Blood Transfusion Science

What are the storage requirements for platelet concentrates?

(1 mark)

Patients with thrombocytopaenia need transfusions

of platelet concentrates to prevent or stop bleeding.

Storage temperature Shelf life Comments

20–24 ºC 5 days Platelets components must be

agitated gently and continuously in
a single layer on a platelet agitator.
Red Cells

Storage temperature Shelf life Comments

2–6 ºC Red cells: 42 days All blood refrigerators, including

theatre and other holding
Paediatric red cells: 35 days
refrigerators, must comply with AS
3864.1, AS 3864.2 (1, 2)
Washed red cells: 28 days
Storage temperature of Fresh frozen Shelf life Comments
plasma, cryodepleted plasma,
cryoprecipitate
At or below –25 ºC 12 months Freezers must comply with AS
3864.1 & 3864.2
(1,2).
What is Column Agglutination Technology (CAT) and what is it used for? (1 mark)

A new system for typing and screening blood,

Blood bank QC for CAT methods

is intended for quality control testing of routine blood bank reagents used in
manual column agglutination technology (CAT) blood typing and antibody
screening systems.
Give two (2) examples where mixed-field agglutination may be seen.
In a mixed field reaction, two different ABO groups are present in the same sample,
causing discordant ABO typing. The front and back type results are not as predicted

https://prezi.com/5651_rci6iwk/what-is-mixed-field-
agglutination/

1) Transfusion of donor red cells. For example, a blood group B individual

who has received a transfusion of group O donor red cells may show mixed
field agglutination with anti-B sera. His own group B red cells are
agglutinated by the anti-B sera while the group O donor red cells in his
circulation are unagglutinated
2) After an ABO mismatched stem cell transplant for example a blood group
O stem cell donor and a blood group A stem cell recipient.[2][3]
3) Weak expression of the A or B blood group antigen
4) In some diseases, for example leukaemia
Which is the most common ABO blood group in Australia?

According to the Australian Red Cross Blood Service, the

percentage of blood group frequency in Australia is:
•O positive – 40 per cent
•O negative – 9 per cent
•A positive – 31 per cent
•A negative – 7 per cent
•B positive – 8 per cent
•B negative – 2 per cent
•AB positive – 2 per cent
•AB negative – 1 per cent.
  What is FFP and what is it used for? (1 mark)
 Fresh frozen plasma
Deficiency of coagulation factors

Description:
FFP is plasma prepared from whole blood, either from the primary centrifugation of whole
blood into red cells and plasma or from a secondary centrifugation of platelet rich plasma. The
plasma is rapidly frozen to –25°C or colder within 8 hours of collection and contains normal
plasma levels of stable clotting factors, albumin, immunoglobulin and Factor VIII at a level of at
least 70% of normal fresh plasma.

Definite indications:
Replacement of a single coagulation factor deficiency, where a specific or combined factor
concentrate is unavailable or contraindicated.
Immediate reversal of warfarin effect where prothrombin complex concentrate is unavailable.
Thrombotic thrombocytopenic purpura.
Inherited coagulation inhibitor deficiencies where specific concentrate is unavailable.
C1 esterase inhibitor deficiency where specific concentrate is unavailable.
Cryoprecipitate has Fibrinogen & factor XIII deficiencies
For Used for hemophilia A & von Willebrand disease only if factor VIII concentrate or
recombinant factor preparations not available. Should contain 3 80 IU of factor VIII & 3 150 mg
of fibrinogen

Platelets: Severe thrombocytopenia or abnormal platelet function

• Blood of which type is usually available for emergency transfusion? (1
mark)

O Rh(D) Negative
List four (4) causes of anomalous results in ABO and/or Rhesus blood grouping reactions. (4
marks)

Fever; chills; shock;

1- Hemolytic, intravascular
renal failure; DIC; pain in chest, back, or flank

2- Febrile

3- Anaphylactic

4- Allergic
What percentage of people in the Australian population are D positive? (1 mark)

In Australia, approximately 83% of people will have Rh (D) on their red cells.
Their blood type is called Rh positive. The other 17% that do not have the D on
their red cells are called Rh negative. The percentage of Rh
negative people varies in different countries
What is the optimal temperature for storage of liquid red cells products prior to transfusion? (1
mark)
1-6 c
• How should a sample for crossmatching blood be labelled? (2 marks)

.
Specimen collected within 3 days of tf if pt has been pregnant or transfused in preceding 3
months
• Confirmation of identifying information on request form & specimen
• Check of blood bank records
• Repeat ABO type on donor
• Repeat Rh type on donor if unit is labeled Rh neg
(weak D not required)
• ABO type on recipient
• Rh type on recipient (weak D not required)
• Antibody screen on recipient
• Xmatch recipient serum & donor RBCs
• Retain pt specimen & unit segment at 1°–6°C for 7 days
after tf
• What anticoagulant is used in donor units of blood? (1 mark)

Acid citrate-dextrose (Formula A) ACD-A…. 21 days …Citrate prevents coagulation by chelating Ca2+.
Dextrose (glucose) supports ATP generation.
Used for apheresis.

Citrate-phosphate-dextrose CPD 21 days Higher pH preserves 2,3-DPG better. Better O2

delivery.

Citrate-phosphate-double-dextrose CP2D 21 days Contains 100% more glucose than CPD.

Citrate-phosphate-dextrose with adenine CPDA-1 35 days Adenine increases ADP, which increases
synthesis of ATP. Contains more glucose to
sustain cells during longer storage.

CPD (Citrate Phosphate Dextrose)

Constituents g/L Total g per pack
Sodium citrate dihydrate 26.3 1.75
Citric acid monohydrate 3.27 0.22
Monobasic sodium 2.51 0.17
phosphate dihydrate
Dextrose monohydrate 25.5 1.70
Anticoagulants for apheresis collections

Pack type Anticoagulant formulation

Haemonetics Corporation •Sodium citrate 4% solution:40 g/L
Product 420J-SL sodium citrate dihydrate
Contains 250 mL This is mixed ~1:16 with whole blood.
Used for plasma apheresis

Terumo BCT •ACD-A (Acid Citrate Dextrose)

Product 777967-966 solution:22.0 g/L sodium citrate dihydrate
Contains 750 mL •8 g/L citric acid monohydrate
Used for platelet apheresis •24.5 g/L dextrose monohydrate
This is mixed ~1:9 with whole blood.
Red cell additive solution (Macopharma LQT6283LB)

SAGM (Saline Adenine Glucose Mannitol)

Constituents g/L Total g per pack
Dextrose 9.0 0.95
monohydrate
Sodium chloride 8.77 0.92
Mannitol 5.25 0.55
Adenine 0.169 0.02
The volume of platelet additive solution contained in each unit of Platelets Pooled in SSP+ is
approximately 70% of total component volume.
The volume of platelet additive solution contained in each unit of Platelet Apheresis in SSP+ is
approximately 50% of the total component volume. Apheresis platelets manufactured by the Blood
Service are currently resuspended in plasma.

Constituents in 100mL SSP+

Manufacturer MacoPharma
Sodium chloride 405 mg
Sodium acetate trihydrate 442 mg
Sodium citrate dihydrate 318 mg
Sodium dihydrogenophosphate 105 mg

Di-sodium hydrogenophosphate 305 mg

Potassium chloride 37 mg
Magnesium chloride 30 mg
• What is the difference between the Groups A1 and A2 on a routine blood grouping? (1 mark)

There is no difference between the group A1 and A2 on a routine blood grouping.

• What blood group is known as the universal recipient? (1 mark)

In transfusions of packed red blood cells, individuals with type O Rh D

negative blood are often called universal donors.

Those with type AB Rh D positive blood are called universal recipients.

• List two (2) clinically significant antibodies other than anti D. (2 marks)

Anti E
Anti C
• Blood groups can be performed on tiles and in test tubes. List two (2) other ways of performing
blood groups. (2 marks)

To compare the ease of use and accuracy of 5 feline AB blood-typing methods:

card agglutination (CARD),

immune chromatographic cartridge (CHROM),

gel-based (GEL),

and conventional slide (SLIDE)

and tube (TUBE) agglutination assays.

Tube, Gel, and Solid-Phase testing