Blood components

We Listen, We Care

  • Introduction about Scott Springworth, Deputy Service Manager at Blood Transfusion NUH.

Overview of Blood Transfusion

  • Topics Covered:
    • Blood Donation
    • Donor Testing
    • Processing
    • Overview of Components
    • Clinical Indications for use

Blood Bank Activity (NUH)

  • Samples Processed Last Year:
    • 111,838 samples covering 412,681 tests.
  • Issued Blood Products:
    • 43,831 total products:
    • 35,104 Red Blood Cells (RBC)
    • 4,397 Frozen products
    • 4,318 Platelets
    • Average 120 products a day issued.

Clinical Indications for Blood Transfusion

  • Main Functions:
    • Support oxygen delivery to organs and tissues.
    • Regulation of haemostasis.
  • Common Usage:
    • During surgery.
    • Following trauma.
    • Medical conditions such as bleeding disorders.
  • Usage Statistics (NHSBT 2014):
    • 67% for medical conditions
    • 27% for surgery (planned and emergency)
    • 6% for blood loss following childbirth.

Sources of Blood Donation

  • Donors: General public (you and me).
  • NHSBT collects approximately 2 million donations per year.
  • Only 4-6% of the eligible population donates.

Blood Donation Types

  • Types of Donation Schemes:
    • Voluntary & unpaid (UK standard).
    • Family/Replacement donations.
    • Paid donations (not in the UK).
  • Variables Affecting Donation:
    • Constant stock vs. usage patterns, influenced by sporting events and hot weather.

Donation Process - Safeguarding Patients

  • Eligibility: Ages 17-65 (1st time donors).
  • Safety Checks:
    • Complete donation safety check form to identify risk factors.
    • Minimum Hemoglobin levels required:
    • Females: ≥125 g/l
    • Males: ≥135 g/l.
  • Collection Procedure:
    • Arm cleansing and diversion pouch collection.

Collection Methods

  • Types of Collections:
    • Whole Blood collection (450 ml with anticoagulant CPD).
    • Component Donation (Apheresis).

Safety and Testing of Donations

  • Mandatory screening for:
    • Infections (e.g., HIV, Hepatitis B/C, Syphilis).
    • Transfusion-related risks (appearance, behavior, previous illness, etc.).
    • Additional testing for specific antibodies and conditions.

Blood Component Processing

  • Blood consists of four components:
    • Red Blood Cells (RBC)
    • Plasma
    • Platelets
    • White Blood Cells.
  • Whole blood rarely used; specific components are more beneficial.

Leucocyte Reduction

  • Introduced to reduce risk of vCJD and febrile transfusion reactions.
  • Filtered to reduce leucocyte count to below 5 x 10^6 per unit.

Centrifugation and Component Expression

  • Centrifugation: Separates whole blood into components (cell-free plasma, buffy coat, red cells).
  • Automated Devices: Used for extraction of components; process bags are heat sealed.

Red Blood Cells (RBC) - Specifications and Processing

  • Standard RBC Unit Specifications:
    • Volume: 280 +/- 60 ml.
    • Hemolysis: < 0.08%.
  • Storage: 4°C +/- 2°C to promote viability and slow metabolism.
Additional RBC Processing
  • Irradiation: Inactivates T lymphocytes in donations to prevent Transfusion Associated Graft vs Host Disease (TA-GvHD).

Fresh Frozen Plasma (FFP)

  • Processing: Must occur within 7.5 hours post-donation; quickly frozen to -25°C.
  • Specifications:
    • Volume: State volume +/- 10%.
    • Total Protein: >50 g/l.
  • Storage and Shelf Life:
    • 24 months frozen.
    • 4 hours thawed at 20°C, 120 hours at 4°C.

Cryoprecipitate

  • Production: Made from FFP; involves thawing and centrifugation to retain cryoglobulins.
  • Shelf Life: 24 months frozen; adult dose typically involves pooled units.

Platelet Collection and Usage

  • Donation Methods:
    • Pooled platelets from multiple donors.
    • Apheresis from single donors (up to 3 doses per session).
  • Clinical Usage:
    • Supporting life-threatening hemorrhage.
    • Surgical cover.

Management of Acute Blood Loss

  • Treatment Goals:
    • Restore oxygen-carrying capacity.
    • Maintain circulatory pressure and replace clotting factors.

Alternatives to Blood Transfusion

  • Indications for Use:
    • Refusal for religious or personal reasons.
  • Alternatives include:
    • IV iron therapy, erythropoietin, cell salvage.

Case Study: Major Trauma

  • Overview of a major trauma case involving multiple product usage (RBC, FFP, Cryo, Platelets).
  • Affected a patient with life-threatening injuries, necessitating a coordinated treatment plan.
  • Outcome: Patient managed to recover after extensive care and transfusion support.

Conclusion

  • Emphasis on the importance of blood donation and transfusion in critical healthcare settings. Thank you for listening!