Blood Component Preparation

What is a storage lesion?

Refers to changes in red cells during storage

FDA requires that means to avoid storage lesions so that ___ % of transfused RBC’s survive hours after transfusion and that less than __% hemolysis occurs

FDA requires that means to avoid storage lesions so that 75% of transfused RBC’s survive 24 hours after transfusion and that less than 1% hemolysis occurs

What is PVC plastic?

used in most collection sets and storage bags

contains plasticizers that leach into blood components

have been shown to stabilize the red blood cell membrane

How does citric acid act as an anticoagulant and preservative?

slows the breakdown of glucose during cell metabolism

protects RBC membrane

How does dextrose act as an anticoagulant and preservative?

provides a source of sugar to feed metabolism (supports ATP generation)

How does Monobasic sodium phosphate act as an anticoagulant and preservative?

acts as a buffer to maintain a physiologic pH

How does Adenine act as an anticoagulant and preservative?

acts as substrate to sustain ATP levels

Differentiate which increases and decreases in blood during storage:

plasma pH

viable cells

free hemoglobin]

RBC ATP

RBC 2,3 DPG

plasma sodium

potassium

plasma pH: Decreased

viable cells: Decreased

free hemoglobin: Increased

RBC ATP: decreased

RBC 2,3 DPG: decreased

plasma sodium: decreased

potassium: Incresed Increased

CPD (Citrate-Phosphate-Dextrose) preserves blood for how long?

21 days

CP2D (Citrate-Phosphate-2-Dextrose) preserves blood for how long?

21 days

CPDA-1 (Citrate-Phosphate-Dextrose-Adenine) preserves blood for how long?

35 days

AS-1 and AS-5 (Dextrose, Adenine, Mannitol, and Saline) preserves blood for how long?

42 days

AS-3 (Dextrose, Adenine, Saline, Citrate) preserves blood for how long?

42 days

AS-7 (Dextrose, Adenine, Mannitol, Saline, Citrate, Sodium Bicarbonate) preserves blood for how long?

42 days

What are the contents of whole blood?

RBCs, plasma, leukocytes, and platelets

Which components are stored at 1-6ºC?

Whole blood & Packed red blood cells,

What compnents are tranported at 1-10ºC

Whole blood & Packed red blood cells

In PRBCs what should HCT be?

60-80%

What are the contents of PRBCs?

RBCs, leukocytes, and platelets

What are the contents of platelet concentrates?

Platelets & some RBCs

What is the storage and transport temperature for platelet concentrates?

20-24ºC

*needs constant agitaion and pH of >6.2

What are the contents of fresh frozen plasma?

plasma & coagulation factors

What temp is FFP stored and transported at?

Stored:

≤-18°C

Thawed: 2-6° C (refrigerator temp)

Transported:

≤-18 C (using dry ice)

What are the contents of cryoprecipitate?

Fibrinogen (>150mg),

Factor VIII (>80 units),

Factor XIII,

vWF; 15 mL or less of residual plasma

What is the storage and transport temp of cryoprecipitate?

Storage:

≤-18° C

Thawed: 20-24° C

Transport:

≤-18° C (using dry ice)

What is the storage and transport temp of granulocytes?

Storage Temperature:

•20–24° C

Transport Temperature:

•20–24° C

What is the QC requirement for granulocytes?

•Should have 1.0 x 10¹⁰ granulocytes/unit

What is the purpose and process of Leukoreduced RBC units?

• Removes contaminating WBCs and PLTs

• Retains at least 85% of RBCs but reduces WBC count to <5x10⁶/unitLeukocyte-reduced

What is the purpose and process of RBC Aliquots RBC units?

Used for neonates (4 months) and younger

Once blood goes into a syringe it must be used within 24 hours and stored at 1-6ºC

What is the purpose and process of Washed RBC units?

Removes harmful soluble mediators such as Hb and isoprostanes

Wash the RBC’s in 1-2L of normal saline

After wash, shelf life is 24 hours

What is the purpose and process of Rejuvenated RBC units?

To restore 2,3-DPG and ATP levels RBC unit

Use PIPA solution

• Pyruvate, inosine, phosphate, adenine

extend expiration date by 3 days

Frozen RBC units are stored at or below ___ ^oC for up to ____ years.

-65^oC for up to 10 years

How are frozen RBCs prepared?

Glycerol is first added as a cryoprotective that helps prevent intracellular dehydration

• Slowly added to unit to 40% weight per volume conc

• Deglyceroilzation involves multiple washes:

• First: 12% saline solution wash

• Second: 1.6% saline solution wash

• Third: 0.9% saline and 0.2% dextrose solution (final)

After frozen RBCs have been thawed/deglycerolized, what is the shelf life?

24hrs

What is the purpose and process of Irradiated RBC units?

Prevents proliferation of T-cells that cause GVHD (graft vs host disease)

A gamma irradiator using cesium-167 or cobalt-60 is used on a unit of RBC