Immunohematology Unit 3

Traditional Blood Draw Volume

450mL + 63mL of anticoagulant

New Blood Draw Volume

500mL + 70mL anticoagulant

RBC Storage

1-6 C

RBC Transport

1-10 C

Platelet Storage

20-24 C

Shift to Right

Decreased affinity for O2. Increased delivery of O2 to tissues, increased 2,3 DPG. Hypoxia

Shift to Left

Increased affinity for O2. Decreased O2 delivery to tissues (12%), decreased 2,3 DPG.

Anticoagulant preservatives

ACD-A, CPD, CP2D (21 day), CPDA-1 (35 day)

Adsol

AS-1.

Nutricel

AS-3, has citrate/phosphate

Optisol

AS-5

SOLX

AS-7

Additive Solution Shelf Life

42 days of storage

Bag 1

PRBCs

Bag 2

Platelets

Bag 3

Plasma

RBC Freezing Temp

-65 up to 10 years

Open System Expiration and Rejuvenation expiration

24 hrs

Closed system expiration

14-15 days

Rejuvenation Window

3 days

Whole Blood

Large volume deficit. Raises Hgb 1g/dL (Hct 3%) in 48-72 hrs. Stored at 1-6 C

PRBC Component

Final volume at 160-275mL. Raises Hgb 1g/dL (Hct 3%) very quickly.

Critical Hgb value

Less than 6g/dL

RBC Aliquots

Dosage is 10-25mL per dose. Raise Hgb by 3g/dL. Open system expires in 24hrs

Irradiation

2,500cGy or 25 Gy. Expires 28 days after or date of OG unit. Stored at 1-6C

WBC Reduced RBCs

Less than 5 × 10^6 WBCs. 99.9% removed, 85% OG blood volume needed.

Platelet Shelf Life

5 days. Stored in 20-24 C. pH above 6.2

Random Donor Platelets

At least 5.5 × 10^10. Raises count by 5-10k. Pooled is 5-6 mixed, expires in 4 hours.

Single Donor Platelets

At least 3 × 10^11. Raises by 30,000-60,000. 5 day shelf life.

Granulocyte Pheresis

At least 1 × 10^10. Increases by 1000mL. 24 hour shelf life, stored at 20-24C.

Fresh Frozen Plasma

1 year at -18, 7 years at -65. Thawing at 30-37. Thawed expires in 24 hours at 1-6. Rh can be disregarded. Increases clotting factors by 20-30%, 10-20mL/kg

Single Donor Plasma

Only stable factors. Up to 4 days after thawing, transfused up to 5 after whole blood EXP date

Cryoprecipitate

Fibrinogen, VIII, XIII, vWF, fibronectin. VIII 80 IU, 150mg fibrinogen that raises by 5-10mg. Thawed shelf life is 6 hours at 20-24.

Factor VIIa

Treatment for patients w hemophilia A/B w circulating antibodies or inhibitors to Factor VIII/IX. Made w recombinant DNA tech

Factor VIII

Treatment for hemophilia A or factor VIII deficiency. Made w recombinant DNA tech but must be purified if from humans. Increases level by 2%, stored at 1-6

Factor IX

Treats hemophilia B. Stored at 1-6, increases levels by 1.5%

Normal Serum Albumin

Shock and burn patients. 96% albumin, 4% globulin. Stored at 2-10, 5 years

Plasma Protein Fraction

83% albumin

RhIg

Dose of 300 micrograms.

2 weeks

Measles/rubeola, mumps, oral polio, typhoid and yellow fever.

Female Donor

Hgb more than 12.5, Hct more than 38%

Male Donor

Hgb more than 13, Hct more than 39%

Autologous Donor

Hgb more than 11, Hct more than 33%

Preoperative

5-6 weeks before. Last collection at least. 72 hours before procedure.

Acute Normovolemic Hemodilution

Whole blood collected during surgery. Reinfused within 8 hours.

Intraoperative

Blood from surgical site. Often not quite enough. Reinfused within 6 hours.