COMPONENT PREPARATION

Introduction Apheresis
• Blood donation can provide multiple • It involves centrifugation of whole blood at the • Apheresis plasma can collect up to 1 L,
components for transfusion therapy: donor's bedside, returning the blood fractions approximately 3 to 4 times the volume obtained
RBCs, platelets, fresh-frozen plasma, that are not collected. from a single whole blood donation.
cryoprecipitate, and derivatives of • Apheresis donations can collect larger • Apheresis double-red blood cells can collect
plasma. quantities of target components compared to up to 2 units, double the amount obtained from a
• Components can be prepared by either collecting whole blood. single whole blood donation.
transforming whole blood into • Apheresis platelets can collect up to three • Apheresis collections can be combinations of
components using centrifugation or by adult doses or 18 times the quantity obtained platelets and plasma, platelets and red blood
collecting targeted components through from a single whole blood donation. cells, or plasma and red blood cells.
apheresis.

Blood Product Manufacturing

Whole Blood Red Blood Cells Platelets
• 14:100 - 14mL of anticoagulant-preservative • RBCs are separated from whole blood • Platelet components can be produced from
for every 100 mL of whole blood. through centrifugation, apheresis, or whole blood donations through apheresis,
• Whole blood transfusions provide both sedimentation. where each component contains 1 adult dose
oxygen-carrying capacity and volume • RBC components are typically prepared from a single donor.
expansion. shortly after donation to prioritize the • Apheresis platelet collections are increasing,
• When stored as whole blood, the shelf life manufacture of other time-sensitive blood while the manufacture of platelets from
depends on the anticoagulant / preservative components such as platelet concentrates, whole blood is decreasing in the United
used. frozen plasma, or cryoprecipitate. States.
Anticoagulant / Shelf-life (WB) • RBC components without additive solutions • Random-donor platelets (RDPs) derived
Preservative have a shelf life (same as WB) of: from whole blood are relatively inexpensive to
ACD-A o 21 days (CPD, CP2D, ACD-A) manufacture.
CPD 21 days o 35 days (CPDA-1) • Single-donor platelets (SDPs) obtained
CP2D • The addition of an additive solution through apheresis are indicated for patients
CPDA-1 35 days (with additive) extends the shelf life to 42 unresponsive to random platelets or to limit
*Acid-citrate-dextrose formula A (ACD-A) days exposure from multiple donors. (1 adult dose
*Citrate-phosphate-dextrose (CPD) from a single donor)
*Citrate-phosphate-double dextrose (CP2D)
*Citrate-phosphate-dextrose-adenine (CPDA-1)
Leukoreduction Plasma Cryoprecipitate
• The process of removing WBCs from blood or • Plasma from whole blood donations can be • Cryoprecipitated antihemophilic factor
blood components before transfusion, with the processed into different components, (AHF) is a concentrate of factor VIII, along
aim of reducing transfusion reactions and including fresh-frozen plasma (FFP) and with other proteins like fibrinogen, factor XIII,
transmission of infections. plasma frozen within 24 hours (PF24), vWF, cryoglobulin, and fibronectin.
• Leukoreduction can be performed prestorage depending on the time of freezing. • Cryoprecipitate-reduced plasma (CPP) is
(shortly after collection) or at the patient's • FFP contains maximum levels of both stable the plasma from which cryoprecipitate has
bedside during infusion. and labile clotting factors been removed, containing residual albumin,
• Prestorage leukoreduction is more common • PF24 has slightly reduced levels of factor VIII factors II, V, VII, IX, X, XI, and ADAMTS13.
and involves using special filters to achieve at but maintains normal levels of other stable • Cryoprecipitate and CPP are prepared from
least a 99.9% removal of leukocytes from proteins. thawed fresh-frozen plasma (FFP) at 1° to
RBCs and WB. • Liquid plasma (LP) has variable factor levels 6°C
• Leukoreduced blood components have shown and is stored in a liquid state at 1-6°C. • Separation:
to reduce febrile non-hemolytic transfusion • Thawed FFP and PF24 can be stored at 1° o Cryoprecipitate – centrifugation and
reactions, alloimmunization to leukocyte to 6°C for up to 24 hours, and if not refrozen
antigens, and protect against cytomegalovirus transfused within the initial 24-hour period, o CPP – stored for up to 24 hours.
(CMV) transmission. they can be stored for up to 5 days but • Transfusion:
labeled as "thawed plasma." o Cryoprecipitate – within 6 hours of
• Thawed plasma cannot maintain therapeutic thawing
levels of labile clotting factors. o CPP – within 24 hours if labeled as
thawed plasma.
• Used for / in:
o Cryoprecipitate – Factor XIII
deficiency, hypofibrinogenemia,
hemophilia A, and von Willebrand's
disease
o CPP – Thrombotic Thrombocytopenic
Purpura (TTP) cases or as a source of
remaining factors after cryoprecipitate is
harvested.

Dimasacat, Jeremiah S. | MED206

Blood Banking
 Granulocyte Concentrates Aliquots Washing
• A granulocyte component should contain at • Aliquoted blood products are commonly used • RBCs and platelets are stored in solutions
least 1 × 1010 granulocytes, which can be for transfusions in neonates and infants with containing additive solution, residual plasma,
measured using an automated hematology small blood volume. and anticoagulant.
analyzer as long as the results are within the • Aliquots are prepared by attaching a small • Washing, the process of removing the
linearity limits. container to the finished component using a extracellular solution and replacing it with
• Dilutions may have to be considered at higher sterile connection device, and the desired normal saline, can be done using automated
WBC concentrations volume is delivered into the container. devices or manually with a centrifuge.
• Aliquots of RBCs, platelets, and plasma • Washed RBCs can be stored for up to 24
can be prepared using closed systems, hours at 1° to 6°C
retaining the outdate of the original • Washed platelets must be transfused within
component, or open systems, which must be 4 hours and are stored at 20° to 24°C.
transfused within 24 hours.
Irradiation Pooling Frozen, Deglycerolized RBCs
• It is performed to prevent transfusion- • Pooled blood components allow for multiple • RBCs can be frozen with glycerol as a
associated graft-versus-host disease (TA- components to be transfused together based cryoprotective agent, dating back to the
GVHD), which can occur in on the patient's needs. 1950s.
immunocompromised patients receiving bone • Pooled cryoprecipitate can be prepared • Frozen RBCs can be stored for up to 10
marrow or stem cell transplants, fetuses during manufacturing or by pooling single years for patients with rare phenotypes,
undergoing intrauterine transfusion, and frozen units after thawing, with usage time autologous use, and military blood
recipients of blood components from blood limits. inventories.
relatives or HLA-matched donors. • Pooled plasma can be combined into a large • Cryoprotective agents can be penetrating
• Irradiation damages the nucleic acid of bag for therapeutic plasma exchange (e.g., glycerol) or nonpenetrating (e.g.,
donor T lymphocytes in the blood procedures, requiring multiple liters at times. hydroxyethyl starch, dimethylsulfoxide)
components, preventing their proliferation and • Pooled platelets are created by combining • Different methods can be used for
immune response against the patient's multiple units, typically six, into one bag for cryopreservation (high-glycerol or low-
tissues, thereby reducing the risk of TA- storage, with a time limit for transfusion. glycerol) with variations in equipment, storage
GVHD. • Reconstituted whole blood involves pooling temperature, and freezing rate.
• Recommended gamma irradiation dose: red blood cells and plasma to create a • High Glycerol method involves a slow,
o Minimum of 25 Gy (central portion) component suitable for neonatal exchange uncontrolled freezing process using a
o No less than 15 Gy (any part) transfusions, with hematocrit levels monitored mechanical freezer at -65°C or below, widely
• Irradiated RBCs have an expiration date of to ensure the desired range is achieved. used due to its simplicity and less delicate
28 days. handling. It requires a larger volume of wash
• The expiration date of platelets and solution for deglycerolization. (40% weight per
granulocytes is not affected by irradiation. volume)
• Low Glycerol method requires a rapid,
controlled freezing procedure using liquid
nitrogen (N2) at -120°C or below. Due to
minimal glycerol protection, temperature
fluctuations during storage can lead to RBC
destruction. (20% weight per volume)

WHOLE BLOOD

PACKED RBC PLATELET-RICH PLASMA

(PRBC) Soft / Light spin (PRP)
(2-3 mins | 3,200 RPM) Heavy / Hard spin
Transfusion
(5 mins | 3,600 RPM)
PLATELET PLATELET-POOR
CONCENTRATE PLASMA (PPP)
Freezer (-18⁰C or -65⁰C)

FROZEN PLASMA FRESH FROZEN

(PF24) PLASMA
Fractionation Slow thaw (1-6⁰C)

PLASMA CRYOPRECIPITATE
DERIVATIVES

Dimasacat, Jeremiah S. | MED206

Blood Banking
 Component Shelf-Life Storage Temperature Indication for Use
Whole Blood (Depends on anticoagulant) 1-6⁰C Volume expansion
CPD 21d ↑O2
CPDA-1 35d
CP2D 21d
Whole Blood Irradiated Original expiration / 1-6⁰C Prevent GVHD
28 days from irradiation Volume expansion
↑O2
RBCs CPD 21d 1-6⁰C ↑O2
CPDA-1 35d
CP2D 21d
ACD 21d
AS 42d
RBC’s Irradiated Original outdate / 1-6⁰C Prevent GVHD
28 days from irradiation ↑O
RBC Leukoreduced Closed: Same (28 days) 1-6⁰C Febrile reaction
Open: 24 hours ↑O
Washed RBCs 24 hours 1-6⁰C IgA-negative persons
Frozen RBCs 10 years ≤ -65⁰C Rare phenotypes
RBC Deglycerolized 24 hours 1-6⁰C Rare phenotypes
↑O2
Platelets, RD 5 days 20-24⁰C Thrombocytopenia
DIC
Bleeding
Platelets, SD 5 days 20-24⁰C Platelet refractoriness
Platelets, Irradiated 5 days 20-24⁰C Prevent GVHD
Platelets, Pooled 4 hours 20-24⁰C Thrombocytopenia
DIC
Bleeding
Platelets, Leukoreduced 5 days 20-24⁰C Febrile reactions
FFP 1 year -18⁰C Coagulation deficiency
7 years -65⁰C Liver disease
DIC
Massive transfusion
PF24 1 year -18⁰C Coagulation deficiency
7 years -65⁰C Liver disease
DIC
Massive transfusion
Cryoprecipitate Frozen: 1 year -18⁰C Hemophilia A
Thawed: 6 hours 20-24⁰C vWD
Pooled: 4 hours FXIII deficiency
Fibrin sealant
Hypofibrinogenemia
Granulocytes 24 hours 20-24⁰C Neutropenia <500 PMN/uL
Granulocytes, Irradiated 24 hours 20-24⁰C Prevent GVHD
Neutropenia
*GVHD – Graft versus Host disease; RD – Random donor; SD – Single donor; FFP – Fresh-frozen plasma; PF24 – Plasma frozen within 24 hours

1 unit of cells Increases HGB (1 g/dL)

Increases HCT (3%)
Platelets, RD ≥ 5.5 x 1010 Platelets
Platelets, SD ≥ 3 x 1011 Platelets
Granulocytes ≥ 10 x 1010
Leukoreduction < 5 x 106

Dimasacat, Jeremiah S. | MED206

Blood Banking