Preparation of Blood Components (Exam 3)

What are the anticoagulants and preservatives used in initial whole blood donation?

- Dextrose

- Adenine

- Citrate

- Sodium biphosphate

- Mannitol

Dextrose supports ATP generation via ______.

glycolysis

(-ose = sugar = glucose = glycolysis)

Adenine is a substrate for RBC ______ synthesis.

ATP

(Adenine = ATP, A and A)

Citrate is an anticoagulant that ______.

chelates calcium

(Citrate = Chelates Calcium, C, C and C)

Sodium biphosphate buffers ______.

pH

(biPHosPHate = pH)

Mannitol stabilizes the RBC ______.

membrane

(Mannitol = Membrane, M and M)

What anticoagulants allow for 21 day storage of RBCs at 1-6C?

ACD, CPD, CP2D

(3 letters in each, 3 x 7 = 21, 21 days)

ACD, CPD and CP2D allow for ______ day PLT storage.

5 day

(ACD is 5-7 days)

CPDA-1 allows for RBC storage up to ______ days at 1-6C.

35

(CPDA-1 has 5 characters, 5 x 7 = 35, 35 days)

CPDA-1 allows for PLT storage up to ______ days.

5

AS-1, AS-3 and AS-5 allow for ______ day storage of RBCs at 1-6C.

42

(AS has 2 letters, 2 x 2 = 4; each number has only 1, 1 x 2 = 2; 4 and 2 = 42).

AS-1, AS-3 and AS-5 ______ (are/are not) used for PLT storage.

are not

What are the primary anticoagulants used?

ACD or CPD

Additive solutions must be added to the RBCs within ______ hours of collection, after the plasma has been removed.

72

Additives for RBCs are designed to slow the ______ of storage.

lesion

Storage lesion refers to the ______ changes to stored RBCs that reverse within 24 hours of transfusion.

biochemical

Storage lesion causes increased ______ in plasma.

hemoglobin

In the overall unit, storage lesion causes ______ to increase.

K+

In the overall unit, storage lesion causes what three things to decrease?

pH, ATP, 2,3-DPG

Neonatal component processing must include the additive ______.

CPD

Neonatal patients require ______ transfusions. Why is this so?

fresh

To avoid storage lesion - neonatal patients are very sensitive to increased K+ levels

What components can be prepped and separated from a blood donation?

- Whole blood

- Packed RBCs

- FFP

- PF24

- PLTs

- Cryoprecipitate

For all components, what testing must be completed prior to labeling?

- ABO/Rh

- Ab screen

- Infectious disease testing (13 tests)

Blood must be transported at ______C until arrival at the laboratory.

1-10C

Whole blood is stored at ______C within 8 hours of collection.

1-6C

Can additives be added to whole blood after its collection?

No; only what was in the bag prior to collection

What is the order of separation upon whole blood collection?

1. Whole blood

2. Soft spin, separating into RBCs and platelet-rich plasma

3. Additives added to RBCs

4. Hard spin, separating platelet-rich plasma into platelets and FFP/PF24

5. FFP/PF24 is frozen, then thawed at 1-6C

6. Hard spin, separating FFP/PF24 the cryo-reduced plasma

After centrifugation (soft spin), the unit is placed into a ______.

plasma extractor

This is how ______ is separated from the unit.

platelet-rich plasma

______ will be added to the RBCs after the platelet-rich plasma has been separated.

Additive solution

A small filter bag is attached to the additive solution line to remove any ______ within the AS.

free-floating aggregates

RBCs without additive solution should have a final hematocrit of ______ after preparation.

less than or equal to 80%

One unit of RBCs contains ______mg of iron.

200-250mg

AS-1, 3 or 5 must be added to RBCs within ______ hours of collection.

72

RBCs must be separately fully from plasma before ______ is added.

additive solution (AS-1, 3, 5)

At this point, the hematocrit of the RBCs is approximately ______%.

65%

Additive solution is not added to ...

Plasma, platelet or cryo products

RBCs must be refrigerated within ______ hours of collection at 1-6C.

8

Fresh frozen plasma has been frozen within ______ hours from draw.

8

Fresh frozen plasma is obtained from ______ after spinning and separation.

whole blood

FFP is stored at or less than ______C.

-18C

FFP contains ______ coagulation factor(s).

all

FFP expires ______ after collection.

1 year

FFP is thawed in a ______C water bath.

37C

FFP thawed expires within ______ hours of thawing.

24

FFP thawed can not be ______.

refrozen

Once thawed, FFP must be stored at ______C.

1-6C

PF24 has been frozen in what period of time from the draw?

Between 8-24 hours

PF24 expires ______ after collection.

1 year

PF24 does not contain ...

- Factor V (Proaccelerin)

- Factor VIII (Anti-hemophiliac)

- vWF

Factors V and VIII are ______ coagulation factors.

labile

They denature after 8 hours of not being frozen

Thawed plasma must be stored at ______C for up to _____ days post-thaw.

1-6C, 5

How are platelets separated from whole blood?

Whole blood --soft spin--> PRP --hard spin--> platelets

Platelets are derived from whole blood that has not yet cooled below ______C within 8 hours of collection.

20C

Platelets are stored at ______C with gentle agitation.

20-24C

Platelets expire ______ days after collection.

5

Random platelets must show at least 90% of units in a batch with at least ______ platelets and a pH of ______ or higher at the end of the storage period.

5.5 x 10^10, 6.2

If the pH of a unit of random platelets is under 6.2, what happens?

The unit is discarded, but it doesn't affect the whole batch quality

Random and pooled platelets must be stored at ______C with agitation.

20-24C

What does the agitation do for the platelet units?

The bag contains tiny holes, so agitation allows for even oxygen distribution

Random, pooled, and apheresis platelets expire ______ days from collection.

5

Pooled platelets expire ______ hours from the time the units are spiked (open system).

4

Apheresis platelets must show 90% of the units with at least ______ platelets and pH of ______.

3 x 10^11, 6.2

Cryoprecipitate plasma contains ______.

Anti-Hemophiliac Factor (AHF)

Cryoprecipitate AHF is prepared from ______ after at least 24 hours of storage.

FFP

Cryoprecipitate AHF is thawed overnight at ______ or in a 0-4C waterbath.

1-6C

Cryoprecipitate AHF is created from a ______ of FFP.

hard spin

Cryoprecipitate AHF is refrozen at less than ______C.

-18C

Cryoprecipitate AHF expires ______ after collection date.

1 year

Thawed cryoprecipitate is thawed at ______C in a water bath.

37C

Thawed cryoprecipitate expires ______ hours after thawing but before pooling.

6

Thawed cryoprecipitate expires ______ hours from thawing if pooled.

4

Thawed cryoprecipitate is stored at _______C.

20-24C

Cryoprecipitate AHF must have a minimum of ______mg fibrinogen and at least ______IUs of Factor VIII per unit.

150, 80

Granulocytes are collected via ______.

apheresis

Apheresis granulocytes must yield at least ______ granulocytes in 75% of units tested.

1 x 10^10

Apheresis granulocytes must be ______ and ______.

crossmatched, irradiated

What are the requirements for blood unit labeling?

- Barcode

- Contents

- Additives

- Modifications

- Blood type

- Unique donor ID

- Collection facility, registration number, license number

- Product code

- Expiration date

- Special testing info

- Name of facility that modified the original product

Labeling must be verified by ...

2 people or 1 person and a computer

The unique donor number must not repeat within ______ years.

5

Washed RBCs are stored at 1-6C and expire at ______ hours.

24

Washing RBCs acts to remove ______ from the components.

plasma proteins

Leukoreduced RBCs can be prepared via ______ or ______.

filtration, apheresis

Leukoreduced RBC:

Residual WBC and recovery percentage

5 x 10^6 WBCs or less

85% RBC recovery

Leukoreduced platelets from whole blood:

Percentage of units, platelet number, pH, WBC number

75% of units

5.5 x 10^10 platelets or more

6.2 pH or more

Less than 8.3 x 10^5 WBCs

Pooled Leukoreduced platelets:

Percentage of units, WBC number, pH

95% of units

5 x 10^6 WBCs or less

Leukoreduced apheresis platelets:

Percentage of units, platelet number, pH, WBC count

90% of units

3 x 10^11 platelets or more

6.2 pH or more

5 x 10^6 WBCs or less in 95% of units

Glycerolized RBCs must be frozen within ______ days of collection.

5

Glycerolized RBCs have a ______ day expiration if rejuvenated.

5

Glycerolized RBCs must be frozen at ______C or lower, and stored at ______C or lower.

-80C, -65C

Glycerolized RBCs expire ______ from collection.

10 years

Deglycerolized RBCs are thawed at ______C.

37C

Glycerolized RBCs have their glycerol removed with decreasing concentration of ______.

NaCl (starting with 12%, ending with 0.9%)

Deglycerolized RBCs end with ______% dextrose.

0.2%

Deglycerolized RBCs are stored at ______C and expire ______ hours from thaw.

1-6C, 24

Deglycerolized RBCs are good for ______ and ______ blood.

rare, autologous

A positive hemoglobin S screen test will show ______.

precipitate/cloudiness

Irradiation is used to prevent ______.

TA-GVHD

Irradiated inactivates ______.

T cells

Irradiation is used for ______ and ______.

platelets, RBCs