Académique Documents
Professionnel Documents
Culture Documents
The procedure
can be done for
treatment or
transfusion
purposes.
Blood Preservation
• Whole blood or red cells
1-Liquid phase storage : 1-6º C
• 63 ml anticoagulant-preservation liquid/unit
duration of preservation
– ACD: 3 weeks
– CPD: 3 weeks
– CPD-A1: 35 days
– RBC concentrate with SAG-Mannitol : 7 weeks
2- Frozen storage of red cells
• -80 to - 196 º C , with glycerol etc: Years
Blood Preservation
• Effects of storage
– Red cells: ATP, 2-3 DPG,
osmotic fragility and oxygen affinity
– Plasma : Hb, K, NH3 :
pH:
– Platelets: Lost in 2 days
– Coagulation factors:
Eg:
• FV: adequate levels for about 5 days
• FVIII: Below 80% of original level after 1-2 days
• FXI: Less than 20% of original level after 7 days
Blood Preservation
• Platelets:
– liquid phase :
1 - 5 days,
room temp.,
avoid light exposure
kept on special agitator
• Plasma : Use fresh or freeze
– frozen at -18 º C within 8 hrs of collection
Blood components & products
• Cell containing components
– Red cells:
• Whole blood( fresh or not)
• Red cells: packed red blood cells
washed red blood cells
frozen red blood cells
leukocyte – reduced red blood cells
– Platelets: Random donor platelets
Apheresis platelets ( single donor platelets)
– Granulocytes or mononuclear cells
– Peripheral blood progenitor cells
Blood components & products
• Platelets:
Thrombocytopenia due to decreased platelet production
Platelet count/mm3 Bleeding /surgery Indication for plt transfusion
> 50.000, No No
< 50.000 Yes Yes
10.000-20.000 No No
(if there is bleeding/fever/DIC/plt dysfunction) Yes
< 10.000 Yes or No Yes
Some special conditions about platelet
transfusion
Disease status may change Practical issues
the transfusion effectiveness: • ABO matched platelets have a
• DIC longer in-vivo life span after
transfusion
• Hypersplenism • Use Rh- platelets for Rh-
• Sepsis recipients (to prevent Rh
immunisations) or use anti-
• Allo-immunisation Rh(D) Ig if Rh+ component
used in such recipients
Cotraindicated in Thrombotic
Thrombocytopenic Purpura: Used
only in high risk bleeding
• Cryoprecipitate
– Includes FVIII, vWF, FXIII, fibrinogen and
fibronectin
– 80-120 units of FVIII,
≥150 mg fibrinogen and 20-30 % of FXIII that
is in one unit of plasma
– Can be used for the purpose of replacing the
deficient state of these factors in case of
bleeding or surgery
Practical Issues
• Is there a need for transfusion?
• Which product should be used?
• Number of units?
• Re-check the blood types of the patient and donör
and be sure about the cross match
• Read label, ID, inspect the product
• Is irradiaton necesssary?
• Temperature?
• Filters?
• Flow rate ? (start 5 ml/min-15 minutes , the rest 200-500ml/hr)
• Drugs ?
Transfusion Reactions
• Immunologic reactions
• Non-immune reactions
or
• Acute reactions
• Late reactions
Hemolytic reactions