Blood Component Therapy-4th Year MS

8/12/2019 Blood Component Therapy-4th Year MS

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4th year medical students

Blood Component Therapy

Salwa I HindawiMSc FRCPath CTM

Director of Blood Transfusion ServicesKAUH . Jeddah


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RBC Agglutination


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ABO typePt Cells Pt Serum

vs vs

anti-A anti-B Acells Bcells

A + 0 0 + 40%

B 0 + + 0 11%

AB + + 0 0 4%

0 0 0 + + 45%


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BLOOD COMPONENT THERAPYIt is the transfusion of specific blood components

required by the patient.

Principles Use blood products only when it is essential.

Replace only the deficient component, if

possible. Identify the cause and nature of the deficiency

and if possible, treat it.


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Wholeblood

Platelets

rich

plasma

1stcentrifugation

Platelets

concentrate

Wholeblood

Wholeblood

2ndcentrifugation

Fresh plasma

FFP for

clinical use

FFP for

fractionation

Optimal additive

solution

Red cells in

OAS

Cryoprecipitate

RedCell

concentrate


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Blood COMPONENTS AVAILABLE

FROM THE BLOOD BANK Whole blood

Packed RBCs

Platelets

Single donor platelets (Apheresis)

Fresh Frozen Plasma (FFP) Cryoprecipitate


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Indication for Red Blood Cells

Transfusion Red blood cells are

component of choiceto maintain anadequate supply ofoxygen to meettissue demands.Oneunit increase thehaemoglobin levelby 1g/dL in a 70kgrecipient.


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Indication for Transfusion ofWhole Blood

Fresh whole blood 30-40% of their bloodvolume.


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Indication for red blood cells

Transfusion Symptomatic anaemia

Acute blood loss>30-40% of blood volume.

Pre-operative Hb< 8g/dl and operativeprocedure associated with major blood loss.

Evidence of inadequate oxygen delivery.


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Administration and Dose

Red blood cells transfusion has to be grouped specific

& Rh specific, if not one of alternative compatiblegroup.

This component must be administered through a

suitable transfusion set (170 mM filter).

Dose of 4ml/kg raises venous Hb by about 1g/dl.


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Specifications

Whole blood volume 450mls+63mls of CPD-A1

anticoagulant. Packed RBCs volume 250mls50mls.

Hct=0.55-0.75.

Anticoagulant CPD-A1 store at 4c2cfor 35 days.

SAG-M for 42 days.


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Cont, Platelet Transfusion

In acute D.I.C (Disseminated intravasculr coagulation).

In neonatal alloimmune thrombocytopenia (NAIT) fromdonor known to be negative for the appropriate HPA or

mother platelet. Platelet function disorders or thrombocytopenia


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Administration of PlateletConcentrate:

ABO compatible platelet are preferred but not necessary.

Platelet concentrate should be transfused as soon as possibleafter reaching the ward with standard blood transfusion setswith 170 mm filters.

The transfusion should normally be completed within 30minutes.

Observation during platelet transfusion should include pulse&temperature before& after transfusion.


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Indications For The Use Of FFP

Definite indication:

Replacement of single factor deficiencies

Immediate reversal of warfarin effect

Vitamin K deficiency

Acute disseminated intravascular coagulation

Thrombotic thrombocytopenic purpura Inherited deficiencies of inhibitors of

coagulation:at, protein S, protein C.

CI esterase inhibitor deficiency


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Conditional uses of FFP

FFP is only indicated in the presence of bleedingand disturbed coagulation.

Massive transfusion

Liver disease

Cardiopulmonary bypass surgery

Special Paediatric indications:sever sepsis, DIC.


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Administration of FFP

1unit of FFP= APPROXIMATELY 200 ML Dose = 12-15 ml/kg Should be administered within 2 hours of thawing.

PT & PTT used for monitoring in addition to the clinicalassessment.

ABO compatible FFP should be used. Compatibility testing isnot required.Group O should only be given to group O recipient.

Group A or B FFP can be given to group O recipient.Group AB FFP should be reserved for group AB recipients andfor emergencies.


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Administration of Cryoprecipitate

1 unit of cryo= approximately 10-20ml Adult dose equivalent to 10 units of cryo For factor replacement the dose can be calculated

according to the volume of the factor in theconcentrate. Fibrinogen 150-300mg/pack Von Willebrand factor 80-120u/pack Factor V111c 80-120u/pack Factor X111 20-30% of factor X111 present in the

FFP. Should be ABO compatible to avoid risk of haemolysis

caused by donor antiA or antiB. Should be administered within 4 hours of thawing.


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Platelet, Apheresis

An adult dose of Platelets prepared from

anticoagulated blood which is separated intocomponents by apheresis machine with retention

of the platelets and a portion of the plasma.

The remaining elements may be returned to the

donor


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Specification

Volume 200800 mls

Platelet count > 240 x 109/ unit

Leucocyte count < 5 x 108/ unit

PH at end of shelf life 6.4-7.4Availability: On request.

Shelf life storage: 5 days at 22 2c gentlyagitated


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Documents

Blood Component Therapy-4th Year MS