1. TRANSFUSION MEDICINE MBBS,MCPS,FCPS. Professor of Pathology
DR. AYESHA JUNAID
MBBS,MCPS,FCPS.
Professor of Pathology
Consultant Haematology
Incharge Blood Transfusion Services SIH

2. TRANSFUSION REQUIREMNT
ONLY APPROPRIATE TRANSFUSION
Transfusion of safe blood products to treat a condition leading to significant
morbidity /mortality that could not be prevented or managed effectively by other means

3. TRANSFUSION MEDICINE Blood Transfusion can be fatal if incorrectly
administered

4. TRANSFUSION Haematological malignancies
15% of all red cell units transfused to haematological diseases are transfused for Malignant disorders
Effect of the disease itself
Myeloablative /myelosuppressive effects of specific treatment

5. Indications for RCC, Plts,FFP
NO UNIVERSAL TRIGGER FOR TRANSFUSION
Clinical judgment
Quality of life indices
Approach to the management and prevention of complications

6. BLOOD COMPONENTS Whole blood Packed red blood cells
Leukodepleted red cells
Washed red blood cells
Platelets concentrates
Single-donor/Random-donor
Irradiated blood products
(red blood cells and platelets concentrates)
Leukocyte (granulocyte) concentrates

7. BLOOD COMPONENTS Plasma components/products Fresh-frozen plasma (FFP)
Cryoprecipitate
Factor concentrates (VIII, IX)
albumin
Immune globulins

8. Blood Components

9. Whole Blood
Red Blood cells, Platelets and White Blood Cells all suspended in Plasma constitute Whole Blood.

10. Whole Blood Unit
After centrifugation whole blood separates into the plasma and platelets on top and packed red blood cells on the bottom.
A plasma expresser is used to literally squeeze the plasma and platelets off the top and leave only the red blood cells in the original bag.

11. PLASMA SEPARATION

12. Blood Components Random donor Platelets Packed Red Blood Cells
Plasma Product

13. RBC Components Packed RBCs(RCC)
Approx. 1/2 the volume of Whole Blood
Same RBC mass therefore same oxygen carrying capacity
Total Volume 250ml
Expiration Date days
CPDA days closed system
AS days closed system
Open System - 24 hours

14. RBC Components continued…
LEUKOCYTE REDUCED RBC’S
Removal of leukocytes from RBC component to <5.0 X 106 per unit
1. Leukopoor filtration
2. Washing
3. Freezing and Deglycerolization

15. Leucodepletion Removal of majority of white cells is leucodepleton.
Purpose : To reduce incidence of febrile illness and alloimmunization after transfusion.

16. Platelets Random-donor platelets concentrates (RPC)
Single-donor platelets concentrates
(SPC)

17. PLATELETS CONCERTERATES
They are harvested by cell separators or from individual donor units of blood.
Need of transfusion is in patients with thrombocytopenia , active bleeding or platelet dysfunction .
For prophylaxis the platelet count should be more than 5-10 x109/ l
Platelet transfusion should be avoided in autoimmune thrombocytopenic purpura.

18. Platelet Components: Random Donor Platelets
Prepared from a Whole Blood (WB) component
Step 1: Soft (light) Spin (2-3 min at 3200 rpm) to keep the platelets in the plasma.
Step 2: Hard (heavy) Spin (5 min at 3600 rpm) to aggregate platelets. Express off all but ml of plasma and let platelets rest and resuspend on counter (room temp) for 1-2 hours before aggitation.

19. Platelet Components
Includes Random donor platelets, Single donor platelets and Pooled Platelets.

20. Platelet Components Random Donor Platelet
At least 5.5 x 1010 platelets/unit
Single Donor Platelet - Apheresis
At least 3.0 x 1011 platelets/unit
Suspended in 300 ml plasma

21. SINGLE DONOR PLATELET APHARESIS

22. Platelet Components Pooled Platelets
Process of pooling Random Donor Platelets into a central bag. Typically done for adult patients. Need a common “Pool” number on the unit. (Remember we are pooling many donors who each have a unique donor number.)
Pool anywhere from two to twenty units.
Expiration changes from 5 days to 4 hours - Need to be sure the floor is ready to transfuse before pooling.

23. Plasma Components Fresh Frozen Plasma
Plasma expressed from Whole Blood, needs to be frozen within 8 hours (6 hrs for ACD) of collection for CPDA-1 anticoagulant.
Frozen at -18oC:
Frozen at -65oC:
Thawed:
ml total volume
Contains all clotting factors

24. HUMAN PLASMA PREPARATIONS
Fresh frozen plasma ( FFP) , is mainly used for replacement of coagulation factors ( when specific concentrates are unavailable )
FFP are also given after massive transfusion , DIC , in liver disease .

25. TRANSFUSION REQUIREMNT IN LEUKEMIC PATIENTS
Review your decision
Irradiated
Leukodepleted
CMV negative
Single donor Platelets
TO THE CORRECT PATIENT