Blood Component:
gunshot wounds, accidents with active bleeding
Description:
a. Whole Blood: contains all blood elements plus anti-
coagulant-preservative
b. Red blood cells: units of WB with most of the plasma
removed
c. Platelets concentrates: from WB that have not been
allowed to cool below 20’C
a. PRP: separated w/in 4 hrs. after completion
of the phlebotomy or w/in the time frame
specified
d. Plasma: stored at -18’C or colder; used up to 5 years
after date of collection
a. Liquid plasma: not frozen but stores at 1-6’C
and transfused up to 5 days after expiration
date of WB
b. FFP: prepared from WB (primary
centrifugation or secondary centrifugation);
frozen within 8 hrs. of collection
c. Recovered plasma: converted plasma and
liquid plasma to an unlicensed component
(plasma for manufacture); processed into
derivatives such as albumin/ immune
globulins.
e. Cryoprecipitated AHF: cold-insoluble portion of
plasma that precipitates when FFP is thawed between
1 to 6 C.
f. Plasma cryoprecipitate reduced: cryoprecipitate
has been removed from plasma; stored at -18’C or
colder (12 month expiration date from date of
collection)
g. Granulocytes: by apheresis techniques or buffy coats
harvested from fresh WB (<1 x 10 )
3 
Collection:
 Target collection time: 4 to 10 minutes
 Platelets and FFP: up to 15 minutes
Centrifugation process:
 Done prior to preparation of blood component
 Separate into transfusable components such as
plasma, red cell, and platelets
 Plasma can be separated into cryoprecipitate
(patients with risk of bleeding through promoting blood
clotting)
 Platelets and red cells are leuko-reduced white cells
are removed to reduce possibilities of transfusion
reaction
 Requirement:
o Must be done 6-8 hours after collection
A. Heavy Spin
 5000 x g for 5 minutes yields platelet concentrate
and pRBC
 5000 x g for 7 minutes  Cryoprecipitate
B. Light Spin
 2000 x g for 3 minutes  Platelet rich plasma (PRP)
Blood components:
A. Whole Blood
 Preparation: Approximately 450 mL of blood with
anticoagulant (CPD or CPDA-1) 63 mL
anticoagulant
 A unit of blood must be transfused within 24 hours
if the seal on the bag is broken to remove plasma
o If not transfused, disregard immediately
 Indication: For actively bleeding patients such as
replace the loss of both RBC mass and plasma
volume in actively bleeding patients
o WB may be used for in neonates in
exchange transfusion
 Contraindication: not for patients with severe chronic
anemia
o Due to reduced amount of RBC but is
compensated by increased plasma volume
to restore total blood volume patients do
not need the plasma in whole blood can
adversely respond by developing pulmonary
edema and heart failure due to volume
overload
o PRBC only
 Dosage effect:
o 1 unit of WB increases:
 Hb: 1-1.5 g/dL
 Hct: 3-5%
 Storage temp: 1-6°
 Shelf-life: depends on the anticoagulant
o 42 days
B. Washed RBCs
 Patients who have history of allergic reaction or
antibody against plasma
o Prevent allergic reactions
 Preparation:
o Plasma is removed from WB after
centrifugation
o use of NSS to remove unwanted antibodies
 Storage Temperature: 1-6’C
Shelf-life: 24 hours discard when not used within
the time limit
 Indications:
o Patients with IgA deficiency and anti-IgA
antibodies
o Anemia
o Patients who have severe allergic
(anaphylactic) transfusion reactions to
ordinary units of RBCs
C. RBC aliquouts
 For pediatric patients (<4 months old)
o If WB is transfused, it will result to TACO
[Transfusion Associated Cardiac Overload]
o For neonates in the treatment of anemia
secondary to spontaneous fetomaternal
hemorrhage, obsterric accidents and internal
hemorrhage
 Anticoagulant: CPDA-1
 Storage Temperature: 1-6’ C
 Shelf-life: 24 hours
NOTE: Any blood components containing RBC, the storage
temperature is 1-6’C with the exception of Frozen RBCs (-
65’C)
D. Frozen RBCs
 Use to preserve rare blood types (e.g. Bombay
phenotype)
 Deglycerolization [avoid infusing hypertonic glycerol]
o Wash red cell with decreasing concentration
of saline [12 % NSS 1.6 % NSS  0.85%
NSS  add 0.2% dextrose]
 Storage temperature: -65’C
 Shelf-life: 10 years
E. Packed RBC  300 mL (volume/unit)
 Preparation: Each unit of pRBC’s contain  30,000-60,000 platelets/unit
approximately 250mL  Storage temperature: 20-24’C with continuous
o Prepared by removing 200 to 250 mL of agitation
plasma unit of WB  Shelf-life: 5 days
 Patients with symptomatic anemia but normovolemic  pH: 6.2 or higher
(↓ Hgb only)
 Storage: 1-6’C I. Platelet concentrate
 Shelf-life: 42 days  Preparation: Separated at RT by centrifugation from
o A pRBC that has been out of the refrigerator RBC’s within 6 hours of collection of WB
but was not used due to circumstances (e.g.,  PRP centrifuged, PPP supernatant is removed
death of the patient) can be refrigerated back leaves approx. 50 ml of plasma with the platelet
if it was only away for 30 minutes. Beyond 30 concentrate
minutes is not accepted back  Shelf-life: Stored at RT (20-24’C) with continuous
o Cells prepared in an open system must be gentle agitation (allows proper oxygen transport within
transfused within 24 hours platelets, maintaining proper pH)
o If cells are prepared using the close system ,
they have the same expiration date as the
original unit of the WB sterility is not
broken
 Average Hct: 65-80%
 Indication: increasing RBC mass requiring increased
oxygen carrying capacity
 Critical level: 6 g/dL or less hb immediate
transfusion  For adults: 6-8 units (single dose)
 Contraindication: not for well compensated patients in o Pooled specimen from different donor (in a
the case of chronic renal failure single bag) must be transfused within 4
 A unit of PRBC can increase: hours
10
o Hb level: 1 g/dL  Each unit: 5.5 x10 /L
o Hct level: 3%  Each unit must increase the count 5,000 to 10,000/uL
o In pediatric patient, a dose of 10 to 15 mL/kg in 70kg man
will increase:  Washed platelets using saline to remove plasma
 Hb: 2-3 g/dL proteins causing allergic reaction transfused within
 Hct: 6-9% 4 hours since it is prepared using open system
 Platelet concentrate is the most at risk with bacterial
F. Fresh frozen plasma contamination since it is stored at room temp.
 Patients with multiple clotting factor deficiency
J. Cryoprecipitate
 DIC
 Liver disease  Indicated with hemophilia, fibrinogen deficiency,
 Contains all the clotting factors except platelets vWD at ease the bleeding
 Storage condition:  Used primarily for fibrinogen replacement
o Frozen:  AABB: 150 mg of fibrinogen for each unit of
 -18’C (1 year) cryoprecipitate
 -65’C (7 years)  Component preparation: 5 units are pooled for a
o Thawed (prior to transfusion): single dose
 Subjected to a water bath at 37’C  Each pool (5 units): 750-1250 mg of fibrinoge
then is brought back in the ref  Derived from FFP
 1-6’C for 24 hours (or 5 days)  Components:
 Preparation: o Factor VIII (80 units)
o Must be frozen within 8 hours of collection o Fibrinogen (150 mg/dL)
o Plasma is immediately frozen at or below - o Factor XIII
18’C o vWF
 ABO compatible with the recipient’s red cell  Preparation:
o FFP thawed at 1-6’C  heavy spin 
G. Random-Donor Platelet (Whole blood-derived white mask at the bottom
platelets)  Storage:
 Preparation: Light spin to heavy spin o ≤18’C until thawing
10
 Yields 5.5 x10 platelets o After thawing: 20-24’C (RT)
 50-65 mL (volume/unit) o Never refrigerate or place in a cooler since
 5,000-10,000 platelets/unit clotting factors are sensitive to temperature
 Storage temperature: 20-24’C with continuous o Frozen: 1 year
agitation
K. Leukocyte-reduced RBC
 Shelf-life: 5 days
 pH: 6.2 or higher  Preparation: Average unit of RBC contains approx. 2
9
x 10 leukocytes
H. Single-donor platelet (Platelet apheresis)  Patients who manifests/develops febrile reactions
 Preparation: Light spin to heavy spin  Removal of leukocyte:

11
3.0 x 10 platelets (yields more than the Random- o Saline washing
donor platelet) o Filters
 Storage: 1-6’C o TRALI
 Shelf-life: o Transfusion related graft-vs-host disease
o Open system 24 hours o Transfusion related immune suppression
o Close system  same with WB (what is  Shelf-life:
indicated in the blood bag) o Closed system follows the same original
 Donor leukocytes may cause the following: unit of blood (expiration date)
o Febrile nonhemolytic transfusion reactions o Open system 24 hrs
o Transfusion-associated graft versus-host o Stored at 1-6’C disregard if not tested
disease (TA-GVHD) within 24 ho
o Transfusion-related immune suppression  may harbor:
o In addition, human leukocyte antigens (HLA) o CMV
are responsible for HLA alloimmunization o EBV
o Leukocytes may harbor cytomegalovirus o HIV
(CMV) o HTLV
 To reduce HLA alloimmunization and CMV  Leukocyte reduction filters reduce leukocytes
transmission, the leukocyte content must be reduced  Therapeutic uses:
6
to less than 5 x 10 /L o In addition to increasing RBC mass,
 Use of leukocyte reduction filters leukocyte poor RBC’s also minimize febrile
transfusion reactions in patients who have
leukocyte antibodies as well as reducing
CMV transmission

O. Frozen deglycerolized RBC

 Preparation: RBC’s to be frozen are collected in CPD,
CPDA-1
o Frozen within 6 hours from collection
 Stored up to 10 years
L. Irradiated blood  Deglycerolization:
 For bone marrow transplant o Thaw the cells at 37’C
 To prevent GvHD o Wash multiple times in a gradient
 Use of radiation concentration of saline (hypertonic
 Required radiation: 25-35 gamma rays concentrations isotonic solution containing
 Storage: 1-6’C glucose)
 Shelf-life: 28 days o One unit = 180 mL of cells
o Done when preparing for transfusion
M. Granulocyte concentrate  Shelf-life:
 For patients with absolute neutropenia, fever, o 1-6’C
unresponsive to antibiotic o Transferred within 2 hrs of deglycerolization
 Frozen with the use of glycerol
o High Glycerol
 Freezer temperature
 -65’C
 40% w/v
 Most recommended
 Storage temperature: 20-24’C w/o continuous o Low Glycerol
agitation  Freezer temperature
 Shelf-life: 24 hours Transfused ASAP because their  -120’C
half-life is only 6 hours  20% w/v
 Preparation: prepared by Leukapheresis or from a  Indications:
freshly drawn donor unit o Increase red cell mass
 Administer corticosteroids to donor 12-24 hours prior o Minimize febrile or allergic transfusion
o Increase the number of circulating reaction because it is washed with saline
granulocytes by pooling them from the decreasing allergic tendencies
marginating pool o Use of prolonged RBC blood storage
 HES/ Hydroxyethyl starch(sedimentating agent)  Allows for long term storage of rare blood donor units,
increases separation between WBC and RBC autologous units
facilitating the recovery of buffy coat o In the case of Bombay phenotype
 Dose (case to case):  Extended shelf-life: 10 years
o Adults: one WBC daily for 4 days or more  Once thawed, must be used within 24 hours ONLY
 Neonates: Once or twice
P. Factor VIII concentrate
N. WBC poor RBC  From fractionation and lyophilization of pooled plasma
 Preparation: 70% of the original WBCs removed and  Stored at refrigerated temperature and is
at least 70% of the original RBCs are left reconstituted with saline
 Methods of obtaining leukocyte poor RBCs  Indications:
o Centrifugation, filtration, and wasing o Treat patients with hemophilia
 Reduction is done to avoid the following:
o Febrile non-hemolytic transfusion reactions Q. Factor IX complex
o HLA alloimmunization  Prothrombin complex
 Prepared from pooled plasma using various methods
of separation and viral inactivation
 Contains:
o Factor II, VII, IX, and X
 Indications:
o Hemophilia B/Factor IX deficiency
o Factor VII or X deficiency (rare)
o Selected patients with factor VIII inhibitors or
reversal of warfarin overdose