Blood Component Preparation and Therapy PDF

blood component 14 preparation and therapy BLOOD PRESERVATION AND BANKING 1. Contents content action Citrate (Sodium citrate): Chelates calcium to prevent coagulation Phosphate buffer (Sodium...

blood component 14 preparation and therapy BLOOD PRESERVATION AND BANKING 1. Contents content action Citrate (Sodium citrate): Chelates calcium to prevent coagulation Phosphate buffer (Sodium Buffer to prevent decreased pH biphosphate) Dextrose (Glucose) Sugar to support RBC life Adenine Used in ATP synthesis  blood preservatives APPROVED PRESERVATIVES STORAGE TIME (at 1°-6°C) Acid citrate dextrose (ACD) Citrate phosphate dextrose (CPD) Citrate phosphate double dextrose (CP2D) Citrate phosphate dextrose adenine-1 (CPDA-1) Citrate phosphate dextrose adenine-2 (CPDA-2) 2. Additive Solutions (AS) Added to RBC after the plasma has been removed from whole blood (WB) collected using _______________ Procedure: Plasma expressed from WB ->100-110 mL additive transferred from attached satellite bag to RBCs within 72 hours of collection or per manufacturer's instructions. Final hematocrit: 55%-65% (Hct of RBCs without additive 65%-80%) lower viscosity facilitates transfusion Consist of: SAGM: saline, adenine, glucose, mannitol SAGC: saline, adenine, glucose, citrate  blood additives ADDITIVE SOLUTIONS (AS) STORAGE TIME (at 1°-6°C) Adsol (AS-1) Nutricel (AS-3) Optisol (AS-5) 3. Rejuvenation Solutions Used in some blood centers to regenerate adenosine triphosphate (ATP) and 2,3-diphosphoglycerate (2, 3-DPG) Red cells stored in the liquid state for fewer than 3 days after their outdate are rejuvenated for 1-4 hours at 37°C with solution Consist of: PIGPA: phosphate, inosine, glucose, pyruvate, adenine PIPA: phosphate, inosine, pyruvate, adenine Rejuvesol The only FDA-approved rejuvenation solution in US Wash rejuvenated RBCs to remove ______ Freeze rejuvenated RBCs: shelf-life of _____ using CPD and CPDA-1 shelf-life of _____ using AS-1 SUBMISSION OF THE WHOLE BLOOD TO BLOOD BANK/CENTER Collected units stored at 1-6°C: submit within Collected units stored at 20-24°C: submit within Whole blood submitted within _____ hours after collection can be used for platelet preparation DONOR BLOOD UNIT PROCESSING All donor units are processed before being released for compatibility testing and transfusion The tests done on the donor blood unit include the following: ABO Grouping Rh typing (and Du testing) Antibody screen (required only on those with previous pregnancy and/or transfusion) Screening tests for Transfusion-Transmissible Infections (TTIs) Component preparation 1. Centrifugation Heavy Spin 5,000 x g for 5 minutes: 5,000 x g for 7 minutes: Light Spin 2,000 x g for 3 minutes: For preparation of platelet concentrate, centrifugation is performed at For all other blood components, centrifugation is carried out between  Normal ig Albumin Normal serum albumin ahf/fVIII PT complex Hyper ig 2. Sedimentation For RBC preparation 3. Leukocyte reduction Standard filter Microaggregate filter Leukoreduction filters: used to remove 99.9% of WBC from RBC and platelet products Leukoreduced RBC: Leukoreduced Random Donor Platelet (RDP):. Leukoreduced Single Donor Platelet (SDP): 4. Washing RBC: Platelets: 5. Apheresis Blood is drawn from a donor or a patient and separated into components; one or more of the components is retained, and the remaining constituents are recombined and returned to the individual Types: Erythrocytapheresis Plateletpheresis or thrombocytapheresis Leukapheresis Plasmapheresis total protein of donor must NOT be less than ______ 6. irradiation Using For whole blood, RBC, granulocytes, and platelets Irradiate up to ___ of collection and stored for another ___ Minimum dose: (1) center of the unit: (2) other parts of the unit: 7. Recombinant DNA technology A process of recombining two DNA fragments from different species and inserting such recombinant molecule into a host organism in order to produce new genetic combinations that are of value in medicine, science, and industry open system vs close system 1. open system Seal on unit is broken to attach external transfer bag Exposure to air poses threat of bacterial contamination Components stored at 1°-6°C must be used within 24 hours after system opened Components stored at 20°-24°C within 4 hours 2. close system Sterility maintained through use of attached satellite bags or sterile connecting device that welds tubing from 1 bag to another No exposure to air Expiration Date: No change transfusion therapy 1. Hemotherapy: use of blood components to treat a disease in a patient 2. Component Therapy: transfusion of specific components rather than whole blood to treat a patient 1. red blood cells Main indication for use: Patient hemoglobin is __ and/or hematocrit is ___ 1 unit of Whole Blood or unit of Packed RBC can Increase hemoglobin by Increase hematocrit by. Whole blood Provide blood volume expansion and RBC mass in acute blood loss; for actively bleeding patients who have lost at Indication: of their blood volume, or patients requiring exchange least 25% transfusions Storage: Transport: Shelf Life: ACD and CPD = 21 days CPDA-1 = 35 days When whole blood is not available, reconstitute whole blood Others: by mixing RBCs with thawed AB type plasma from a different donor Packed RBCS Indication of RBC mass of symptomatic, normovolemic patients Indication: For oncology patients undergoing chemotherapy or radiation therapy, trauma patients, dialysis patients, premature infants and patients with sickle cell anemia Preparation: 80% of plasma removed from whole blood Hematocrit: 65-80% (not exceed 80%) Storage: Transport: Shelf Life: Open system: 24 hours Close system: ACD and CPD = 21 days; CPDA-1 = 35 days Leukocyte-reduced RBCs Increase RBC mass in patients with severe and/or recurrent febrile transfusion reactions due to leukocyte Indication: antibodies Increase RBC mass in patients at risk for HLA alloimmunization or susceptible to cytomegalovirus (CMV) Filtration (within, _____ from time of collection) or Preparation: apheresis; saline washing Must retain 85% of original RBCs; 1 unit contains /= 6.2 Others: 1 unit should increase platelets by ______ in 75-kg recipient Should not be used if visible aggregates present; may contain residual RBCs Usually pooled Guidelines for the Effectiveness of Platelet Transfusion Corrected Count Increment for Platelets Good increment: ______ Refractoriness: ______ Percent Recovery: _____ at 1 hour _____ at 24 hours Plateletpheresis Unit or Single Donor Platelet (SDP) For thrombocytopenic patients alloimmunized to HLA or Indication: platelet antigen (donor should be HLA matched) Limit the donor exposure in thrombocytopenic patients who acquire long term platelet transfusions Preparation: Apheresis Storage: shelf-life: 5 days with constant agitation 1 unit contains _____ platelets; equivalent to 4-6 units Others: 200-400 mL plasma; pH >/= 6.2 1 unit should increase platelets by _____ in 75-kg recipient Exposes recipient to fewer donors Leukocyte-Reduced Platelets Indication: Same with Single Donor Platelet (SDP) or Plateletpheresis unit WBCs removed by filtration or during apheresis Preparation: processing Filters can reduce number of leukocytes in a bag while being transfused Storage: shelf-life: Open system: Apheresis: 5 days with agitation 3. Granulocyte Main indications for use: For patients with absolute granulocyte count of Apheresis Granulocytes or Granulocyte Pheresis Unit Patients with granulocyte dysfunction or myeloid hypoplasia who are unresponsive to antibiotics; Indication: severe neutropenia with infection non-responsive to antibiotic therapy Limited to septic infants Apheresis; uses hydroxyethyl starch (HES) as sedimenting Preparation: agent Administer corticosteroid to donor 12-24 hours before donation Storage: shelf-life: others: 1 unit contains _____ granulocytes, platelets, and 20-50 mL of RBCS 4. Plasma and Derivatives Main indications for use: PT is aPTT is Fibrinogen is Fresh Frozen Plasma Bleeding patients who require factors II, V, VII, IX, and X Replace isolated factor deficiencies when specific component is not available Reverse effects of Warfarin (Coumadin; Panwarfin; Indication: Sofarin) anticoagulant drug Treatment of thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome Patients with liver disease to prevent or correct bleeding Antithrombin Ill deficiencies; disseminated intravascular coagulation when fibrinogen is thaw in waterbath at 30°-37°C for 30-45 minutes -> thawed plasma Preparation: Thawed plasma from FFP Transfuse immediately Store at 1°-6°C for up to _______ or Store at 4°C for up to _______ if factor VIII is not needed Storage and Frozen: