with the first successful transfusion in 1829.

The History of Blood Transfusion

• Three major advances reduced the risk of adverse reactions, including the discovery of ABO blood groups, the development of anticoagulants, and refrigeration.
• The National Blood Transfusion Service was established in 1946 and became NHS Blood and Transplant in 2005.

Transfusion Science

• Transfusion science is an integrated role in multi-disciplinary diagnosis and treatment.
• The scope of transfusion science includes knowledge and practical competence in areas such as platelet immunology, transfusion, and transplantation.

Role of NHS Blood and Transplant

• NHS Blood and Transplant is donor-focused, ensuring safe processing of donor blood and maintaining a supply of blood components and products for therapeutic use.
• The organization is also patient-focused, acting as a reference laboratory and providing education programs for hospital staff.

Blood Functions and Components

• Primary blood functions include transporting oxygen, removing waste, plugging wounds, and fighting disease.
• Blood components include red cells, white cells, platelets, and plasma.

Diagnostic Observations in Blood Samples

• Diagnostic observations in blood samples can indicate diseases requiring transfusion support.
• Treatment of these diseases requires transfusion support.

Processing Whole Blood Donations

• Whole blood donations are processed into three main components for therapeutic use: red cell concentrates, fresh frozen plasma, and platelet concentrates.
• Each component can only be transfused with a deficient component, and multiple patients can benefit from one donation.

Storage and Transport

• Red cells are stored in SAGM for 35 days at 4°C or in CPD for 28 days.
• Platelet concentrates are stored at 22°C for 7 days with continuous agitation.
• Fresh frozen plasma is stored at -25°C for 3 years.
• Components are transported in special isolated containers with temperature inserts to maintain the temperature for 4 hours.

Compatibility Testing

• Compatibility testing is performed by the blood management system (BMS) in the hospital "blood bank".
• The aim is to provide the recipient with a transfusion that is both beneficial and safe.
• Standard procedures must be carried out prior to administration of red cell transfusions to patients.