THE USE OF BLOOD

PRODUCTS

Dr.Hemalatha Shanmugam

Department of Pathology

University Malaya

Blood Collection

Sources:

Voluntary Non-Remunerated

Autologous

Directed

Paid

Blood Collection

Methods

Whole Blood

Apheresis

Blood Collection

Volume of collection dependant on body weight of donor

300-450 mls

Single bag

Double bag

Triple bag

Blood Processing

Component preparation done within 8

hours of collection

Centrifugation to separate different

components of blood

Density gradient

Red cells Platelets Plasma

Components

Red Cell Derived:

Whole Blood

Reconstituted Red Cells

Washed Red Cells

Irradiated Red Cells

Leukoreduced Red Cells

Whole Blood

300 or 450 mls with appropriate

volume of anticoagulant-preservative

Contains red cells and plasma

elements plus anticoagulant (CPD-A)

Haematocrit is 36-40%

Stored at 2-6 C

Shelf-life is 35 days

Whole Blood

Factors V and VIII concentrations are

decreased and platelet function is non-

existent

Indications:

Actively bleeding patients

Exchange transfusion

Reconstituted Red Cells

Prepared from centrifugation of whole

blood and removal of most of the

plasma

Additive solution is added (SAGM –

100 mls)

Approximately 300-330 mls

Haematocrit is 55-60%

Stored at 2-6 C

Reconstituted Red Cells

Shelf-life is 42 days

1 unit of rbcs should increased the Hb

by 1g/dL and the Hct by 3%

Indications:

Acute and chronic anaemias which are

not amenable to drug therapy

Haemorrhage

Components

Platelet derived:

Single donor platelets (Apheresis)

Random donor platelets

Washed platelets

Filtered/Irradiated platelets

Random donor platelets

Platelet concentrates prepared within

8 hours of collection from individual units of whole blood which are stored

at room temperature

Suspended in 50-60 mls of plasma

Approximately 5.5 x 1010 platelets/unit

Random donor platelets

Stored at 20-24 C in continuous gentle

agitation

Shelf life is 5 days

1 unit of RDP should raise the

peripheral plt count by 5,000-

10,000/ul Dosage is 1 unit/10 kg of body weight

(max. of 6 units)

Random donor platelets

Indications:

Thrombocytopenia

Functional Platelet disorders

Single donor platelets

Platelets suspended in plasma

prepared from a single donor by

apheresis

Approximately 150 - 200 ml of plasma

and ACD

At least 2.0 x 1011 platelets/unit

Leucoreduced

Single donor platelets

Stored at 20-24 C in continuous

agitation

Shelf-life is 5 days

Indications:

Same as random donor platelet

• Only advantage as compared to RDP is

reduced number of donor exposures

Components

Plasma derived

Fresh frozen plasma

Cryosupernatant

Cryoprecipitate

Factor concentrates/immunoglobulins/

albumin

Fresh Frozen Plasma

Separated from the cellular elements

of whole blood and frozen within 8

hours

Contains all blood coagulation factors

Approximately 220-250 mls

Stored frozen (< -18 C)

Shelf-life is 1 year

Fresh Frozen Plasma

1 ml FFP contains 1 unit of each

clotting factor activity

Dosage is 10-15 mls/kg

Thawed at 30-37 C prior to transfusion

Fresh Frozen Plasma

Indications

Isolated clotting factor deficiencies

where factor concentrates not

available

Reversal of warfarin effect

Liver disease

DIVC

Massive blood transfusion

Cryoprecipitate

Prepared by thawing frozen units of

plasma

Approximately 30-35 mls

Stored frozen at -18 C , shelf-life 1 yr

1 unit of CP:

150-300 mg fibrinogen

80-120 IU of FVIII

vWF/fibronectin/FXIII

Cryoprecipitate

Indications:

fibrinogen deficiency and

dysfibrinogenemia

uraemic bleeding

haemophilia A and vWD (when factor

concentrates are not available)

DIC

Cryosupernatant

By product from preparation of

cryoprecipitate from plasma

Contains plasma components with the

absence of fibrinogen, FVIII, vWF and

fibronectin

Indications

– liver disease

– warfarin reversal – Exchange transfusion in TTP

Compatibility Testing

Identification of patient and collection of

appropriate samples for testing

Testing of the patient sample and review of

past blood bank records

Selection of appropriate donor units

Crossmatching

Prior to Transfusion

Informed consent

Component selection

Proper documentation and

completion of request forms

Positive patient identification and

blood taking (no pre-labeling)

Patient Preparation

Explain how the transfusion is going

to be given

Venous access

Assemble all necessary equipment

Premedication if required

Equipment

Needles and cathethers

preferably 18 to 20G cannulae

Infusion set

must have an inline 170µm filter

change set after 4 hours of

infusion

Continue..

Blood warmers

– routine warming not warranted unless

infusion exceeds 100ml/min

IV solutions

- ONLY normal saline

Starting The Transfusion

Correct patient

Confirm identity of blood unit

recipient identification

unit identification

ABO and RhD groups

expiration date

Document start transfusion time and

person starting the transfusion

Monitoring Patient During

Transfusion

Close monitoring for first 15 mins

Continue at least 1/2 hourly

monitoring up to 1 hour after

completion

Duration of infusion should not

exceed 4 hours

Completing the transfusion

Record time of completion

Continue monitoring for at least 1

hour after completion of the

transfusion

Return empty blood bags