ISBB (Part 4) [Policarpio, 2024]

Who should receive :

-WHOLE BLOOD

-px with symptomatic anemia (<7g/dL) with large vol deficity

Who should receive :

-Packed RBCs

px with symptomatic anemia with normal blood vol

Who should receive :

Washed RBCs

Px with history of:

1) allergic trans reax

2) anaphylactic trans reax

Who should receive :

Leuko-reduced/ Leuko-poor RBCs

Who should receive :

Frozen/deglycerolized RBCs

Px with rare phenotype

What should a px receive if:

-chronically transfusion-dependent

-px with thalassemia and sickle cell anemia

Neocyte-enriched RBCS

What should a px receive if:

-immunocompromised

-HIV/AIDS

-cancer px

-newborn

Irradiated blood components

what does irradiation do?

inactivates T cells (triggers GvHD)

What should a px receive if:

- multiple coagulation factor deficiency

-liver disease

- collected usually

FFP (fresh frozen plasma)

What should a px receive if:

- multiple coagulation factor deficiency

-liver disease

- collected via PLASMAPHERESIS

SDP (single donor plasma)

What should a px receive if:

- the px has vWD

-F13 defi

-F8 defi

-hypofibrinogenemia

Cryoprecipitate

What should a px receive if:

px bleeding bc of platelet prob

-Dengue virus

-collected usually

Random donor platelet

What should a px receive if:

px bleeding bc of platelet prob

-Dengue virus

-collected via PLATELETPHERESIS

Single donor platelet

What should a px receive if:

px with bacterial infection

-unresponsive to antibiotic therapy

Granulocyte concentrates

What should a px receive if:

px with specific factor deficiency

-Hemophilia B

Factor 9

What should a px receive if:

px with specific factor deficiency

-Hemophilia A

Factor 8

What should a px receive if:

px with congenital hypogammaglobulinemia

-given on a monthly basis

Immune Serum Globulins (ISG)

What are the components in the blood bag? (CPDA); what is their purpose?

citrate - anticoagulant

phosphate - for formation of 2,3-DPG (release of O2)

dextrose/ glucose - food for RBCs (EMP - anaerobic glycolytic pathway)

adenine - source of adenosine (energy molecules)

used in heart and lung machines; not routinely used

heparin

3 preservatives that's not much used nowadays; 21 days

ACD

CPD

CP2D

how many days does CPDA1 blood bags last?

35 days

how many days if we were to add AdSol?

42 days

what does AdSol have? clue: SADMan and what is the purpose?

Saline - maintains isotonicity

Adenine - ATP

Dextrose - food

Mannitol - STABILIZER - intact RBCs

restore 2,3-DPG and ATP levels

will not add days to the unit

Rejuvinating Solutions

what does RejSol have? clue: PIGPA; what is the sometimes removed?

Phosphate

Inosine

Glucose - sometimes removed

Pyruvate

Adenine

post storage viability

at least 70%

<70% = not stored properly

post transfusion viability

at least 75%

<75% = transfusion reaction

temperature during transfusion of blood

1-10 degC

term used to describe the changes in the blood during storage

storage lesions

what DECREASES in the blood during storage? (2.Gl.N.At.P)

2,3-DPG

glucose

Na

ATP

pH

what INCREASES in the blood during storage? (H.Am.L.K)

Hgb

Ammonia

Lactic acid

K

QA of Blood Components

:Hct approx 40%

WB

QA of Blood Components:

:Hct less than or equal 80%

PRBC

QA of Blood Components

: at least 5.5 x 10^10 platelets per unit

:pH of > 6.2

RDP

QA of Blood Components

: at least 3.0 x 10^11 platelets per unit

:pH of > 6.2

SDP

QA of Blood Components

: should be prepared within 6- 8hrs after collection

FFP

if within 6 hrs what additive?

ACD

if within 8 hrs what additive?

CPD, CP2D, CPDA1

If more than 8 hrs but within 24 hours?

PF24

QA of Blood Components

: FVIII of at least 80 IU

: Fibrinogen of at least 150mg per unit

Cryoprecipitate

QA of Blood Components

:______ of at least ___ IU

: Fibrinogen of at least 150mg per unit

FVIII; 80 IU

QA of Blood Components

: FVIII of at least 80 IU

: ________ of at least ______ per unit

Fibrinogen; 150 mg per unit

QA of Blood Components

:>1.0 x 10^10 PMNs/unit

Granulocyte

QA of Blood Components

:80% RBC recovery, <1% glycerol, <300mg Hgb

Frozen RBC

QA of Blood Components

:___% RBC recovery, ___% glycerol, <___mg Hgb

80%; <1%; <300mg

QA of Blood Components

:Hct 70-80%

Washed RBC

QA of Blood Components

: 25 Gy to the center of canister

Irradiated components

QA of Blood Components

: WBCs should be <5 x 10^6; >85% RBC recovery

Leuko-reduced RBCs

QA of Blood Components

: pH >6.2; In SDP, WBC should be <5 x 10^6, In RDP, WBCs should be <8.3 x 10^5

Leuko-reduced Platelets

QA of Blood Components

: pH ____; In SDP, WBC should be ______, In RDP, WBCs should be ________

>6.2, <5 x 10^6, <8.3 x 10^5

Storage and Shelf-Life of Blood Components

: 1-6 degC; ACD, CPD or CP2D = 21 Days CPDA1 = 35 Days

Whole Blood

Storage and Shelf-Life of Blood Components

: ___ degC; ACD, CPD or CP2D = ___ Days CPDA1 = ___ Days

1-6, 21, 35

Storage and Shelf-Life of Blood Components

: 1-6 degC; ACD, CPD or CP2D = 21 Days; CPDA1 = 35 Days; Open System = 24 Hours

Packed Red Blood Cells

Storage and Shelf-Life of Blood Components

: ___ degC; ACD, CPD or CP2D =___ Days; CPDA1 = ___ Days; Open System = ___ Hours

1-6, 21, 35, 24

Storage and Shelf-Life of Blood Components

: 20-24 degC 5 Days; Pooled (No Turning Back-Shorten Life-span): 20-24 degC 4 hours (Risk of bacterial Contamination)

Random Donor Platelet

Storage and Shelf-Life of Blood Components

: 20-24 degC 5 days

Single Donor Platelet

Storage and Shelf-Life of Blood Components

: - 18degC = 1 Year; - 65degC = 7 Years

Fresh Frozen Plasma

Storage and Shelf-Life of Blood Components

: ___ degC = ___ Year; ___ degC = ___ Years

-18, 1, -65, 7

Storage and Shelf-Life of Blood Components

: Frozen: -18degC, 1 Year; Thawed: 20-24degC, 6 Hours; Pooled: 20-24degC, 4 Hours

Cryoprecipitate

Storage and Shelf-Life of Blood Components

: Frozen: ___ degC, ___ Year

-18, 1

Storage and Shelf-Life of Blood Components

: Thawed: ___ degC, ___ Hours

20-24, 6

Storage and Shelf-Life of Blood Components

: Pooled: ___ degC, ___ Hours

20-24, 4

Storage and Shelf-Life of Blood Components

: 20-24degC, 24 Hours

Granulocytes

Storage and Shelf-Life of Blood Components

: <-65degC, 10 Years

Frozen Red Blood Cells

Storage and Shelf-Life of Blood Components

: 1-6degC, 24 Hours

Washed Red Blood Cells

Storage and Shelf-Life of Blood Components

: 1-6degC, Original outdate or 28 days from irradiations

Irradiated Components

Storage and Shelf-Life of Blood Components

: Closed system: same; Open System: 24 Hours

Leuko-reduced RBCs

Storage and Shelf-Life of Blood Components

: 20-24degC, 5 Days

Leuko-reduced platelets with constant agitation

Requirements for Allogenic Donation (Harmening)

Age:

atleast 17 years old: Int'l Standards, 18 years old: Ph Standards

Requirements for Allogenic Donation (Harmening)

Temperature

<37.5decC or <99.5degF

Requirements for Allogenic Donation (Harmening)

Pulse

50-100bpm: Int'l Standard, 60-100bpm: Ph Standards, <50bpm: Athletes

Requirements for Allogenic Donation (Harmening)

Blood Pressure

<180mmHg systolic/ <100mmHg diastolic Pressure (International)

Requirements for Allogenic Donation (Harmening)

Blood Pressure

90/60mmHg - 160/100mmHg (Ph Standard)

Requirements for Allogenic Donation (Harmening)

Hemoglobin

12.5g/dL

Requirements for Allogenic Donation (Harmening)

Hematocrit

>38% or >0.38L/L

Requirements for Allogenic Donation (Harmening)

Weight

at least 50kg or 110lbs

Requirements for Allogenic Donation (Harmening)

General Appearance

appears healthy