Blood Component preparation and it disuse

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BLOOD
COMPONENT
PREPARATION AN
D ITS USE
DR A. I. GIREI

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OUTLINE
• INTRODUCTION
• BLOOD COMPONENTS
• BLOOD COLLECTION
• PREPARATION METHODS
• INDICATIONS
• CONCLUSION

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INTRODUCTION
• Blood products, components, derivatives
• Whole blood consists of cells, colloids
and crystalloids
• Whole blood transfusion is rarely done
nowadays
Advantages of component therapy
• Targeted therapy based on patient’s
need
• Optimization of blood resource
• Reduce risk of circulatory overload

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COMPONENTS
1. Whole blood
2. Red cells
• Packed red cells
• Red cell concentrate
• Leukodepleted red cells
• Red cells in additive solution
• Washed red cells
• Frozen red cells
• Irradiated red cells

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COMPONENT
S
3. Platelets
• Single-donor platelets
• Pooled platelets ( platelet
concentrates)
4. Plasma
• Fresh frozen plasma
• Cryoprecipitate
5. Granulocyte
concentrate

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BLOOD COLLECTION
Whole blood
• Collected in a primary bag containing
anticoagulants/preservative
• Satellite bags may be added
• One unit of donor blood processed to components
• Stored in blood bank refrigerator before separation ( not
more than 6hrs)
• Volume: 450-500ml
• Composition: RBCs, plasma, platelets, granulocytes

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PREPARATION
• Components have different relative densities
• Preparation done through
• Centrifugation of one unit of whole blood
• Apheresis
• Major equipment used
• Centrifuges
• Blood bags
• Plasma expressor
• Cell separators
• Refrigerators
• Sterile tubing sealer

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Primary blood bag with satellite bags

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Preparation of blood components
• Centrifuge a unit of whole blood using light spin to suspend the
components and make them settle out into RBC, WBC & platelet-
rich plasma(PRP)
• The platelet rich plasma (PRP) is separated and thereafter
centrifuged again for a longer time & harder spin to form platelet
poor plasma (PPP)
• Platelet is heavier than plasma & therefore settles at the bottom
of the bag and the PPP is harvested and frozen to solid within 8
hours of collection
• The frozen plasma can then be thawed at 1-6˚C, centrifuged and
plasma expressed leaving behind a precipitate known as
cryoprecipitate or "cryo" which can both be stored subsequently
at -18 ˚C

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Whole Blood
• Clinical indications for use of WB are now becoming extremely limited. Whole blood
comprises RBCs, WBCs, platelets and plasma (with anticoagulant).
• Used for massive transfusion to correct acute hypovolaemia such as trauma and shock,
exchange transfusion.
• 1 unit increases Hgb 1 g/dL and Hct 3%
• RARELY used today, platelets non-functional, labile coagulation factors gone.
• Must be ABO identical.
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Packed Red Cell
Components
• Prepared by sedimenting whole blood (WB) or centrifuging it to
remove 200-250ml of supernatant plasma from a unit of WB.
• This produces 200-250ml red cell concentrates with a
haematocrit of approximately 80% for non-additive (CPD), 60%
for additive (ADSOL).
• A unit increases patient’s Hb level by about 1g/dL (10g/L) and
haematocrit by 3%.
• It does not contain functional platelets or granulocytes and has
same O2 carrying capacity with W.B.
• It is used to treat symptomatic anaemia and routine blood loss
during surgery to increase patient’s red cell mass without
increasing their blood volume.

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Fresh Frozen Plasma
• Prepared by removing plasma from WB within 8
hours of collection and must be frozen within same
duration.
• It contains all clotting factors (labile and non-labile)
• Each unit of FFP measures 200-225ml
• Each unit elevates the level of each clotting factor
by 2-3% in adults
• Therapeutic dose: 10-15ml/kg

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Fresh Frozen Plasma
• The storage temperatures:
- frozen -18˚C, preferably -30˚C or lower
- thawed - 1-6˚C
- Thawed in 30-37˚C water bath.
• Expiration:
- frozen - 1 year if stored at <-18˚C.
- frozen - 7 years if stored at <-65˚C.
- thawed - 24 hours.
• Must have mechanism to detect units which have thawed and
refrozen due to improper storage.
• Must be ABO compatible.

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• FFP is thawed before transfusion at 30-37°C in a
water bath for 30-45 minutes and can then be stored
at 1-6°C and transfused within 24 hours.
Fresh Frozen Plasma

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Fresh Frozen Plasma
• Indications for FFP
- Replacement for isolated/multiple coagulation function deficiencies
- The reversal of warfarin therapy
- In the case of massive blood transfusion
- Antithrombin III deficiency treatment
- Correction of coagulopathy or liver disease
- Thrombotic thrombocytopenic purpura

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Cryoprecipitated antihemophilic
factor (AHF)
• The plasma is first frozen, then thawed at 1-6˚C
which results in the formation of a precipitate.
• The plasma is centrifuged, cryoprecipitate goes to
the bottom.
• Plasma is then expelled or removed and frozen at -18
˚C within 1 hour of preparation.

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FFP
Frozen
within 8
hours
Thawed
FFP
Cryoprecipitate
(VIII, vW)
Plasma cryoprecipitate reduced
(TTP, FII, V, Vii, IX, X, XI)
Thaw at 30-37°C
Store at RT 4 hrs
Refrozen with 24 hrs of
separation
Store at ≤18°C 1 yr
5-day expiration at 1-6°C

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Cryoprecipitate antihemophilic factor
(AHF)
Contents of cryo:
• Factor VIII (about 80 IU in each unit),
• Plasma (10-15ml)
• von Willebrand’s factor
• Fibrinonectin
• Fibrinogen (150 mg in each unit).
Used for treatment of hemophiliacs and Von
Willebrand disease when concentrates are
unavailable
Sometimes used in DIC

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Platelet concentrates
• Prepared from
• by single unit of whole blood by cytapheresis
(thrombocytapheresis)
• by separating PRP from a unit of WB within 8hrs of
collection and recentrifuged
• 40-60 mL of plasma is thereafter expelled into
another satellite bag after the re-centrifugation and
the remaining bag contains platelet concentrate
• It is the most likely component to be contaminated
with bacteria due to their storage at room
temperature

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Preparation of platelet concentrate
RBCs PRP
Plasma
Platelet
concentrate

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Platelet concentrates
• Each unit of platelet should elevate the platelet count by 5-
10,000x109
/L in a 75kg person
• Adult transfusion dose >240x109
/L
• Shelf life for single unit is 5 days as a single unit
• Shelf life for pooled units is 4 hours
• Platelet concentrates are best stored at 20-24˚C (RT) with constant
agitation
Indications
• Treat and prevent bleeding due to
thrombocytopenia/thrombocytopathy
• Hereditary disorders of platelet function
• Massive blood transfusion
 An Rh “D" negative patient should be transfused with Rh “D"
negative platelets due to the presence of a small number of RBCs.

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Granulocyte concentrate
• Rarely used because of
• Effective antibiotics
• Risk of CMV, febrile non-haemolytic reactions
• Single donor GCs has insufficient granulocytes and is heavily
contaminated by RBCs
• GC is obtained by single donor units or leukapheresis
• Expiration time is 24 hours but best to infuse ASAP and can
be stored at 20-24˚C for the time being
Indication: Severe neutropenia with bacterial or fungal
infection that is unresponsive to appropriate antibiotics

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CONCLUSION
Components, its preparation and its use are the cornerstones
in modern blood transfusion practice and indeed in health
care
It optimize the blood resources, minimize risks of
transfusions and targets patient's requirement

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THANK YOU FOR YOUR ATTENTION

Blood Component preparation and it disuse

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