LAB - BloodBank (Ch1)

52% protein

The biochemical composition of the RBC membrane is approximately ___, 40% lipid, and 8% carbohydrate.

40% lipid

The biochemical composition of the RBC membrane is approximately 52% protein, ___, and 8% carbohydrate.

8% carbohydrate

The biochemical composition of the RBC membrane is approximately 52% protein, 40% lipid, and ___.

Deformability and Permeability

In addition, RBCs maintain a critical role in two important RBC characteristics: ___ and ___.

Deformability

What is the ability of RBCs to remain viable, flexible, deformable, and permeable?

Permeability

What is the property of the RBC membrane and the active RBC cation transport to prevent colloid hemolysis and control the volume of the RBC?

Right

Shift to the ___ decreases hemoglobin’s affinity for the oxygen molecule

Left

Shift to the ___ is an increase in hemoglobin-oxygen affinity

blood components

The goal of blood preservation is to provide viable and functional ___ for patients requiring blood transfusion.

in vivo RBC survival

RBC viability is a measure of ___ following transfusion.

U.S. Food and Drug Administration (FDA)

___ requires an average 24-hour post-transfusion RBC survival of more than 75%.

24-hour ; 75%

U.S. Food and Drug Administration (FDA) requires an average ___ post-transfusion RBC survival of more than ___.

<1%

red blood cell integrity be maintained throughout the shelf-life of the stored RBCs. This is assessed as free hemoglobin ___ of total hemoglobin.

liquid ; 1’C and 6’C

To maintain optimum viability, blood is stored in the ___ state between ___ and ___ for a specific number of days, as determined by the preservative solution(s) used.

Storage lesion

he loss of RBC viability has been correlated with the ___

Decrease

RBC STORAGE LESION
Characteristic	Changes Observed
Viable cells (%)	___
Glucose	Decrease
ATP	Decrease
pH	Decrease
2,3-DPG	Decrease
Oxygen dissociation curve	Shift to the Left
Lactic acid	Increase
Plasma K+	Increase
Plasma hemoglobin	Increase

Decrease

RBC STORAGE LESION
Characteristic	Changes Observed
Viable cells (%)	Decrease
Glucose	___
ATP	Decrease
pH	Decrease
2,3-DPG	Decrease
Oxygen dissociation curve	Shift to the Left
Lactic acid	Increase
Plasma K+	Increase
Plasma hemoglobin	Increase

Decrease

RBC STORAGE LESION
Characteristic	Changes Observed
Viable cells (%)	Decrease
Glucose	Decrease
ATP	___
pH	Decrease
2,3-DPG	Decrease
Oxygen dissociation curve	Shift to the Left
Lactic acid	Increase
Plasma K+	Increase
Plasma hemoglobin	Increase

Decrease

RBC STORAGE LESION
Characteristic	Changes Observed
Viable cells (%)	Decrease
Glucose	Decrease
ATP	Decrease
pH	___
2,3-DPG	Decrease
Oxygen dissociation curve	Shift to the Left
Lactic acid	Increase
Plasma K+	Increase
Plasma hemoglobin	Increase

Decrease

RBC STORAGE LESION
Characteristic	Changes Observed
Viable cells (%)	Decrease
Glucose	Decrease
ATP	Decrease
pH	Decrease
2,3-DPG	___
Oxygen dissociation curve	Shift to the Left
Lactic acid	Increase
Plasma K+	Increase
Plasma hemoglobin	Increase

Shift to the Left

RBC STORAGE LESION
Characteristic	Changes Observed
Viable cells (%)	Decrease
Glucose	Decrease
ATP	Decrease
pH	Decrease
2,3-DPG	Decrease
Oxygen dissociation curve	___
Lactic acid	Increase
Plasma K+	Increase
Plasma hemoglobin	Increase

Increase

RBC STORAGE LESION
Characteristic	Changes Observed
Viable cells (%)	Decrease
Glucose	Decrease
ATP	Decrease
pH	Decrease
2,3-DPG	Decrease
Oxygen dissociation curve	Shift to the Left
Lactic acid	___
Plasma K+	Increase
Plasma hemoglobin	Increase

Increase

RBC STORAGE LESION
Characteristic	Changes Observed
Viable cells (%)	Decrease
Glucose	Decrease
ATP	Decrease
pH	Decrease
2,3-DPG	Decrease
Oxygen dissociation curve	Shift to the Left
Lactic acid	Increase
Plasma K+	___
Plasma hemoglobin	Increase

Increase

RBC STORAGE LESION
Characteristic	Changes Observed
Viable cells (%)	Decrease
Glucose	Decrease
ATP	Decrease
pH	Decrease
2,3-DPG	Decrease
Oxygen dissociation curve	Shift to the Left
Lactic acid	Increase
Plasma K+	Increase
Plasma hemoglobin	___

220 to 250 mg

Approximately ___ of iron are contained in one RBC unit.

anticoagulant preservative Citrate–Phosphate–Dextrose

The addition of various chemicals, along with the approved ___, was incorporated in an attempt to stimulate glycolysis so that ATP levels were better maintained.

Acid citrate-dextrose (formula A)*

APPROVED ANTICOAGULANT PRESERVATIVE SOLUTIONS
Name	Abbreviation	Storage Time (Days)
___	ACD-A	21
Citrate-phosphate dextrose	CPD	21
Citrate-phosphate-double-dextrose	CP2D	21
Citrate-phosphate-dextrose-adenine	CPDA-1	35

Citrate-phosphate dextrose

APPROVED ANTICOAGULANT PRESERVATIVE SOLUTIONS
Name	Abbreviation	Storage Time (Days)
Acid citrate-dextrose (formula A)*	ACD-A	21
___	CPD	21
Citrate-phosphate-double-dextrose	CP2D	21
Citrate-phosphate-dextrose-adenine	CPDA-1	35

Citrate-phosphate-double-dextrose

APPROVED ANTICOAGULANT PRESERVATIVE SOLUTIONS
Name	Abbreviation	Storage Time (Days)
Acid citrate-dextrose (formula A)*	ACD-A	21
Citrate-phosphate dextrose	CPD	21
___	CP2D	21
Citrate-phosphate-dextrose-adenine	CPDA-1	35

Citrate-phosphate-dextrose-adenine

APPROVED ANTICOAGULANT PRESERVATIVE SOLUTIONS
Name	Abbreviation	Storage Time (Days)
Acid citrate-dextrose (formula A)*	ACD-A	21
Citrate-phosphate dextrose	CPD	21
Citrate-phosphate-double-dextrose	CP2D	21
___	CPDA-1	35

Citrate (sodium citrate/citric acid)

CHEMICALS IN ANTICOAGULANT SOLUTIONS
Chemical	Function	Present In
		ACD-A	CPD	CP2D	CPDA-1
___	Chelates calcium; prevents clotting.	X	X	X	X
Monobasic sodium phosphate	Maintains pH during storage; necessary for maintenance of adequate levels of 2,3-DPG.	X	X	X	X
Dextrose	Substrate for ATP production (cellular energy).	X	X	X	X
Adenine	Production of ATP (extends shelf-life from 21 to 35 days).				X

Monobasic sodium phosphate

CHEMICALS IN ANTICOAGULANT SOLUTIONS
Chemical	Function	Present In
		ACD-A	CPD	CP2D	CPDA-1
Citrate (sodium citrate/citric acid)	Chelates calcium; prevents clotting.	X	X	X	X
___	Maintains pH during storage; necessary for maintenance of adequate levels of 2,3-DPG.	X	X	X	X
Dextrose	Substrate for ATP production (cellular energy).	X	X	X	X
Adenine	Production of ATP (extends shelf-life from 21 to 35 days).				X

Dextrose

CHEMICALS IN ANTICOAGULANT SOLUTIONS
Chemical	Function	Present In
		ACD-A	CPD	CP2D	CPDA-1
Citrate (sodium citrate/citric acid)	Chelates calcium; prevents clotting.	X	X	X	X
Monobasic sodium phosphate	Maintains pH during storage; necessary for maintenance of adequate levels of 2,3-DPG.	X	X	X	X
___	Substrate for ATP production (cellular energy).	X	X	X	X
Adenine	Production of ATP (extends shelf-life from 21 to 35 days).				X

Adenine

CHEMICALS IN ANTICOAGULANT SOLUTIONS
Chemical	Function	Present In
		ACD-A	CPD	CP2D	CPDA-1
Citrate (sodium citrate/citric acid)	Chelates calcium; prevents clotting.	X	X	X	X
Monobasic sodium phosphate	Maintains pH during storage; necessary for maintenance of adequate levels of 2,3-DPG.	X	X	X	X
Dextrose	Substrate for ATP production (cellular energy).	X	X	X	X
___	Production of ATP (extends shelf-life from 21 to 35 days).				X

Additive solutions (AS)

___ are preserving solutions that are added to the RBCs after removal of the plasma with or without platelets.

Plasma

Removal of the ___ component during the preparation of packed RBCs removed much of the nutrients needed to maintain RBCs during storage

Adsol (AS-1)

Currently, four additive solutions are licensed in the United States:

1. ___

2. Nutricel (AS-3)

3. Optisol (AS-5)

4. SOLX (AS-7)

Nutricel (AS-3)

Currently, four additive solutions are licensed in the United States:

1. Adsol (AS-1)

2. ___

3. Optisol (AS-5)

4. SOLX (AS-7)

Optisol (AS-5)

Currently, four additive solutions are licensed in the United States:

1. Adsol (AS-1)

2. Nutricel (AS-3)

3. ___

4. SOLX (AS-7)

SOLX (AS-7)

Currently, four additive solutions are licensed in the United States:

1. Adsol (AS-1)

2. Nutricel (AS-3)

3. Optisol (AS-5)

4. ___

42 days

Benefits of RBC Additive Solutions:

• Extends the shelf-life of RBCs to ___ by adding nutrients

• Allows for the harvesting of more plasma and platelets from the unit

• Produces a packed RBC of lower viscosity that is easier to infuse

lower viscosity

Benefits of RBC Additive Solutions:

• Extends the shelf-life of RBCs to 42 days by adding nutrients

• Allows for the harvesting of more plasma and platelets from the unit

• Produces a packed RBC of ___ that is easier to infuse

satellite bag

The additive solution is contained in a ___ and is added to the RBCs after most of the plasma has been expressed.

saline, adenine, and glucose

All three additives contain ___, ___, and ___.

SAG + Citrate & Phosphate

ADDITIVE SOLUTIONS IN USE IN NORTH AMERICA
Name	Abbreviation	Storage Time (Days)
Adsol	AS-1	42	SAG + Mannitol
Nutricel	AS-3	42	___
Optisol	AS-5	42	SAG + Mannitol
SOLX	AS-7	42	SAG + Mannitol

RBC freezing

___ is primarily used for autologous units and the storage of rare blood types.

Autologous transfusion

___ allows individuals to donate blood for their own use to meet their needs for blood transfusion

cryoprotective agent ; <6 days old

The procedure for freezing a unit of packed RBCs involves the addition of a ___ to RBCs that are ___.

Glycerol

___ is used most common as cryoprotective agent and is added to the RBCs slowly with vigorous shaking, thereby enabling it to permeate the RBCs.

-65’C

The usual storage temperature for RBC freezing is below ___

40%

high-concentration glycerol (___ weight in volume [wt/vol]

20%

low-concentration glycerol (___ wt/vol)

Saline ; deglycerolizing

Removal of glycerol in RBC freezing is achieved by systematically replacing the cryoprotectant with decreasing concentrations of ___ and is known as ___.

ATP and 2,3- DPG

Rejuvenation of RBCs is the process by which ___ and ___ levels are restored or enhanced by metabolic alterations.

3 days

Rejuvenated RBCs may be prepared up to ___ after expiration when stored in CPD, CPDA-1, and AS-1 storage solutions

Inosine ; 24 hours

Rejuvenated RBCs must be washed before infusion to remove the ___ (which may be toxic) and transfused within ___

Amustaline (S-303) pathogen reduction system

___ is currently being studied and has demonstrated adequate post-transfusion viability according to FDA criteria.

blood pharming

Creating RBCs in the laboratory (___) is another area of research that has the potential to increase the amount of blood available for transfusion.

Type O Rh-negative

Turn hematopoietic stem cells (HSCs) from umbilical cords into ___ RBCs.

Hemoglobin-Based Oxygen Carriers

“Oxygen therapeutic” indications to provide immediate oxygenation

Perfluorocarbons

___ are synthetic hydrocarbon structures in which all hydrogen atoms have been replaced with fluorine

Platelets

___ are involved in the blood coagulation process and are given to treat or prevent bleeding.

20’C to 24’C ; agitation ; 5 days

platelets are stored at ___ to ___ with maintaining continuous gentle ___ throughout the storage period of ___.

platelet storage lesion

The loss of platelet quality during storage is known as the ___.

whole blood ; apheresis

platelets are prepared as concentrates from ___ and by ___

PAS-C (Intersol) and PAS-F (Isoplate)

FDA approved, ___ and ___, for the storage of apheresis platelets for 5 days. The PASs are designed to support platelets during storage in reduced amounts of residual plasma.

Bacterial growth

major concern associated with storage of platelets at 20°C to 24°C is the potential for ___ if the prepared platelets contain bacteria because of contamination at the phlebotomy site or if the donor has an unrecognized bacterial infection.

pathogen inactivation (PI) ; pathogen reduced (PR)

The term ___ is the process of treating the blood component, and the components themselves are referred to as being ___.

5 days

DA approved a pathogen reduction technology for apheresis platelets stored for up to ___

amotosalen ; ultraviolet A (UVA) ; nucleic acids

The INTERCEPT system (Cerus Corp.), uses ___ that is activated by ___ light and binds to the nucleic acid base pairs of pathogens, preventing replication and targets ___

paraformaldehyde ; 5% albumin and lyophilization

Two products prepared from human platelets are in preclinical testing. One preparation uses washed platelets treated with ___, with subsequent freezing in ___ and ___.

trehalose-loaded platelets

Two products prepared from human platelets are in preclinical testing. A second method involves the freeze-drying of ___.

dimethyl sulfoxide (DMSO) ; -80’C ; 2 years

Platelets are collected by apheresis, the cryopreservative ___ is added, and the platelets are frozen at ___. The frozen platelets can be stored for up to ___.