Enclonar, Kimberly / MLS 3A
Component Preparation
April 28, 2021
Meshane Bato-on, RMT
Goals of Blood Component Preparation
• To provide the optimal therapy to patients needing
blood transfusion
• Blood components are a lot safer than whole blood
• Blood component therapy = optimal therapy
• FDA Storage Lesion
o Collection • Biochemical changes that affect RBC viability and
o Testing survival
o Separation • At least 75% of original red cells in the recipients
o Labeling circulation within 24 hours and <1% hemolysis
o Storage • Neonates require "fresh" RBC products
o Distribution
• ↑ plasma Hgb, K+
• ↓ Viable cells, plasma pH and Na+, RBC ATP & 2,3-
Collection DPG
• Blood is collected in a primary bag which contains the
anticoagulant-preservative mixture Materials Needed
• Satellite bag = closed system • Swing Bucket centrifuge
• "Red Blood Cells Low Volume" • Refrigerator
o When the whole blood collection does not meet • Expressor
the volume requirements of the collection bag • Electric sealer
and anticoagulant has not been adjusted • Type of blood bag:
o 450mL = 63mL (300-404mL) o Single, double, triple, quadruple bags
o 500mL = 70mL (330-419mL)
o Can't make Blood Components
▪ Platelets • Packed RBC
▪ FFP o Leukoreduced RBC
▪ CRYO 1317 o Frozen RBC
o Washed RBC
Anticoagulant/Preservative Storage o Irradiated RBC
Limit • Plasma (light spin)
o Platelet Rich Plasma (heavy spin)
CPD/citrate-phosphate-dextrose 21
▪ Plt concentrate (pH 6.2)
CP2D/Citrate-phosphate-2-dextrose 21 □ Irradiated plt concentrate
CPDA-1/citrate-phosphate-dextrose-adenine 35 □ Leukoreduced plt concentrate
o Plt poor plasma
AS-1 (Adsol); AS-5 (Nutricel)/dextrose, 42
▪ Fresh Frozen Plasma/PF24
adenine, mannitol, saline
□ Cryoprecipitate
AS-3 (Optisol)/dextrose, adenine, saline, 42
citrate Blood Component Preparation
• Red cells move to the bottom because they are the
Dextrose Supports ATP generation by glycolytic heaviest component, whereas the platelets and
pathway plasma components remain on top.
o Light spin = short time, low RPM
Adenine Acts as a substrate for red cell ATP ▪ Platelet concentration
synthesis o Heavy spin = longer spin, high RPM
Citrate Prevents coagulation by chelating • Refrigerator = 1-6C
calcium, also protects RBC membrane • Plts = room temp with agitation or 20-24C
Sodium Prevents excessive decrease pH Heavy Spin Light Spin
biphosphate 5000g for 5min 2000g for 3min
Mannitol Osmotic diuretic acts as a membrane (PRBC, plt. Conc)
stabilizer 5000g for 7 min 3200rpm for 2-3min
(cryo, cell free plasma)
Anticoagulant adjustment in underweight donors 3200 rpm for 5min
• Allowable amount of blood to drawn in mL
Platelets: 20-25C Others: 1-6C
o
Checklist for Receiving Blood
• Amount of anticoagulant needed: • Transport temp: 1-10C
o • Temperature acceptable for component
• Appearance: Clots, discoloration, hemolysis
• Amount of anticoagulant to remove • Container closure
o • Attached segments intact: RBCs
Enclonar, Kimberly / MLS 3A
• Expiration date and time Washed RBCs
• Shipping list correct • Indicated for patients who react to the small amount
• Intact labels of plasma proteins that remain in a unit of RBCs.
• Reactions can be
Whole Blood o Allergic
• RBCs, WBCs, platelets, and plasma proteins with the o Febrile
anticoagulant-preservative solution o Anaphylactic
• 1-6C • IgA deficiency and clinically significant anti-IgA
• Storage time: will depend on additive • Intrauterine transfusion - fetus
• Related to circulatory overload • Saline Washing
• Whole blood is indicated for patients who are actively o 0.9% saline, 1000mL
bleeding and who have lost more than 25% of their • Storage temp: 1-6C
blood volume • Shelf life: 24hours after washing
• Increases • Anemia, IgA deficiency, PNH
o Hgb to 1g/dL
o Hct 3% Irradiated RBCs
• Hemostat - stopper • Viable T cells in cellular blood components may cause
• AS-1 = RBCs transfusion-associated GVHD, which is fatal in more
than 90% of affected patients
Packed Red Blood Cells • Graft-versus-host disease (GVHD)
• Erythrocytes o Immune condition that occurs in a patient after
• ↑ RBC mass = ↑Hgb deliver transplantation when immune cells present in
• ↑ Hgb to 1g/dL; Hct to 3% donor tissue (the graft) attach the host's own
• Open system = transfuse within 24hrs tissues
• Storage: 1-6C • 2500cGy, or 25Gy (center) - gamma radiation
• For: • 15Gy (delivered to any part of the blood unit)
o Sickle cell anemia • Storage temp: 1-6C
o Cancer • Shelf life: 28 days from irradiation
o Bleeding/Trauma • Intrauterine transfusion, immunocompromised
• Celsium 137 or Cobalt 60 isotopes
Leukoreduced RBCs o Ultraviolet irradiation
• Leukocyte-reduced RBCs are prepared with a method o X-rays
known to retain at least 85% of the original RBCs and o Radiochromic Film Label - Quality Control
reduce the leukocyte number in the final component • ↓ Atp, 2,3-DPG
to <5x106 in each unit • ↑ Potassium
• Prevent:
o TRALI Fresh Frozen Plasma
o Febrile-non hemolytic transfusion reactions • Contains all coagulation factors including labile
▪ Biological Response Modifiers (BRMs) - factors V and VIII
fever o Cold labile = 7, 11
o Transmission of EBV, CMV, Human T-cell Virus • Storage temp: ≤18C after thawing 1-6C
• Does not prevent graft vs host diseae • Shelf life: 12 months, after thawing within 6 hours
• Filtration - Leukocyte filters • Indication:
o Polyester or Cellulose acetate nonwoven fibers o For patients who are actively bleeding & have
• Done before storing Packed RBCs multiple clotting factor deficiencies
• FFP: Plasma frozen within 8 hours of collection and
Frozen RBCs stored at or below -18C for up to 1 year or stored at
• RBCs can be frozen for long-term preservation to or below -65C for 7 years
maintain an inventory of rare units or extend the • Plasma frozen within 8-24hours of phlebotomy (PF24)
availability of autologous units stored -18C or colder
• Freezing extends storage up to 10years from • Thawing - water bath
collection when stored at or below -65C
• Frozen in glycerol within 6 days of collection Cryoprecipitate
o 40% glycerol: ≤ -65C • Cryo Antihemophilic Factor contains: 8, vWF, 13,
o 20% glycerol: ≤ -120C Fibrinogen
o Storage: 10years after phlebotomy, 24 hours • Cryo-poor contains: 2, 5, 7, 9, 10, 11, ADAMTS 13 (use
after deglycerolization roman numerals)
o Anemia • Storage temp: ≤18C, after thawing room temp
• Deglycerolization o Frozen: 1 year
o Decreasing osmolar solutions of saline o Thawed: 6hr
▪ 12% saline o Pooled: 4hr
▪ 1.6% saline • Hemophilia A, vWD, Dysfibrinogenemia, Factor XIII
▪ 0.2% saline with dextrose deficiency
o Must be transfused after 24 hours • Thawed: 1-6C
o Check supernatant for remnants of glycerol and • Formation of white precipitate
hemolysis • Heavy spin
• Plasma Cryoprecipitate Reduced
o Refrozen at -18C or colder, 12-month expiration
date
Enclonar, Kimberly / MLS 3A
o Replacement solution for therapeutic Platelets
plasmapheresis for the treatment of thrombotic Random- • Contain a minimum of 5.5x1010
thrombocytopenic purpura donor plts • 20-24C with gentle agitation until
transfusion
• Shelf-life: 5 days
Apheresis Plts • Should contain a minimum of 3x1011
plts in 90% of the sampled units 20-
24C with gentle agitation until
transfusion
• Shelf life: 5 days
Pooled Plts • Accomplished by transferring the plt
concentrates into a transfer set
• 20-24C with gentle agitation until
transfusion
• Shelf life: 4 hours (due to open
system)
Irradiated • Made from either random donor or
Platelet Concentrate plts single donor
• Contraindicated: ITP, DIC, TTP
• Irradiation requirements the same
• Storage temp: 20-24C with RBC
• Shelf life: 5 days with agitation
• Prevent bleeding, quanti and quali plt disorders Plt • Febrile nonhemolytic reactions and
• Contain at least 5.5x1010 platelets and maintained at Leukocytes HLA alloimmunization leukocytes
pH ≥6.2 Reduced • Random Donor platelets: 8.3x105
• 1 unit should raise the plt count by 5000-10000/uL in leukocytes
a 75kg px
• For Apheresis
o Actively bleeding patients who are • General term for taking away targeted cell type
thrombocytopenic (<50,000/uL) • Cytapheresis - blood cells
o Cancer patients during chemotherapy • Plasmapheresis - plasma
o Thrombocytopenic preoperative patients • Storage temp: 20-24C
• Evaluation of the effectiveness of plt transfusions is • Shelf-life: 24 hours
important in determining whether the patient is • Neutropenia with infection
o Refractory or Unresponsive to the plt
transfusions
• Corrected Count Increment (CCI) of 5000/uL at
10mins to 1hour posttransfusion may indicate a
refractory state to plt therapy
