BLOOD

&

BLOOD PRODUCTS

Whole Blood

Red Blood Cells

Plasma

Leuko-reduced RBC

Washed RBC

Irradiated RBC

Platelets Fresh Frozen Plasma

Cryoprecipitate

Derivatives

Albumin

Immunoglobulin

Factors VIII & IX

Compose of RBC, plasma, WBC, platelets Restores blood volume and oxygen carrying capacity Maximise use of WB: Preparation of specific blood components

and plasma derivatives Platelets not functional and clotting Factors V and VIII are

greatly reduced

Indication Extensive bleeding to replace the loss of both red cell mass and

plasma volume Massive transfusion: such as major trauma case, certain surgical

procedures

Cellular Components – Red Blood Cell Products Platelets

Plasma Components – Fresh Frozen Plasma Cryoprecipitate

Plasma Derivatives – Albumin Immunoglobulin

Factors VIII, IX

Cellular Components – Red Blood Cell Products Platelets

Plasma Components – Fresh Frozen Plasma Cryoprecipitate

Plasma Derivatives – Albumin Immunoglobulin

Factors VIII, IX

Most plasma removed from whole blood Provide oxygen-carrying capacity without unnecessary volume Platelets removed Lack of clotting factors in RBC: 1 FFP given every 4 units

transfused. High volume transfusions result in decreased clotting factors

 Indication Anaemia Blood loss during surgery Thalassaemia

Washed with sterile normal saline to remove most of the plasma proteins, antibodies and platelets

Not leukoreduced –some leukocytes removed but not enough to prevent alloimmunization

Shelf-life of 24hrs – preparation in an open system and most of the anticoagulant-preservative solution removed.

Indication Patients with recurrent febrile reactions Urticarial reactions Anaphylactic reactions

Prepared by filtration method: Reduce leukocyte count to less than 5 x 106

Indication Prevent febrile nonhaemolytic transfusion reactions due to donor leukocytes Decrease post-transfusion reactions due to HLA

alloimmunization Reduce transmission of CMV infections, since

CMV lives in WBCs

Gamma irradiation inactivates donor lymphocytes Graft vs host disease (GVHD) is reduced in

immunocompromised or immunodeficient patients

Indications Prevention of post-transfusion GVHD eg bone

marrow transplant recipients

RAD-SURE indicators show if a blood bag is irradiated or not

Anticoagulants - Prevent blood clotting

Preservatives - Provide cells with nutrients during storage; maintain red cell viability and function

CPDA-1 Citrate – Anticoagulant (binds to calcium)

- Calcium essential component of clotting cascade - Binding to calcium decreases clotting ability 

Phosphate – Maintain 2,3-diphosphoglycerate (2,3-DPG) levels in red cell

- 2,3-DPG essential for movement of oxygen from RBCs to body tissues 

Dextrose – Sugar substrate needed to generate ATP

Adenine – Synthesis of ATP allowing longer shelf life of 35 days

SAGM – Sodium chloride, Adenine, Glucose and Mannitol Nutrition source for red cells Supports integrity of red cell membrane to reduce haemolysis Maintain high ATP levels in RBCs Extending shelf life from 35 to 42 days Lowers viscosity = faster transfusion

Compose of platelets, WBC and plasma Aid in clotting Viable for 5 days Maintained at 20-24°C with constant agitation Cold temperatures and lack of agitation decrease the viability of

the platelets

Indications Massive bleeding or undergoing invasive surgery Platelet dysfunction Thrombocytopenia - platelet count

Cellular Components – Red Blood Cell Products Platelets

Plasma Components – Fresh Frozen Plasma Cryoprecipitate

Plasma Derivatives – Albumin Immunoglobulin

Factors VIII, IX

Plasma Contains all coagulation factors including

labile Factors V and VIII No platelets and RBCs Stored at -30°C for up to 12 months

Indications Treat bleeding due to coagulation factor

deficiencies eg. massive transfusion Plasma exchange – Treatment of TTP

(Thrombotic thrombocytopenic purpura ) patient’s plasma is replaced by donor plasma

Fibrinogen Factors VIII and XIII von Willebrand’s factor Prepared by freezing plasma at -70°C followed by thawing at 4°C. Once thawed,

the precipitate that forms is centrifuged to sediment the cryoprecipitate

Indications Fibrinogen deficiency Treatment of hemophilia A (Factor VIII deficiency) von Willebrand’s disease Massive haemorrhage

Cellular Components – Red Blood Cell Products Platelets

Plasma Components – Fresh Frozen Plasma Cryoprecipitate

Plasma Derivatives – Albumin Immunoglobulin

Factors VIII, IX

Prepared by fractionation of plasma No coagulation factors or blood group antibodies 5% and 20% albumin solutions

Indications Hypovolaemia – decrease in blood plasma due to burns, bleeding.

Eg. Severe burns, act as volume expansion by replacing protein loss from burn site

Hypoalbuminaemia - Liver failure

Compose of IgG antibodies – used in replacement IgG therapy

Maintain adequate antibody levels to prevent infections and confers passive immunity

Indications Treatment of hypoglobulinaemia (reduced

gamma globulins) or agammaglobulinaemia (absent)

Autoimune diseases such as immune thrombocytopenia

Prepared from fractionation of plasma that contains Factor VIII

Product treated to reduce risk of viral transmission

Indication

Control bleeding in haemophilia A patients with: congenital Factor VIII deficiency acquired Factor VIII deficiency Factor VIII inhibitors

Compose of: Factors II, VII, IX and X. Factor IX makes up 5% of this product

Indication Hemophilia B( Factor IX deficiency) Congenital Factor VII or X deficiency Factor IX inhibitors

Granulocyte concentrate Composed of: granulocytes, RBCs,

WBCs, plasma, platelets Shelf-life 24hrs at 20-24°C

Indication Severe neutropenia with severe bacterial

or fungal infections Fever unresponsive to antibiotic therapy

Rh Immune Globulin (RhIg) Protect Rh-negative mother who is

pregnant with Rh-positive infant Usually given in pregnancy and

immediately after birth

Indication Prevention of Rh(D) HDN

AND MORE!!!

Antithrombin III

Alpha-1-proteinase inhibitor

Fibrinogen

Thrombin

Protein C

(Too many to list)

Types of blood donation: Whole blood donation Apheresis donation: Plasma or platelet donation

Advantage of apheresis donation Donations can be made every month (whole blood donations

- 3mths) Allows larger amount of platelets to be collected from a

single donor compared to whole blood donations Minimise patient’s exposure from multiple donors’ blood