Blood Components and uses

APHERESIS: Technique → machine

Gular Soluble
Components components

① Cellular Components

Packed red cells

(Leucocyte depleted red cells
Platelet concentrates
I granulocyte concentrates

① Parked red cells 2

Whole blood → Centrifuge

Parts

Supernatant Plasma Sedimentation

another Satellite bag Red blood cells

Parent blood bag

→ Better method Apheresis machine.

 Indications:

i) symptomatic chronic anaemia

ii) Perioperative anaemia
ii) Acute blood loss > 30%
iv) Cardiac failure E anaemia
v) Leukemias
vi) Ahlastak aeramias

2. Leucocyte Depleted cells

Packed red Cells have leuroustes with HLA

< distinguishable bet"

Recipient immune self and non-self
system recognises

develope several
adverse reactions

Sunodefilited red cells → safe

↳ prepared by filtration technique.

3. Platelet concentrates

(from whole blood

(or apheresis
 stared at 20-26°C - shelf life 3-5 days

One unit of apheresis: 30,000-60.000

platelet ↑es platelet for UL.
count by

One unit of platelets : 10,000-12,000

from whole blood for ML.

Indications

① Patients of thrombocytopenia
in Platelet function defects.

u. Granulocyte concentrates

Prepared from → Whole blood

or
Leeatheresis
stared at 20-26°C
Shelf life: 24ms.

Given to fit. not responding to

standard medical therapy
② Plasma components

① Fresh Frozen Plasma

⑪ Cryopecipitates

① Fresh Frozen Plasma (Contain various

coagulation factors)
(from whole blood by Ahheresis

at-70°C, Shelf life: one year

Used after drawing it.

(melting)

→ Indication: bleeding disorders

⑪ Cryopecipitates

Rich in factor VIII 18 & fibrinogen

Prepared by thawing FFP & separating

the supernatant

stored at-30°C-Shelf life 1 year

Haemophila
@ Hypofibrinogenaemia Indications
@ Von Willebrand disease
Transfusion Process,
① Healthy donor blood selection.
Hb > 12.5 gldl. , free from infections.

② Blood Collection: Phlebotomy.

starile plastic blood bag. Anticoagu: ACD
mixing blood witch Ae.

③ Storage: Refrigerate at 2- 6°C.

④ Donor tasking: ABO-Rh grouting

HBV, HBS Ag, HCV, Syphilis, Malaria, HIV.

③ Recefient tasking: ABO-RM

⑥ Pre- transfusion Compatibility test.

I) Antibody Screening: Pt serum
G) Cross matching: Pt serum & Donor RBC.

⑦ Supervised blood transfusion

⑧ Anti: loager: CPD: 21 days 2- 6°C

CPDA: 35 days 2- 6°C
 Compatibility testing

i) small test tube: Drop of Recipient's blood

i) Washed donor RBC (5% Saline)

iii) Mix & incubate at 370C for 30 mins.

iv) Centrifuge 3000 spm, 1min.

v7 dislodge the cell halette

+1-agglutination or haemolysis
first groosly → microscope.

Interpretation.
① no agglutination) : matched
haemolysis

② citcher agglutination: mismatch.

or haemolysis/or
botch
Indications for blood transfusion

* Blood is tasked for

i) Hepatitis B (for HBS Ag by ELISA)

① Jdefratitis c (for anti-HCV by ELISA)
(iii) HIV (for anti HIV 1, 2 by ELISA or spot test)
Iv) Syphilis (for treponema Ag by VDRL
④ Malaria (for malarial antigen by malarial
antigen assay)
Autologous Blood Transfusion

Blood Collected from the same person who

has to be transfused.

Types and Procedures.

① Preoperative autologous blood transfusion

② Intraoperative and Postoperative transfusion
③ Acute normovolaemic harmodilution
autologous transfusion.

☐ Preoperative autologous blood transfusion

banking blood before surgery and

reinfused after surgery

① Patients witch rare blood group

⑪ Patients refusing donor blood transfusion

2) Intraoperative and Post operative transfusion

(blood in the body cavity of patient

L blood lost during surgery
L blood lost post operatively in drain

anticoagulation, filtration washing.

 INDICATIONS:
① blood loss in > 20% volume
⑪ risk factors for bleeding tendencies
very low haemoglobin.

3) Acute normovalamic harmodilution autologous

transfusion.
blood collected before anaesthesia and
before start of mainsurgery and
transfused back before end of surgery
when indications appear

Rapidly witchdrawing predetermined amount of

blood

storage in operation room.

INDICATIONS:
① Need for fresh whole blood Σ
platelets and Clotting factors.
eg 1. Cardiac bypass surgery
⑪ Rh negative trait
difficult ABO grouting
Problamata blood cross-matching
 ADVANTAGES

① Safer: avoidance of autoimmunisation

⑪ No transmission of infectious
① Useful when shortage of blood
⑩ Rare blood groups or difficult cross-matching.

DISADVANTAGES

① Do not reduce overall exposure to

transfusion process
⑪ Does not prevent adverse reaction of
wrong blood episode due to error in
patient identification or in collection.
iii.
Unecessary transfusion due to
availability of autologous blood.
Transfusion Reactions

Supervised blood transfusion: safe

5-6%: Complications occur

They are of two types:

① Immunologic transfusion reactions

② Non-Immune transfusion reactions.

① Immunologic transfusion reactions

against RBC
burocytes
platelets
Immunoglobulins.

① Haemolytic transfusion reactions

② Transfusion related acute lung injury
③ Other allergic reaction

① Haemolytic transfusion reactions

(Immediate (Intravascular
or or
Delayed extravascular
 ① Intravascular Haemolysis

Very Rahid All destruction

→ Usually due to ABO in compatibility since

botch Ab , auto A and antiB are
capable of fixing complement.

Restlessness, anxiety, flushing,

Chest and lumbar pain
Tachypnoea, Tachycardia
Shock and Renal failure.

② Extravascular Haemolysis.

→ Usually due to Ab of Rh system

less severe Clinical → Malaise

manifestation fever

delayed manifestation → anaemia

RBC destruction by
RE systemen
 ② Transfusion related acute lung injury
(TRACI)

Uncommon resulting from transfusion of

↓
Donor plasma: E high anti HLA-Ab

Bind to leucocyte of Recipient

Release mediators of
↑ Vascular permeability

acute pulmonary oedema

signs and symptoms of respiratory failure.

③ Other allergic reactions

① Febrile reaction: immunologic ion against

WBC, Platelets, IgA

⑪ Anaphyletic shock: Pt witch Ab against IgA

iii Urticaria

① Graft vs host disease: by donor

T-lymphocytes
② Non-Immune transfusion reactions

① Circulatory overload
② Massive transfusion
③ Transmission of infection
④ Air embolism
③ Thrombophlebitis
⑥ Transfusion haemosiderosis

① Circulatory overload.
Pulmonary congestion
acute heart failure
↓
death following transfusion

High risk: Chronic anaemia

Infants
elderly

② Massive transfusion

stored blood
transfused > normal blood
volume

dilutional thrombocytopenia
dilution of coagulation factors.
③ Transmission of infections

i) HBV, HBC
II) CMV infection
iii) Syphilis
iv) Malaria
v) Toxoplasmosis
vi) Infectious mononucleosis
VII) AIDS
Viii) Brucellosis
ix) Babesiosis

High freq. of transfusion → High risk of inf.

Haemophila
Thalassemia major
acute leukemias
acute severe haemorrhage

④ Air embolism

Unlikely if from plastic bags with

- ve pressure

weak person (↑ risk): 10-home

Healthy person: less risk.

 ③ Thrombophlebitis

↑ Risk factors
• Venesection for blood transfusion
Lmose if saphenous vein of
ankle
instead of veins of arms

> 12 his at single site.

⑥ Transfusion haemosiderosis

Post transfusion iron overload

↓
deposition in tissues

Refreated transfusion (liver

without blood loss (myocardium
↓ (endocrine glands
Thalassemia major
severe chronic refractory anaemia

Body cannot excrete more than Img/day.

1 Unit of whole blood: 250mg of iron.