blood bank 3

whole blood separated into components

1. red blood cells

   1. packed RBC

   2. leukocyte reduced packed red blood cells

   3. washed packed RBC

   4. frozen RBC

2. platelets

3. plasma

   1. fresh frozen plasma

   2. cryoprecipitate

packed red blood cells stored at

1-6°C

packed RBC expiration

dependent on anticoagulant whe

What is a leukocyte reduced packed RBC

fluid retaining 85% of original red blood cells but reducing WBC contents to >5×10^6

what are wash packed RBCs

removes plasma proteins that can cause reactions

shelf life of wash packed RBC

24 hours

why do we freeze/ deglycerize RBC

to preserve rare blood units

frozen RBC storage

-65°C

frozen RBC shelf life

10 years

after thawing frozen RBCs, what is their usage time

24 hours

what are irradiated RBC

gamma radiation of cellular blood products to prevent proliferation

main reason rbcs are irradiated

prevent graft v host

what does irradiation of red blood cells cause

• rbc membrane damage

• increase potassium

• decreased levels of ATP

• decreased 2,3 DPG

why do we transfuse rbcs

• anemia

  • sickle cell

  • oncology

  • other hematological conditions

• acute blood loss

  • trauma

  • gi bleed

platelet processing

• centrifuge whole blood and express off plasma

• plasma then centrifuged again to provide poor platelet plasma

platelet pH

6.5

platelet storage

20-24°C with continues agitation

platelet shelf life

5 days

what are pooled platelets

for adults to achieve a therapeutic dose

pooled platelet shelf life

4 hours

pooled platelet storage

20-24°C

what are irritated platelets and why do we do this

gamma radiation of cellular blood products to prevent proliferation to prevent graft vs host

when do we give platelets

• thrombocytopenia

  • decreased platelet production

  • bleeding/increase use

• abnormal platelet function

fresh frozen plasma processing

centrifuge whole blood and express off plasma, but needs to be frozen solid within 8 hours

storage of fresh frozen plasma

←18°C

expiration for fresh frozen plasma

1 year

how to thaw fresh frozen plasma

30-37°C for 20-30 min in a water bath stored after thawing at 1-6°C for 24 hours

what is cryoprecipitate

cold insoluble precipitate that forms after thawing fresh frozen plasma 1-6°C

cryoprecipitate contains concentrated forms of

• vonwilllebrand factor

• fibrinogen

• fibronectin

• factor VII

• factor XII

storage of cryoprecipitate

<-18 °C for one year

thaw at 30-37°C for 6 hours

when do we use cryoprecipitate

• treating hemophilia A

• factor XII deficiency

• dysfibrinogenemia

• fibrin glue

why is plasma cryoprecipitate reduced

removal of cryoprecipitate and refrozen

-contains ADAMTS13

storage and expiration for plasma cryoprecipitate

store at <-18 °C for 1 year

what is apheresis

separated whole blood into different components then give extra back to donor

pathogen reduction

processes uses a chemical agent that is activated by UVA light to bind nucleic acids

• dna cannot replicate

• cells cant replicate

• platelets are cell fragments

granulocytes

• collected through apheresis that contains leukocytes and platelets

• deteriorate rapidly so need to be transfused ASAP

• to prevent graft v host

Rh immunoglobulin

• given to RH negative pregnant females

• contains igg that is directed against d antigen

• testing

  • fetal screen

  • kleihauer-betke

what packed red blood cells and blood cells can be given to an O positive

O positive

O negative

what packed red blood cells and blood cells can be given to an O negative

O negative

what packed red blood cells and blood cells can be given to an A positive

A positive

A negative

O negative

O positive

what packed red blood cells and blood cells can be given to an A negative

A negative

O negative

what packed red blood cells and blood cells can be given to a B positive

B positive

B negative

O positive

O negative

what packed red blood cells and blood cells can be given to a B negative

B negative

O negative

what packed red blood cells and blood cells can be given to an AB positive

AB positive

AB negative

A positive

A negative

B positive

B negative

O positive

O negative

what packed red blood cells and blood cells can be given to an AB negative

AB negative

A negative

B negative

O negative

what plasma products can be given to an O

O, A, B, AB

what plasma products can be given to an A

A, AB

what plasma products can be given to a B

B, AB

what plasma products can be given to a AB

AB

compatibility and cross match testing is only preformed on what product

RBC

Blood product requirements must include

• two unique patient identifiers

• component requested

• number of units

• special considerations

• physician name

when checking a patients blood bank history for additional blood bank testing requirements, what are we talking about

saline replacement and warm autoantibody

sample timing must be collected within

72 hours

patient samples are held for

7 days

required testing for donors

• ABO/Rh

• antibody screen

• infectious disease testing

  • hepatitis b surface antigen

  • hepatitis b core antibodies

  • hepatitis c antibodies

  • hiv 1 and 2

  • human t-cell lymphotrophophic virus

  • syphilis

  • west nile

  • zika

IS crossmatch

• verifies ABO compatibility

• patient must have

  • negative antibody screen

  • no history of clinically significant antibodies

AHG crossmatch

• preformed when patient has a positive antibody screen

• can detect low incidence antigens

Emergency transfusion

• immediate transfusion

• O negative packed red blood cells

  • female of child-bearing age

• emergency issues of units

  • label labs as uncross matched blood

massive transfusion

8-10 units in less than 10 hours

• 4-6 units of crossmatched rbc

• 4 units of fresh frozen plasma

• 1 apheresis platelet or 6 random platelets pooled

neonatal transfusion

• small amount of product needed for transfusion

• small aliquots are prepared

intrauterine transfusion

blood to fetus through umbilical cord

exchange transfusion

a blood transfusion in which the patients blood is exchanged with donor blood

• can be used to treat excessively high concentrations of unconjugated bilirubin in neonates