Blood Component Preparation and Storage

what are the phases of blood component preparation and the steps involved in each?

1. donor blood testing - T&S and Infectious Disease Screen

2. component preparation - creating components and preparing them for storage, appropriate labeling, and assessing stability

FDA requires that at least ___% of transfused cells survive 24 hrs post transfusion

75%

storage lesions refer to …?

changes in red cells during storage

how does polyvinylchloride (PVC) plastic help improve blood component storage conditions?

PVC contains plasticizers that leach into blood components and have been shown to stabilize the RBC membrane

how does citric acid/citrate help improve blood component storage conditions?

an anticoagulant that slows the breakdown of glucose during cell metabolism

how does dextrose help improve blood component storage conditions?

provides a source of sugar to feed RBC metabolism

how does monobasic sodium phosphate help improve blood component storage conditions?

acts as a buffer to maintain physiologic pH

how does adenine help improve blood component storage conditions?

helps sustain ATP levels

what are some changes that can happen to donated blood during storage

increased free Hgb and potassium

decreased viable cells, plasma pH, plasma sodium, RBC ATP, and RBC 2,3 DPG

during the storage of donated blood, ATP within the RBC decreases due to

metabolism

adenine is a useful donor blood preservative because it

acts as a substrate for ATP generation

the addition of CPDA-1 provides blood components with a shelf life of ___ days

35

the addition of CPD & CP2D provides blood components with a shelf life of ___ days

21

the addition of AS-1, AS-3, and AS-7 provides blood components with a shelf life of ___ days

42

blood drawn directly into CPDA-1 has a storage/shelf life of

35 days

describe the process of manufacturing pRBCs, FFP, PLTs, and CRYO from a donated whole blood unit

1. whole blood w/ satellite bags attached are centrifuged in a light spin

2. platelet-rich plasma is separated off the RBCs in a separate bag

3. additive solution is added to pRBCs and they are now sealed off

4. PLT rich plasma is centrifuged, and plasma is separated off the PLTs

5. PLTs are sealed in their own bag

6. plasma can either be frozen to make FFP OR frozen and thawed to make CRYO/CRYO poor plasma

***you can’t make FFP and cryo from the same unit***

PRP is separated into ____ & ____

Platelets and plasma

light spin is used to

separate plasma from pRBCs

heavy spin is used to

separate plasma from PLT

what components are in whole blood

RBCs, plasma, leukocytes, and PLTs

what temperature is whole blood stored at

1-6 degrees Celsius

what temperature is whole blood transported at

1-10 degrees Celsius

whole blood is not used often, but may be used for

autologous donations (blood from oneself, typically used before surgery)

what components are in pRBCs

RBCs, leukocytes, and PLTs

what temperature are pRBCs stored at

1-6 degrees Celsius

what temperature are pRBCs transported at

1-10 degrees Celsius

what are the QC requirements for pRBCs

HCT should be 60-80%

what components are in PLT concentrates

PLTs, some RBC`

what temperature are PLTs stored at

20-24 degrees Celsius with constant agitation

what temperature are PLTs transported at

20-24 degrees Celsius

what are the QC requirements for PLTs

PLT count and pH

PLT products for transfusion are stored

at room temp. with constant agitation

what are the components in FFP

plasma, coag factors

what temperature is FFP stored at

< -18 degrees Celsius

if thawed then 2-6 degrees Celsius

what temperature is FFP transported at

< -18 degrees Celsius with dry ice

FFP has a shelf life of

5 days after thawing (kept at 2-6 degrees Celsius)

12 months (kept at -18 degrees Celsius in freezer)

7 years if kept at -65 degrees Celsius

what are the components of cryo

fibrinogen, factor VIII, Factor XIII, vWF, and plasma

what temperature is cryo stored at

< -18 degrees Celsius

if thawed, 20-24 degrees Celsius

what temperature is cryo transported at

< -18 degrees Celsius using dry ice

what is the shelf life of cryo

12 months if frozen

6 hours if thawed

cryo contains fibrinogen, factor VIII, vWF, and

factor XIII

what temperature are RBCs with additive solution stored at and how long is their shelf life?

1-6 degrees Celsius

42 days

what temperature are washed or deglycerolized RBCs (open system) stored at and how long is their shelf life?

1-6 degrees Celsius

24 hours once system becomes open

what temperature are irradiated RBCs stored at and how long is their shelf life?

1-6 degrees Celsius

28 days after irradiation or original outdate

what temperature are frozen RBCs stored at and how long is their shelf life?

< -65 degrees Celsius

up to 10 years

what is the difference between PF24 and FFP

`PF24 is plasma that was frozen within 24 hrs instead of 8 and is only good for 1 year

what temperature is PF24 stored at and how long is its shelf life

< -18 degrees Celsius

1 year

what temperature is FFP stored at and how long is its shelf life

< -18 or < -65 degrees Celsius

1 year if -18; 7 years if -65

what temperature is cryo stored at and how long is its shelf life

< - 18 degrees celsius

1 year

what temperature is thawed PF24 stored at and how long is its shelf life

1-6 degrees celsius

24 hours

what temperature is thawed FFP stored at and how long is its shelf life

1-6 degrees Celsius

24 hours

what temperature is thawed cryo stored at and how long is its shelf life

20-24 degrees celsius

4-6 hours

what temperature are PLTs stored at and how long is its shelf life

if closed system or obtained from leukopheresis, store at 20-24 degrees Celsius & shelf life is 5 days

if open system, store at 20-24 degrees Celsius & shelf life is 4 hours

how are pRBCs changed when they are leukoreduced

85% of RBCs are retained but WBC are reduced to < 5 × 10⁶/unit

to make an RBC aliquot, the unit used must be …?

collected in a special bag with chambers

when are RBC aliquots typically used

for neonates (4 months and younger)

***must be used within 24 hours and stored at 1-6 degrees Celsius

how are washed RBCs made & why would you wash them

wash the RBCs with 1-2L of normal saline to help remove plasma proteins and lyres

what happens to pRBC shelf life after they’re washed

shelf life changes to 24 hrs

the PIPA solution is used to

rejuvenate pRBCs; can extend expiration date by 3 days

glyceration/freezing of RBC units is done to

store units with rare phenotypes for long periods

what is added as a cryoprotective to RBCs before freezing?

glycerol

after frozen RBCs are thawed, how long is their shelf life?

24 hours if stored at 1-6 degrees Celsius

why would RBCs be irradiated

to prevent GVHD (graft vs host disease)

what is the shelf life of irradiated pRBCs

28 days

plasma cryoprecipitate reduced (CPP) contains

Factor II, V, VII, X, XI, ADAMST13

CPP does not contain

Factor VIII, fibrinogen, factor XIII, vWF, cryoglobulin, and fibronectin

what are required components for ISBT blood unit labeling

blood supplier, component description, and ABO/Rh type

Once fresh frozen plasma is thawed, how long can it be stored in a refrigerator and still be considered thawed fresh frozen plasma and be relabeled as thawed plasma?

24 hrs

Which statement about the blood storage lesion is FALSE

 

All the changes are irreversible

 

Changes affect all components of the blood

 

Stored RBC continue to metabolize

 

WBC’s release cytokines and enzymes

all the changes are irreversible

A whole blood donation occurred at 9:00AM. The processing of the unit began at 3:00PM and the plasma was frozen by the 5:30PM. This plasma should be labeled as:

PF24 (it wasn’t frozen within 8 hrs)

The shelf life of thawed FFP that is stored at 1-6 deg C is:

1 day

What is the shipping temperature for leukoreduced red blood cells?

1-10 degrees Celsius

What is the approved shelf-life in days of red blood cell components at use one of the three additive solutions currently licensed in the United States?

42

for standard freezing at -65 degrees C, what percent (w/v) of glycerol should be used?

40%

PIPA solution is used to (select all that apply):

 

Protect RBC's during the freezing process

 

Increase 2,3DPG and ATP levels

 

Remove excess potassium and citrate

 

increase the expiration date

Increase 2,3DPG and ATP levels & increase the expiration date

What temperature must be maintained (in degrees Celsius) for shipping RBC’s

1-10

What is the maximum temperature frozen red blood cells can be stored at?

-65 deg C