CHPTER -NINE
Whole Blood ,Blood Components
and Derivatives
CH
Acknowledgements
Addis Ababa University
Jimma University
Hawassa University
Haramaya University
University of Gondor
American Society for clinical Pathology
Center for Disease Control and Prevention Ethiopia
Content
Whole blood,
Packed red cell
Plasma products
Platelet concentrates
Cryoprecipitate
Albumin
Immunoglobulin
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Learning objectives
At the end of this chapter, the student will be able
to:
Identify the different blood components and
derivatives used in transfusion
Mention the clinical indications for blood
component transfusion.
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9.1 Whole blood, blood components and
derivatives
Only human blood and its components are used
for transfusion into humans
Transfusions are the introduction of either
Whole blood
blood components (RBCs, Plts, plasma or WBCs ) or
blood derivatives (albumin, gamma globulin, Factors
VII,VIII,Von willebrand,or Immune globulins and
prothrombin) directly into the blood stream.
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Whole blood….
Whole blood- complex tissue ,composed of
cells and plasma
Blood components-prepared from blood by
mechanical method especially by centrifugation
Blood derivatives-separated by more complex
process (Filteration,Adsorption)
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Whole blood….
Component therapy gives a better form of
treatment :
Minimizes the risk of immune reactions
Often permits considerable economy in the use of
blood
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9.2 Whole blood (w/b)
Contains all cellular elements and coagulation
factors
Freshly drawn w/b maintains all its properties for
a limited time.
Upon storage a number of changes occur,
Example:
increase in O2 affinity and
loss of viability of RBC.
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Indications for whole blood
To provide both:
O2 carrying capacity and
blood volume expansion
Example In the treatment of massive hemorrhage.
Used as a source material for blood component
preparation.
For exchange transfusion in new born.
Whole blood less than 4-5 days old is often the blood
of choice
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Blood components
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Blood components..
Component make blood use more economical
by using one unit one can treat:-
Anemia with the packed cells
Platelet deficiency with platelet preparations
Clotting factor and other plasma deficiencies
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[Link] cell preparation
Is the product remaining after the removal of
most of the plasma from freshly drawn whole
blood by centrifugation.
The commonly available RBC preparations are
Concentrated red cell suspension
Frozen/ Deglycerolized red cells
Leukocyte poor red cell suspension
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Red cell preparation….
The red cell prepared in this form contain the
same:
redcell mass and
oxygen carrying capacity as whole blood with
approximately one half of the volume.
The final Hematocrit of the product should be
between 70-80% in 250-300 ml of volume
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Red cell preparation…
Concentrated red cell (CRC) is used to treat
patients with symptomatic anemia
Transfusion of 1 unit red cell increases the Hct
by 3% and the hemoglobin by 1 gm.
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9.4. Plasma products
Plasma is a fluid portion of one unit of blood
collected and separated in a closed system
and intended for intra venous use.
The therapeutically useful plasma products
are:
Fresh Frozen plasma (FFP)
Ordinary plasma (OP)/ single donor plasma
Cryodepleted plasma
All plasma products have to be stored at -180C
or colder
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Plasma products….
Fresh Frozen plasma (FFP)
Is the plasma obtained from a unit of whole
blood after centrifugation
It is then separated and frozen solid at a
temperature that will adequately maintain the
labile coagulation factors in a functional state.
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Plasma products….
The indications for FFP are for:
replacement of coagulation factors
labile ( Factors V and VIII) and
stable (fibrinogen, VII, X, XI)
deficiencies of anti-thrombin III
deficiencies of protein C and protein S
treatment of thrombotic thrombocytopenic
purpura (TTP)
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Plasma products….
FFP
Should be stored frozen at –300C or colder for
12 months
beyond this period the factors VII may have
decreased
To maintain adequate levels of coagulation factors
If not used in 12 months time may be re
designated and relabeled ”Plasma” and has 4
more years of shelf life at –180C or colder.
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Single donor plasma (SDP) / ordinary plasma(OP)
Is deficient in labile coagulation factors.
It is separated from single whole blood unit at
any time during its storage and up to 5 days
after the expiration of the original unit.
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plasma….
OP is different from FFP in that it contains high
levels of K and ammonia since it is prepared
after long contact with red cells
is stable up to 5 years after preparation if kept
frozen at-180C or colder.
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plasma…..
Indications:
Inthe treatment of stable coagulation factors
deficiencies
For volume and protein replacement under special
circumstances
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plasma…..
Cryo-depleted plasma (CDP)
CDP is the supernatant plasma following
removal of cryoprecipitate
albumin, immunoglobulin and coagulation factors are
the same as that of FFP,
fibrinogen concentration and levels of the labile
coagulation factors V and VIII are markedly reduced.
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Plasma…..
CDP is indicated for patients requiring volume
expansion or protein replacement when labile
clotting factors are not required
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[Link] concentrates (PC)
Is conversion of whole blood into concentrated
red cells with in the first 6 hours of collection.
PC from random donations are the most
frequently used form of platelet product.
(“random” platelet)
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Platelet …….
Each unit of PC
contains 5.5x1010 platelet in 50-65ml of plasma
represents 60-80% of the platelet present in a unit of
whole blood.
increases the platelet count by approximately 5,000-
10,000 / ml in an average adult.
The normal adult dose is 6-10 units, and for
child 1 unit/ 10kg
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Platelet …….
Platelet should be stored at:
1-60C with agitation for 72 hours if prepared in a close
system
20-240C for
24 hours if prepared in an open system
5 days if prepared in closed system
Refrigerated PC don’t maintain function or
viability as well as the PC stored at room
temperature.
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Platelet …….
Indications
Patients who are actively bleeding from
thrombocytopenia
due to drugs, toxins, infections and bone marrow
failure
Bleeding caused from qualitatively abnormal
platelet.
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[Link] and Rh compatibility in platelet
transfusions
PC of the same ABO group should be used
Rh (D) incompatibility has no effect on platelet
survival
but the extent of RBC contaminating in PC may be
sufficient to immunize Rh (D) negative women in
reproductive age group.
In such cases Rh (D) negative PC should be given
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[Link] (CRyo)
Is a cold- precipitated concentration of factor
VIII, anti hemophilic factor (AHF), obtained after
the plasma has been thawed.
Contains:
Factor VIII: C (pro coagulation factor)
Factor VIII: VWF (Von-Willebrand’s factors)
Fibrinogen factor XIII
Fibronectin factor
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(CRyo)…
Each unit has at least 80μl of factor VIII, 250 mg
of fibrinogen in a volume of 15 to 20 ml.
Cryo:
has a shelf life of 12 months at a temperature of-180C
or colder (preferably-300C) and
it must be transfused within 6 hours after thawing at
370C.
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(CRyo)……..
Indications
In the management of classic hemophilia (factor
VIII deficiency)
In the management of factor XIII deficiency
In the management of von willebrand’s disease
and
source of fibrinogen for the treatment of hypo
fibrinogenemia.
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[Link]
Is the most abundant of the plasma proteins.
Provides the critical colloid osmotic or oncotic
pressure that regulates the passage of water
through the capillaries
Abnormally low levels of Albumin will result in
excessive leakage of fluid in the tissues known
as edema.
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Albumin…
Indications
Albumin is available in either 5% or 25% solution
osmotically equivalent to normal plasma.
Transfused to replace proteins and fluids
in burn patients and
in cases of shock due to hemorrhage or surgery.
Also administered for adult respiratory distress
syndrome and in cases of liver failure.
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[Link](Ig)
Among the plasma proteins, the Ig or antibodies
are second only to albumin in concentration.
The Ig are commonly divided into five classes
designated as IgA, IgG, IgM, IgE, and IgD.
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Immunoglobulins…
Indications
IgG are commonly used in a number of vaccines
including
• TIG (Tetanus immune globulin)
• HBIG, (Hepatitis B immune globulin)
• VZIG (Varicella zoster immune globulin) and
• RIG (Rabies immune globulin)
Igs are administered both intravenously and
intramuscularly (as injections) depending upon
the type.
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Review questions
1. Name the common blood components that can
be prepared from a unit of donated blood.
2. Describe the clinical indications for transfusion
of the different blood components.
3. What is OP? Describe its use.
4. What are the optimum storage temperatures of
plasma products?
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References
[Link] for medical laboratory
science students,Yayehyirad T. and Misganaw
B., Upgraded lecture note.2008
[Link] and applied concepts of
Immunohematology, 2nd ed. Kathy [Link]
and Paula [Link],2009
3. Blood banking and transfusion medicine: basic
principles and practice. Christopher [Link] et
al., 2nd ed.2007.
[Link]
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blood donations, Module 1 WHO.2002
References…
[Link] for HIV and other infectious agents,
Module 2, WHO. 2002
[Link] group serology. Module 3 WHO.2002
[Link] and principles for safe blood
transfusion practice, Introductory module. WHO
2002.
[Link]: Principles and Practice
Quinley. 2nd ed.1998.
[Link] Technical Manual .15th Edition.2005
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