MLT 227 Blood Products Storage, Requirements, Use and Vocabulary

30 vocabulary flashcards defining key storage temperatures, expiry times, yield requirements, and indications for various blood products.

Whole Blood Indication

Indicated for active bleeding in trauma patients.

Whole Blood, Packed RBC in CPD, CP2D, CPDA-1, and AS-1, 3- & 5 Storage and Shipping Temperature

Stored at $1-6\,^\circ\text{C}$ and shipped at $1-10\,^\circ\text{C}$.

Packed Red Blood Cells (CPD or CP2D) Expiration

Expires $21\,days$ from collection when stored at $1-6\,^\circ\text{C}$.

Packed Red Blood Cells (CPDA-1) Expiration

Expires $35\,days$ from collection when stored at $1-6\,^\circ\text{C}$.

Packed Red Blood Cells (AS-1, AS-3, AS-5) Expiration

Expires $42\,days$

Washed Red Blood Cells Purpose

To remove IgA and remove WBCs to stop anaphylactic shock and febrile reactions. RBCs are washed with Saline

Washed Red Blood Cells Expiration

Expires $24\,hours$ after opening.

Frozen Red Blood Cells Storage Temperature and Expiration

Stored at $\le -65\,^\circ\text{C}$ with glycerol added before freezing; expires in $10\,years$.

Deglycerolized Red Blood Cells Expiration

Expires $24\,hours$ from thawing

Neonatal Red Cell Aliquot Special Yield Requirements

Premature babies must be given at $10\,mL/kg$ , and the RBCs must be CMV negative, and irradiated

Irradiated Red Blood Cells Expiration

Expires in $28\,days$ from irradiation or from the original expiration date, whichever is sooner.

Irradiation Dose for Blood Products to prevent GVHD

A standard radiation dose of $2500\,cGy$.

Apheresis Platelets Yield Requirement

Must contain greater than $3.0 \times 10^{11}$ platelets per unit with a pH greater than or equal to $6.2$.

Platelet Storage Requirements (for pooled, apheresis, and irradiated)

Stored at $20-24\,^\circ\text{C}$ with continuous agitation.

Pooled Cryoprecipitate After Thawing Expiration

Expires $4\,hours$ after pooling due to being an open system.

Single Unit Thawed Cryoprecipitate Expiration

Expires $6\,hours$ once thawed.

Cryoprecipitate Special Yield Requirements

Must contain Factor 8 greater than or equal to $80\,IU$ and Fibrinogen greater than or equal to $150\,mg/dL$.

Fresh Frozen Plasma Storage and Expiration

Stored at $-18\,^\circ\text{C}$ or lower and expires in $1\,year$.

Thawed Plasma Expiration

Expires $5\,days$ from thaw

Anticoagulant in Blood Bag

Na-Citrate.

Preservative Components in Blood Bags

Na-Biphosphate or diphosphate as a preservative, Dextrose (or Glucose) for energy, and Adenine to increase ATP.

ACD Definition

Adenine, Citrate, Dextrose (Glucose).

Maximum Hang Time for Blood Unit

A maximum of $4\,hours$ due to an open system.

Time Limit to Spike Unit After Issue

Must be entered or spiked within $30\,minutes$ after issue.

Non-Emergent Transfusion Rate

Fastest transfusion rate is $90-120\,minutes$, dependent on the patient's cardiovascular system.

What happens to a patient’s Hemoglobin and Hematocrit Yield after a unit of RBCs are transfused?

One unit raises Hgb by $1\,g/dL$ and Hct by $3\,\%$.

When are Packed RBCs used for Asymptomatic Transfusion patients and Symptomatic?

When hemoglobin is less than $7\,g/dL$ for Asyptomatic patients and 8g/dL for Symptomatic or Cardiac patients

What product is used for the reversal of Warfarin/Coumadin?

Plasma

Leukoreduction Indications

To prevent febrile non-hemolytic reactions, reduce risk of CMV, and prevent HLA allosensitization.

Why do we wash a unit of Packed RBCs and Platelets?

To prevent a patient from going through anaphylaxis due to IgA. Washing also reduces the remainder of WBCs

Expiration date of Whole Blood

Depends on the Additives and preservatives added to it. For example, AS-1 added=42 days

Special yield requirement for Packed RBCs in CPD, CP2D, CPDA-1

The Hct or ratio of RBCs to a volume of Plasma, is <80%

Special yield requirement for Packed RBCs in AS-1, 3, and 5

The HcT is between 55%-60%

What are the indications for using Packed RBCs in CPD, CP2D, CPDA-1, and AS-1, 3 & 5?

To treat Anemia and for patients with a Hgb <7

What is the Special Yield Requirement for Washed RBCs before using?

It must be washed with saline and has no hemolysis

What is the indication for using Frozen RBCs?

For rare donors/family and autologous units

What are the special yield requirements for Frozen RBCs?

Glycerol must be added before freezing

Storage temperature requirement for Deglycerolized, Neonatal, and Irradiated RBCs?

1-6 deg. C

What is the special yield requirement for Deglycerolized RBCs?

No hemolysis

What are indications of use for Deglycerolized RBCs?

For patients with Hgb<7 and those with multiple antibodies

Expiration date or time of Neonatal RBC aliquoted

4hrs.

What is the indication of use for Neonatal RBC aliquots?

When a baby’s Hgb is <9-10

Expiration date or time of apheresis and irradiated platelets?

Closed System-5 days. Open System-4 hrs.

Expiration date or time of pooled platelets

4 hrs. due to open system

Indications of use for apheresis, and pooled platelets

When a patient’s platelet count is <60,000 during an active bleeding from Trauma, Progenitor Cell Transplants (or errors in that), heart and liver transplant

Indications of leukocyte-reduced platelets

For Cancer patients when platelets counts have reduced to <60,000

Indications of Irradiated Platelets

For patients with a platelet count of <60,000 due to Progenitor Cell Transplant

Special Yield Requirements for Apheresis Platelets

It has to have >3.0×10^11 platelets with a pH >=6.2

Special yield requirement for Irradiated platelets

Must be irradiated at 2500cGy and have >3.0×10^11 platelets with a pH of >=6.2

Indications of use for Irradiated RBCs

For patients with blood cancers that are eligible for bone marrow, and for family donations that are HLA matched

Special yield requirements for other platelets in general

It has to have >5.5×10^10 in 90% of units tested with a pH of >=6.2

Storage requirement for Frozen, single unit thawed, and pooled before freezing Cryoprecipitates

-18 deg. C

Expiration date/time of Frozen Cryoprecipitates

12 Months/1yr.

Indication of use for Frozen, Single unit thawed, and pooled after freezing Cryoprecipitates

A patient’s Fibrinogen <100mg/dL

Expiration date/time for pooled Cryoprecipitates

6 hrs.

Indications of use for FFP, thawed FFP, and thawed Plasma

For replacement of Coagulation Factors, especially 2, 7, 9, and 10

Storage Temperature Requirement for FFP

-18 deg. C

Storage Temperature Requirement for Thawed Plasma and FFP

1-6 deg. C

Expiration time/date for thawed FFP

24hrs.

Expiration time/date for thawed Plasma

5 days from thaw