MLS (ASCP) - Blood Products (Donors, Storage, Components, and QC)

Maximum Blood Collection

10.5 ml of whole blood per kilogram of body weight (including samples)

Aseptic Technique

scrub site for minimum 30 seconds with providine-iodine scrub

Donor Interval

8 weeks after whole blood donation

Medications taken within _____ hours that irreversibly affect platelet function may not be used as the only source for platelets but can be part of a platelet pool.

48

Age for Allogeneic Donor

≥ 16

Temperature (oral) for Allogeneic Donor

≤37.5°C or ≤99.5°F

Blood Pressure for Allogeneic Donor

must be "within normal limits"; institution defined (180/100)

Hgb/Hct for Allogeneic Donor

≥12.5g%/ ≥38%

Weight for Allogeneic Donor

minimum 110 lb / 50kg

Blood Pressure

Systolic / Diastolic

Sky is above Dirt

Time of Donor Deferral

Hepatitis B Immune Globulin

1 Year

Time of Donor Deferral

Possible Exposure to hepatitis, HIV, & malaria

1 Year

Time of Donor Deferral

Recipient of blood/blood products

1 Year

Time of Donor Deferral

Tattoo (unless at state-regulated facility)

1 Year

Time of Donor Deferral

Living with or having sexual contact with a person positive for HBsAg or HBV NAT

1 Year

Time of Donor Deferral

Is symptomatic for Hep C or any other viral Hepatitis

1 year

Time of Donor Deferral

Mucous membrane exposure to blood

1 Year

Time of Donor Deferral

Skin penetration with instruments contaminated with blood/body fluid

1 Year

Time of Donor Deferral

Sexual Contact with individual symptomatic for any viral hepatitis, confirmed + for HBsAg / HIV or in high risk category

1 Year

Time of Donor Deferral

From completion of therapy for syphilis or gonorrhea or reactive STS

1 Year

Time of Donor Deferral

Traveled to endemic area for malaria

1 Year

Time of Donor Deferral

>72 hours in a correctional institution

1 Year

Time of Donor Deferral

Visitor/immigrant from area endemic for malaria

3 Years

Time for Donor Deferral

Previous diagnosed with malaria

3 Years

Time for Donor Deferral

Viral Hepatitis after age 11

Indefinite/Permanent

Time for Donor Deferral

Confirmed positive test for HBsAg or positive HBV NAT result

Indefinite/Permanent

Time for Donor Deferral

Repeatedly reactive test for anti-HBc or anti-HTLV

Indefinite/Permanent

Time for Donor Deferral

Donated only one unit to recipient who developed post transfusion hepatitis, HIV, or HTLV

Indefinite/Permanent

Time for Donor Deferral

Present/Past infection of HCV, HTLV, HIV or T. cruzi

Indefinite/Permanent

Time for Donor Deferral

Evidence of parenteral drug use

Indefinite/Permanent

Time for Donor Deferral

Family history of CJD or risk of vCJD

Indefinite/Permanent

Time for Donor Deferral

History of babesiosis

Indefinite/Permanent

Expiration with anticoagulants

ACD/CPD/CPD2

21 days

Expiration with anticoagulants

CPDA-1

35 days

Expiration with anticoagulants

Additives

42 days

Rejuvenating Solutions

restores 2,3-DPG and ATP

Autologous Donations

Donation for self

No age limit

Autologous Donations

Hct & Hgb

Hct ≥ 33%; Hgb ≥ 11g/dL

Autologous Donations

Collection > _____ hours prior to surgery or transfusion

72

Donor criteria for Apheresis

same as for whole blood

Apheresis Instruments

can selectively remove needed component and return components not needed.

Cytapheresis

separation and collection of cells (granulocytes and leukocytes)

Plasmapheresis

separation and collection of plasma

Plateletpheresis

separation and collection of platelets

Leuka/Granulocytapheresis

separation and collection of leukocytes/granulocytes

Frequency of donation for Leuka/Granulocytapheresis

donations at least 2 days apart; no more than 2 donations in any 7 day period

Where can hematopoietic Progenitor cells be found?

Peripheral circulation or bone marrow

Hematopoietic Progenitor AND Stem Cells are used for:

Used to reconstitute bone marrow post chemotherapy/irradiation or to replace abnormal marrow cells.

Where can Hematopoietic Progenitor AND Stem Cells be obtained?

bone marrow, umbilical cord blood, and peripheral blood

In order to reduce the risk of GVHD, what must allogeneic marrow have?

HLA-identical match

Is ABO compatibility required for allogeneic marrow?

No

Whole Blood Transfusion

Used in cases of severe shock (blood loss ≥25% blood volume) needing rbc's for oxygen and plasma for volume

Red Blood Cells (PACKED CELLS) Transfusion

No plasma, provides same oxygen carrying capacity as whole blood with less volume.

1 unit of red blood cells raises hgb

1g

1 unit of red blood cells raises hct

3%

What changes occur in plasma during storage?

Increased: NH4 and K+

Decreased: pH and Na+

Unit of blood cannot be returned and reissued if >___°C or if seal is disturbed

10

What is the purpose of washing red cells before a transfusion?

used to prevent allergic response to plasma proteins and anaplylactic shock in IgA deficient pt's with anti-IgA

Expiration of washed red cells after seal of original unit broken:

24 hours

One unit of apheresis red blood cells should have a minimum Hgb of what?

>60g

One unit of apheresis red blood cells should have a maximum Hgb of what?

80%

Apheresis red blood cell units should have a combined Hgb of _____ in ____% of the units tested.

>50g -- 95

What should the final hemoglobin value of an individual Leuko reduced apheresis red blood cell unit be?

>=51g Hgb

What should the combined hemoglobin be in 95% of leukoreduced RBC apheresis?

>=42.5g Hgb

A Leukocyte Reduced unit should have what WBC count?

<5x10^6

Why would one want to transfuse Leukocyte Reduced Red Cells?

85% of red cells retained

To prevent febrile nonhemolytic reactions, HLA alloimmunizations, and the transmission of CMV

What usually causes repeated febrile nonhemolytic reactions?

usually due to presence of cytokines released from white cells or alloimmunization to HLA or leukocyte antigens

Frozen Cells/ Deglycerolyzed Cells

Cells protected the ultra low temps by cryoprotective agent (40% glycerol)

How long are frozen/deglycerolyzed cells good for when frozen?

10 years at ≤ -65°C

Why would a unit of blood be frozen?

used for storage of autologous units and "rare" units

What must be done to frozen cells prior to transfusion?

must be thawed at 37C and the glycerol removed

How long are thawed, deglycerized cells good for? (open system)

24 hours at 1-6C

Fresh Frozen Plasma

Prepared by separating cells and plasma by centrifugation and freezing plasma within 8 hours of collection

How long is fresh frozen plasma good for when frozen?

1 year at -18°C or 7 years at ≤ -65°C

When does Fresh Frozen Plasma expire once thawed (between 30-37°C)?

24 hours, if stored between 1-6°C.

FFP must be ABO compatible with recipient ______.

cells

What is FFP used for?

Coagulation deficiencies, specifically factor XI deficiency

Collection of FFP from males and never-pregnant women is to prevent what?

TRALI

What does PF24 stand for?

Plasma frozen within 24 hours after phlebotomy

What kind of collection can PF24 be made from?

whole blood or apheresis

How long is PF24 good for?

ktpt at 1-6C for 24 hours and then frozen at <=-18C

Cyroprecipitate

FFP frozen within 8 hours of whole blood collection is thawed at 1-6°C. Refrozen within 1 hour.

How much Fibrinogen should be in a unit of Cryo?

>=150 mg

How much Fibronectin and Factor VIII must be contain in a unit of Cyro?

≥150 mg and ≥80 IU/bag

What factors does Cryo contain?

vWF

Factor XIII

Fibronectin

Ristocetin Cofactor activity

Storage of Cyroprecipitate

Store at -18°C for 1 year from date of phlebotomy

Room Temperature after thawing

Within how many hours must cryoprecipitate be transfused after pooling in an open system?

4 hours

Within how many hours must cryoprecipitate be transfused after pooling in a closed system?

6 hours

Cryoprecipitate must be transfused within how many hours after thawing?

6

Cryoprecipitate is primarily used for what?

to replace fibrinogen loss due to DIC and/or massive bleeding

(may also be used for dysfibrinogenemia with active bleeding)

What factor deficiency causes Hemophilia A?

Factor VIII aka vWF (Von Willebrand disease)

"A-8-A"

What factor deficiency causes Hemophilia B?

Factor IX

"Be mine, be nine"

What factor deficiency is associated with Hemophilia A and B?

Factor VII

"7 is between A&B"

What would be used to treat moderate to severe Hemophilia A and Von Willebrand disease?

Recombinant (most common) or virally inactive Factor VII concentrate.

What would be used to treat Hemophilia B?

Prothrombin complex concentrates or Factor IX (all virally inactivated)

Prothrombin complex concentrates contain what kind of factors?

vitamin K dependent

What are the vitamin K dependent factors?

Factors II, VII, IX and X

What is used to treat mild hemophilia A and type 1 vWD?

DDAVP (Desmopressin)

What increases circulating factor VIII and vWF?

DDAVP (Desmopressin)

How are platelets isolated from whole blood?

1. Light spin (to remove RBC's)

---followed by---

2. Heavy spin (to spin down plt's and WBC's)

3. Removal of supernatant plasma (will become FFP)

4. Remaining plasma, platelts, and WBC's = Platelets