Chapter 15: Component preparation_Quiz 1 coverage

What was the main method of transfusion for the first 300 years of history?

Whole blood transfusion.

What limited whole blood transfusion in early history?

Lack of anticoagulants, poor storage, and glass bottles.

What major development in the 1950s enabled component therapy?

Plastic blood bags and refrigerated centrifuges.

Why is component therapy preferred over whole blood?

Allows targeted treatment, maximizes each donation, and improves patient outcomes.

How many patients can benefit from a single blood donation?

Up to three patients (via RBCs, platelets, plasma).

What are the two methods for separating blood into components?

Centrifugation of whole blood and apheresis.

Which method usually yields a higher quantity of the desired component?

Apheresis.

What products can be collected by apheresis?

Platelets, plasma, double red cells, or combinations (e.g., platelets + plasma).

What are the three main functions of equipment in the component lab?

Manufacture, quality control, and storage.

What are plasma expressors used for?

Applying pressure to force components between bags.

What is the role of centrifuges in blood banking?

To separate RBCs, plasma, platelets, or cryoprecipitate.

What is a "soft spin"?

Low-speed centrifugation that separates plasma and platelets from RBCs.

What is a "hard spin"?

High-speed centrifugation that separates platelets from plasma.

What equipment seals PVC tubing between blood bags?

Tubing sealers.

How do tubing sealers work?

By using radio frequency energy to melt PVC tubing and form a seal.

What device allows connection of two bags while maintaining sterility?

Sterile connection device (SCD).

At what temperature must plasma be frozen for long-term storage?

-18°C or colder.

At what temperature are RBCs stored?

1°-6°C.

At what temperature are platelets stored?

20°-24°C with agitation.

How much anticoagulant is required per 100 mL of whole blood?

14 mL.

What is the usual whole blood collection volume?

450 mL ±10% with 63 mL anticoagulant OR 500 mL ±10% with 70 mL anticoagulant.

What anticoagulant solutions are commonly used for whole blood?

CPD, CP2D, ACD-A, CPDA-1.

What is the shelf life of CPD, CP2D, or ACD-A whole blood?

21 days.

What is the shelf life of CPDA-1 whole blood?

35 days.

What are the storage requirements for whole blood?

1°-6°C.

What components can be prepared from whole blood?

RBCs, plasma, cryoprecipitate, platelets.

How are RBCs separated from whole blood?

Centrifugation, apheresis, or sedimentation.

What is the storage temperature for RBCs?

1°-6°C.

What is the shelf life of RBCs in CPD/CP2D/ACD-A?

21 days.

What is the shelf life of RBCs in CPDA-1?

35 days.

What is the shelf life of RBCs with additive solutions (AS-1, AS-3, AS-5)?

42 days.

What is the required hematocrit of RBCs without additive solution?

Less than 80%.

What is the required mean hemoglobin content of apheresis RBCs?

At least 60 g of hemoglobin or 180 mL RBC volume.

What is the minimum recovery of RBCs from leukoreduced units?

At least 85%.

What are RBC additive solutions designed to do?

Extend shelf life and improve RBC survival.

What are the two methods for producing random-donor platelets (RDPs)?

Platelet-rich plasma (PRP) method and buffy coat method.

What is the shelf life of platelet concentrates?

5 days (7 with FDA approval/testing).

What is the platelet storage temperature?

20°-24°C with continuous agitation.

What is the minimum platelet content per unit of RDP?

5.5 × 10¹⁰ platelets.

What is the minimum platelet content per unit of SDP (apheresis platelets)?

3 × 10¹¹ platelets.

What is the required pH of platelets during storage?

At least 6.2.

What percentage of platelet recovery is required for QC?

At least 90% of units tested must meet content standards.

What is the platelet yield in a "6-pack" of RDPs?

Equivalent to one SDP.

What is leukoreduction?

Removal of WBCs from blood components before transfusion.

What are the FDA standards for leukoreduced RBCs, WB, and SDPs?

Less than 5 × 10⁶ WBCs per unit.

What is the FDA standard for leukoreduced RDPs?

Less than 8.3 × 10⁵ WBCs per unit.

What percentage recovery must leukoreduced units maintain?

At least 85% of original component.

What are the benefits of leukoreduction?

Reduces febrile reactions, alloimmunization, and CMV transmission.

What is prestorage leukoreduction?

Leukoreduction performed within 72 hours of collection.

What is Fresh Frozen Plasma (FFP)?

Plasma frozen within 8 hours of collection at -18°C or colder.

How long can FFP be stored at -18°C?

1 year.

What is Plasma Frozen Within 24 Hours (PF24)?

Plasma frozen within 24 hours of collection.

What is Liquid Plasma?

Plasma separated and stored without freezing, kept at 1°-6°C.

What are plasma derivatives?

Albumin, clotting factors, immunoglobulins.

What is cryoprecipitate?

A plasma fraction rich in fibrinogen, FVIII, vWF, FXIII, and fibronectin.

How is cryoprecipitate prepared?

Thawing FFP at 1°-6°C and collecting the precipitate.

At what temperature is cryoprecipitate stored?

-18°C or colder.

What is the shelf life of cryoprecipitate?

1 year frozen, 6 hours after thawing (24 hrs if pooled in open system).

What is the required fibrinogen content per unit of cryoprecipitate?

At least 150 mg.

What is the required FVIII content per unit of cryoprecipitate?

At least 80 IU.

What percentage of RBC units must meet hematocrit and hemoglobin standards?

90%.

What percentage of platelet units must meet platelet count standards?

90%.

What percentage of leukoreduced components must meet WBC standards?

95%.

What is the minimum platelet recovery required in QC testing?

90% of tested units.

How soon must plasma be frozen to be labeled FFP?

Within 8 hours of collection.

How soon must plasma be frozen to be labeled PF24?

Within 24 hours of collection.

What temperature is plasma stored at for 1 year?

-18°C or colder.

What temperature is plasma stored at for 7 years (FDA approved)?

-65°C or below.

What is liquid plasma (LP)?

Plasma stored at 1°-6°C without freezing.

How long is LP shelf life?

5 days after the whole blood expiration date.

What is the shelf life of CPD LP?

26 days (21 days WB + 5 days).

What is the shelf life of CPDA-1 LP?

40 days (35 days WB + 5 days).

What does FFP contain in terms of clotting factors?

Maximum levels of stable and labile clotting factors (≈1 IU/mL).

What does PF24 contain in terms of clotting factors?

Stable proteins, normal FV, slightly reduced FVIII.

What are the factor levels in LP?

Poorly characterized; vary depending on manufacture.

At what temperature are FFP and PF24 thawed?

30°-37°C (water bath or FDA-approved microwave).

How long can thawed plasma be stored at 1°-6°C before relabeling?

24 hours.

What happens if plasma is stored longer than 24 hours?

Must be relabeled as "thawed plasma" and may be stored for up to 5 days.

What clotting factors decrease in thawed plasma?

Factor V and Factor VIII.

What is the volume of an apheresis plasma unit?

Up to 800 mL.

What is the volume range of whole blood-derived FFP or PF24?

200-375 mL.

What factors influence plasma yield?

Collection volume, donor hematocrit, centrifugation method.

What is the plasma content of 500 mL WB with 38% Hct?

≈310 mL + 70 mL anticoagulant ≈380 mL plasma.

What is the plasma content of 450 mL WB with 55% Hct?

≈202.5 mL + 63 mL anticoagulant ≈265.5 mL plasma.

How much fibrinogen does plasma contain per 100 mL?

≈300 mg.

What level of clotting factors are present in FFP?

≈1 IU/mL stable and labile factors.

Which clotting factors are slightly reduced in PF24?

Factor VIII (but usually still hemostatically effective).

Is QC required for plasma?

No FDA or AABB QC testing required.

What is cryoprecipitate (cryo)?

Cold-insoluble fraction of plasma rich in FVIII, vWF, fibrinogen, FXIII, and fibronectin.

What is cryo-poor plasma (CPP)?

Plasma remaining after cryoprecipitate is removed.

What factors remain in CPP?

Albumin, factors II, V, VII, IX, X, XI, and ADAMTS13.

Can CPP be used instead of FFP or PF24?

No.

How is cryoprecipitate prepared?

Thawing FFP at 1°-6°C, centrifuging, removing supernatant, refreezing precipitate.

How much plasma is left in a cryoprecipitate unit?

10-25 mL.

How soon must cryoprecipitate be refrozen after preparation?

Within 1 hour.

How many units of cryo make an adult dose?

≈10 units.

How long can cryo be stored frozen?

1 year at -18°C or below.

How long can thawed cryo be stored?

6 hours (prestorage pooled cryo = 6 hrs; open-system pooled = 4 hrs).

What is the fibrinogen content of one cryo unit?

≥150 mg.

What is the FVIII content of one cryo unit?

≥80 IU.