Blood and Blood Products

whole Blood Products

Various blood products include: 1.Whole blood 4.Fresh frozen plasma 2.Red blood cell components 5.cyroprecipitate - Packed RBCs Concentrates 6.Factor concentrates -Washed RBCs Factor VIII -Leuko reduced Red Blood Cells Factor IX -Pediatric/Divided RBC units Anti thrombin III 3.Platelets 7.Granulocytes

1.Whole blood
Whole blood contains one unit of plasma and cells.
Can be stored normally and conventionally for 5 weeks. Factor V and Factor VIII are significantly decreased after
7 days

Indications: Resuscitation of a patient who has been

loosing lots of blood Not used for routine blood transfusion when Red blood cell will sufice.

2.Red Blood Cells Components

contains approximately: 180ml Red cells 100ml Optisol 30ml Plasma -All RBCs transfusion should be ABO/rh compatible with the recipient. -Must be stored between 1c-6c -Indication: symptomatic anemia not treatable with specific therapy -Therapeutic effect: increase hematocrit by 3% or haemoglobin by 1gm/dl in a 155 pound adult.

Packed Red Cells:

One unit of packed RBC

Washed red cells: These are red cells washed with

normal saline to remove most of the plasma

-Must be given with in 24hrs of preparation

-Indications: Patients who have had hypersensitivity reactions to blood or components -Therapeutic effect: A unit of washed Red cells will increase hematocrit less than will a unit of Red cell

Leukoreduced Red Cells:

One unit of leukoreduced red cells contain leukocytes in a specifically reduced amount. -Indication: .For patients who have experienced two or more non hemolytic febrile transfusion reactions .Prevention of non hemolytic febrile transfusion reactions .Prevention of CMV transmission or HLA alloimmunization -Therapeutic effect: They have slightly lower therapeutic effect than RBC not leukoreduced

Pediatric /Divided RBC Units:

Pediatric/Divided red Blood cell units are prepared by separating a CPD anticoagulated (containing no Optisol) packed red Blood cell unit into four bags. -Each pedipack contains 40-45ml of RBC and 15 ml of plasma -Available as Type O -Indication - Divided red Blood cell units are indicated for infants who require small amounts of red cells. -Therapeutic Effect - A divided red Blood cell unit will increase the hematocrit/hemoglobin the same as a standard RBC unit will do

3.platelets

Platelets are cells essential for the coagulation of Blood. Platelet products also contain plasma (coagulation factors), some red cells and some white cells (leukocytes) -Platelets are stored at room temperature and require continuous gentle agitation -can be stored at the Blood center for up to five days. -When received for transfusion, platelets will expire in less than four hours. -The majority of patients with normal platelet function will not experience bleeding until the platelet count drops below a certain point. -In patients with abnormal platelet function, usually caused by drugs (e.g. aspirin or semi-synthetic penicillin), uremia or elevated split products of fibrinogen/fibrin, bleeding may occur with higher platelet counts.

Indications: -platelets transfusions are indicated for patients with bleeding due to thrombocytopenia platelets dysfunction -A bleeding time twice the upper normal limit may be an indication for a platelet transfusion in a bleeding patient. -Patients with auto-immune thrombocytopenic purpura (ITP) should not receive platelet transfusions unless bleeding is significant or life threatening. Therapeutic effect: A single whole blood platelet concentrate increases platelets by 17600 in a 50 pounds adult. Shelf life: 5 days

4.Fresh Frozen Plasma

Fresh frozen plasma (FFP) is the plasma removed from a unit of whole Blood and frozen at or below 55 Fahrenheit within eight hours of collection.
free of red cells, leukocytes and platelets One unit is approximately 225 ml and must be ABO compatible with the recipients red cells, Rh need not be considered. Indications - patients with documented coagulation factor deficiencies who are
- actively bleeding - about to undergo an invasive procedure. - thrombotic thrombocytopenic purpura (TTP), usually in conjunction with plasma exchange.

contains all coagulation factors in normal amounts and is

-Factor deficiencies severe enough to be clinically

significant are usually associated with prolongation of the coagulation screening tests (prothrombin time, partial thromboplastin time) at least 1.5 times the control value or an INR of 1.6 - FFP should not be used for volume expansion or nutritional support. - Reversal of warfarin anticoagulation should be accomplished with Vitamin K rather than FFP - Massively bleeding patients may be given FFP along with red Blood cells to prevent dilution of clotting proteins. Therapeutic Effect: One ml of FFP per 2.2 pounds of patient weight will raise most clotting factors by approximately 1%. The amount of FFP needed depends on the patients clotting factor levels, levels needed to achieve a therapeutic effect, whether or not the patient is bleeding and the patients Blood volume. Shelf Life: 1 year 18C

5.Cryoprecipitate

Cryoprecipitate (Cryo) is a low purity concentrate of

three hemostatic proteins prepared from donated whole Blood A single bag of Cryo contains an average of 100 units of factor VIII and von Willebrand factor and 150 to 250 mg of fibrinogen with some factor XIII and fibronectin No compatibility testing is required Indication- Cryoprecipitate is indicated for bleeding or imminent invasive procedures for patients with significant hypofibrinogenemia (<100 mg/dl). replacement, ten bags should provide enough fibrinogen to raise the fibrinogen 60 to 70 mg/dl in a 155 pound adult. Shelf life: 1 year 18C

Therapeutic Effect - When used for fibrinogen

6.Factor concentrates
Factor VIII:- Factor VIII concentrates are a
commercially prepared, lyophilized powder purified from human plasma -Factor VIII concentrate is cell free and is administered without regard to patient or donor ABO or Rh type. -Factor VIII concentrates are stored refrigerated at 35 to 45 Fahrenheit for up to two years from the date of manufacture (expiration date will be indicated on each vial). -Once reconstituted, it should not be refrigerated. Factor VIII concentrate should be infused within four hours of preparation to reduce the risk of bacterial growth

Indication - for the treatment of bleeding or imminent invasive procedures in patients with hemophilia A, (congenital factor VIII deficiency) and for patients with low titer factor VIII inhibitors -Patients with von Willebrands disease Therapeutic Effect - Dosage is dependent on the nature of the injury, the degree of factor deficiency, the weight of the patient and the presence and level or absence of factor VIII inhibitors.

Factor IX: -Factor IX concentrates are a commercially prepared, lyophilized powder purified from human plasma

-Factor IX concentrates may be refrigerated at 35 to 45 Fahrenheit until the expiration date indicated on each vial, but should not be frozen. Indication: Hemophilia B (factor IX deficiency), also called Christmas Disease Therapeutic Effect - Dosage will depend on the patient factor level and the circumstances making the transfusion necessary. Treatment for bleeding generally requires every 12-hour or daily infusions until symptoms resolve

Antithrombin III: -Antithrombin III concentrates are commercially purified from human plasma pools and lyophilized. -Are provided as a powder in one vial and a diluent (e.g. sterile water) in a companion vial. -Antithrombin III concentrates should be refrigerated (35 -to 45 Fahrenheit) until they expire, but should not be frozen Indication - An acute increased risk of venous thromboembolic disorders in patients with symptomatic, congenital antithrombin III deficiency. Therapeutic Effect - Due to a short life, long term prophylaxis with antithrombin III infusions is not feasible (versus use of oral anticoagulants).

7.Granulocytes:
-Granulocytes (neutrophils) are obtained by an apheresis procedure from an ABO-Rh compatible donor -A four hour expiration time is placed on the granulocytes once issued from the Blood center. Indications: -Severe Neutropenia(<200/ul) -Documented life-threatening bacterial or fungal infection not responsive to appropriate antibiotic therapy. -Neonates with clinical sepsis -Patients with infections who have neutrophil function defects Therapeutic Effect - Even though there may be a clinical effect, there may not be an increase in the recipients neutrophil count.