Platelets

 Used to prevent spontaneous bleeding or stop established bleeding in thrombocytopenic patients.

 Prepared from a single unit of whole blood.
 Due to storage at RT it is the most likely component to be contaminated with bacteria.
 Therapeutic dose for adults is 6 to 10 units.
 Some patients become "refractory" to platelet therapy.
 Expiration is 5 days as a single unit, 4 hours if pooled.
 Store at 20-24 C (RT) with constant agitation.
 D negative patients should be transfused with D negative platelets due to the presence of a small number of
RBCs.

Apheresis Platelet Concentrate

 Used to decrease donor exposure, obtain HLA matched platelets for patients who are refractory to RD-PC or
prevent platelet refractoriness from occurring.
 Prepared by hemapheresis.
 One pheresed unit is equivalent to 5-6 RD-PC.
 Store at 20-24 C (RT) with agitation for 5 days.
 D negative patients should be transfused with D negative platelets due to the presence of a small number of
RBCs
 One bag (unit) from one donor
 One unit is a therapeutic dose
 Volume approximately 250 ccs

Granulocytes
 Primary use is for patients with neutropenia who have gram negative infections documented by culture, but are
unresponsive to antibiotics.
 Therapeutic efficacy and indications for granulocyte transfusions are not well defined.
 Better antimicrobial agents and use of granulocyte and macrophage colony stimulating factors best for adults,
best success with this component has been with babies
 Daily transfusions are necessary.
 Prepared by hemapheresis.
 Expiration time is 24 hours but best to infuse ASAP.
 Store at 20-24 C.
Fresh Frozen Plasma (FFP)
 Used to replace labile and non-labile coagulation factors in massively bleeding patients OR treat bleeding
associated with clotting factor deficiencies when factor concentrate is not available.
 Must be frozen within 8 hours of collection.
 Expiration
 frozen - 1 year stored at <-18 C
 frozen - 7 years stored at <-65 C
 thawed - 24 hours
 Storage temperature
 frozen -18 C, preferably -30 C or lower
 thawed - 1-6 C
 Thawed in 30-37C water bath or FDA approved microwave
 Must have mechanism to detect units which have thawed and refrozen due to improper storage.
 Must be ABO compatible
Pooled Plasma/Solvent Detergent Treated
 Most recently licensed product.
 Prepared from pools of no more than 2500 units of ABO specific plasma frozen to preserve labile coagulation
factors.
 Treated with chemicals to inactivate lipid-enveloped viruses.
  Contains labile and non-labile coagulation factors but lacks largest Von Willebrand’s factor multimers.
 Used same as FFP.
 Safety concerns
 Decreases disease transmission for diseases tested for.
 Doesn’t inactivate viruses with non-lipid envelopes: parvo virus B19, hepatitis A, and unrecognized pathogens
Cryoprecipitated (AHF)
 Cold insoluble portion of plasma that precipitates when FFP is thawed at 1-6C.
 Cryoprecipitate contains high levels of Factor VIII and Fibrinogen, used for treatment of hemophiliacs and Von
Willebrands when concentrates are not available.
 Used most commonly for patients with DIC or low fibrinogen levels.
 A therapeutic dose for an adult is 6 to 10 units.
 Can be prepared from WB which is then designated as "Whole Blood Cryoprecipitate Removed" or from FFP
 Plasma is frozen.
 Plasma is then thawed at 1-6 C, a precipitate forms.
 Plasma is centrifuged, cryoprecipitate will go to bottom.
 Remove plasma, freeze within 1 hour of preparation

Cryoprecipitate (CRYO), Factor VIII or Anti-Hemophilic Factor (AHF)

 Storage Temperature
 Frozen -18 C or lower
 Thawed - room temperature
 Expiration:
 Frozen 1 year
 Thawed 6 hours
 Pooled 4 hours
 Best to be ABO compatible but not important due to small volume

Autologous - derived from organisms of the self; same individual; "autologous blood donation"
Heterologous - derived from organisms of a different but related species; "a heterologous blood donation”
Apheresis- Greek work meaning “take out”
-The process of removal of whole blood from a donor or patient, separating out specific portions, and
returning the other portions to the donor/patient
Can be done for
• Harvesting specific components for transfusion (plasma, platelet, red cells)
• Removal of specific pathologic substances

Cytapheresis- To harvest specific cellular components such as platelets, granulocytes or red cells.
Plasmapheresis- To harvest plasma only and return back the cellular components to the donor/patient

I- TYPE OF BLOOD DONATION

Blood are collected in the blood bank and there are three blood types:

1. WHOLE BLOOD DONATION

2. APHERESIS DONATION
3. AUTOLOGOUS BLOOD DONATION

II- DONOR SECLECTION

Two crucial factors for safe blood products
i. Accurate donor screening or selection
ii. Accurate laboratory testing on each unit collected
PRINCIPLES OF DONOR SELECTION
 iii. Giving blood does not harm the donor (must be in a good health)
iv. Donated blood loss is restored rapidly and completely
v. The blood must not harm the recipient

III- DONOR SCREENING (1,2,3)

1. Registration of the donor
Demographic date:
• Full name, address, Gender, Age (18-55 years)
• Date of last donation if any
» Whole blood should be 3 months
» Apheresis 2 weeks
» Autologous depends on the requirement
• Weight
» Should be >45 Kgs
2. Medical history
• Medical history should be taken by trained health care professional Who CANNOT donate?
Life long 1 year 6 Months
х Abnormal bleeding disorder o Surgery o Tattooing or body
х Heart, Kidney, Liver Disorder o Typhoid piercing
х Thyroid disorder o Dog bite o Dental extraction
х Mental disorders o Unexplained weight o Root canal treatment
х Tuberculosis loss o Malaria
х Asthma o Continuous low grade o Vaccination
х Cancer fever
х Insulin dependent diabetics
х Uncontrolled High blood pressure (BP)

Female donors cannot donate blood……

• During pregnancy
• After delivery for one year
• When lactating
• During menstrual period and for 7 days thereafter
Male donors cannot donate blood……
• If consumed Alcohol in the previous 24 hours

3.Physical Examination
 Determination of hemoglobin
 Males Hb: >12.5 g/dl
 Female Hb: >12.0 g/dl
 Pulse (50-100 beats/min)
 Blood pressure (Maximum 140/90 mm Hg)
 Temperature (Maximum 37.5 0C)
 Donor weight
1. Minimum 45 Kgs
2. Amount of blood to be drawn (Donor wt. in Kg÷50) X 45

V- POST DONATION INSTRUCTIONS

• After donation, please rest in the donation chair for 10 minutes before getting up
• Eat and drink something before leaving and during the next 4 hours
 • If there is bleeding from the site where the needle was placed raise your arm and apply pressure
• If you feel dizzy or faint, lie down or sit down, placing your head lower than your knees
• If either bleeding or faintness persists, return to blood bank

VI- Screening tests for the blood donated

Testing at Blood Bank for Transfusion Transmissible Infections (TTIs)
Blood collected is screened using highest quality screening tests for 5 TTIs
• HIV
• Hepatitis B
• Hepatitis C
• VDRL (syphilis)
• Malaria
VII- Blood Products / Components & their uses
Blood collected is screened for TTIs (infections) & SAFE blood, is separated into components & stored for issue to
patients.
• Used of Whole blood
– For Exchange Transfusion in Babies
– Accident Victims
– Complicated Delivery cases
– Some specific surgeries
• Uses of Blood Components
– Red Cells (for anemia)
– Fresh Frozen Plasma (for clotting disorders, burns)
– Platelets/Platelet rich plasma (for cancer)
– Cryoprecipitate (for clotting disorders)
– Cryosupernatant (for burns)

VIII- Screening test for donors blood prior to transfusion

• Infection screening
• VDRL (syphilis)
• HbsAg
• Anti HIV
• Anti HCV
• Malarial parasite
• Grouping and reverse grouping
• Cross matching
IX- Storage of blood
• Series of changes occur in vitro that alters the physiological properties to ensure that blood retains its in vivo
environment
• These physiological changes involve:
• Anticoagulants
• Preservative
• Characteristics of plastic bag
• Storage temperature
• Shipping and transport conditions

Anticoagulation and preservatives for blood products

• To ensure the viability and stability of the products
• To inhibit growth of microorganisms
• To prevent clotting of the product
• Examples for anticoagulants and preservation: Citrate, Citrate-dextrose and Acid-citrate-dextrose

Storage changes in blood

 • In vivo, red cells are carried and protected by the plasma, which helps
• Regulated temperature
• Controlled pH
• Adequate glucose supply
• Removal of metabolic waste
– In protected environment life span is 110-120 days
– Lowering of temperature and preservatives help in reducing the changes but changes do occur and
known as “storage lesion”

Appropriate storage temperatures

• WBC and packed RBC 1 to 60C
• Plasma ≤ -180C
• Platelets 20 to 240C

Benefits to Donor of blood donation

Health benefits:
Regular donation (2-3 times a year….)
– Lowers cholesterol
– Lowers lipid levels
– Decreases incidence of heart attacks, strokes
Donor is also eligible to receive one FREE unit of blood if needed for
– Self
– Spouse/ Child/ Parents, and
– Even friends