blood components and plasam derivatives

whole blood - major indications

symptomatic anemia with large volume deficit

whole blood - mode of action

increases oxygen - carrying capacity

increases blood volume

whole blood - risk

infectious diease

hemolytic, septic/toxic, allergic, febrile reaction

iron overload, TACO, TRALI, TA-GVHD

whole blood - speical considerations

must be ABO idenitical

RBC, RBC pheresis - major indication

symptomatic anemia; red blood cell exchange transfusion

RBC, RBC pheresis - MOA

increase oxygen - carrying capacity

RBC, RBC pheresis - risk

same as whole blood

infectious diease

hemolytic, septic/toxic, allergic, febrile reaction

iron overload, TACO, TRALI, TA-GVHD

RBC, RBC pheresis - speical

must be ABO compat

RBC; deglyccerolized washed - major indication

IgA deficiency with anaphylactic reaction

severe allergic reaction

RBC; deglyccerolized washed - MOA

deglycerolization removes plasma protein

risk of allergic and rebrile reaction reduced; increases oxgyen carrying cap

RBC; deglyccerolized washed - risk

same as RBCs

hemolysis due to imcomplete deglycerolization can occur

RBC; deglyccerolized washed - speical

must be ABO compatible

RBC; leukocyte-reduced - major idication

symptomatic anemia

febrile reaction due to leukocyte ab

reduction of CMV transmission and HLA alloimmunization

RBC; leukocyte-reduced - MOA

leukocyte reduction is acieved by filtration

1. after collection

   1. after varying periods of storage

RBC; leukocyte-reduced - risks

same as RBC

hypotensive reaction may occur if bedside leukocyte reduction filiter is used

RBC; leukocyte-reduced - speical

must have residual content of leukocytes <5×10^6 and >85% of og rbc content

platelets/apheresis platelets - major indications

bleeding due to thrombocytopenia or platelet function abnormatility

prevention of bleeding from marrow hypoplasis

platelets/apheresis platelets - MOA

improves hemostasis

apheresis platelets may be HLA selected

platelets/apheresis platelets - risk

infectious dieases

septic/toxic, allergic, febrile reaction

taco, trali, tagvhd

platelets/apheresis platelets - speical

one unit derived from whole blood contains >5.5×10^10 platelets suspended in 40 to 70ml of plasma

1 unit of apheresis platelets >3×10^11 units is = to 4 to 6 units of platelets

platelets leukocytes reduced/apheresis platelets leukocytes reduced - major indication

same as platelets above

prevetion of febrile reaction, HLA alloimmunization and CMV infection

platelets leukocytes reduced/apheresis platelets leukocytes reduced - speical

prepared using open or closed system

1 unit contains >5.5 × 10^10 platelets and <8.3 × 10^5 leukocytes

prepared using open system expires 4 hours after prep

apheresis granulocytes - major indications

neutropenia with infection unresponsive to appropriate antibiotics

apheresis granulocytes - apheresis granulocytes - MOA

increase the level of granulocytes to phagocytize and kill bacterial and fungal infections

apheresis granulocytes - risks

infectious diseases

hemolytic, allergic, febrile reaction

taco, trali, tagvhd

apheresis granulocytes - speical

must be abo compat

number of granulocytes in each concentrate >1×10^10 granulocytes/units

apheresis granulocytes - major indications

itital treatment of pt

undergoing massive transfusion

apheresis granulocytes - MOA

coagulation support for life threatening trauma, hemorrhages

apheresis granulocytes - risks

infectious dieases

allergic and rebrile reaction taco trali

apheresis granulocytes - speical

must be ABO compat

cryoprecipitate pooled/cryoprecipitate AHF - major indiction

hypofibrinogenemia

factor XIII deficiency

cryoprecipitate pooled/cryoprecipitate AHF - MOA

provide fibrinogen, factors VIII, XIII, vWF

cryoprecipitate pooled/cryoprecipitate AHF - risks

infectious dieases

allergic and febrile reactions

cryoprecipitate pooled/cryoprecipitate AHF - speical

must contain >150 mg of fibrinogen in each unit

AHF should contain >80 IU of factor VIII in each unit

fresh frozen plasma (FFP) - major indication

cinically sign plasma protein deficiencies when no specific coagulation factor concentrates are available

TTP

fresh frozen plasma (FFP) - MOA

source of all coagulation proteins and plasma proteins

fresh frozen plasma (FFP) - risk

infectious dieases

allergic and rebrile reaction taco trali

fresh frozen plasma (FFP) - speical

must be ABO compat

PF24 - MOA

source of nonlabile plasma proteins

level of factor VIII are sign reduced and levels of factor V and other labile plasma protiens are variable compared with FFP

PF24RT24 - major indication

clinically sign deficiency of stable coagulation factors when no speicifc coagulation factor concentrates are avavilable

PF24RT24 - MOA

source of nonlabile plasma proteins

levels of factor V, VIII, and protein S are sign reduced and levels of other labile plasma protien and variable compared with FFP

thawed plasma - major indicitation

cliniccally significant deficiency of stable coagulation factors when no specific coagulation factor cncentrates are available

thawed plasma - MOA

source of plasma protein and contains stable coagulation factors, similar clinically to the level found in FFP; other factors are variable being reduced in levels that change over time

thawed plasma, cryo reduced - major indications

TTP

thawed plasma, cryo reduced - MOA

plasma protein replacement for plasma exchange in TTP; contains levels of albumin and factors II, V, VII, IX, X and XI