Preparation of blood components Nada Mohamed Ahmed , MD, MT (ASCP)i

Contents Introduction Blood components Processing of blood components Whole blood Packed red blood cells Leukocytes-depleted blood components Fresh frozen plasma (FFP) Cryoprecipitate

Introduction Whole blood unit obtained from donors is separated in the donor processing area of blood bank into various components. • Blood is composed of plasma and blood cells. • Plasma contains vital proteins such as coagulation factors, fibrinogens, albumin, and globulin (including immunoglobulins). • The clinical requirement of a patient determines which blood product should be transfused

Blood components • Blood components and products are obtained by donors. • A donated blood unit consists of around 450- 500 ml of blood mixed with anticoagulant. • An alternative process for the collection of blood is that of apheresis, which uses cell separation equipment and centrifugation.

Blood components • Blood components available from whole blood include: • Red cell concentrates (packed RBCs). • Platelets concentrates. • Fresh frozen plasma • Cryoprecipitate • Products derived from pooled plasma: • (human albumin, immunoglobulins, coagulation factor concentrates)

Processing of blood components Blood is collected as whole blood, as shown below

light centrifugation PRBC's packed red blood cells Plasma + platelets PRBC's packed red blood cells (PRBC's) is prepared by light centrifugation

heavy platelet rich Plasma + fresh frozen centrifugation PRBC's platelets PRBC's PRBC's fresh frozen plasma platelets

Whole blood Characteristics: Approximate Volume : Shelf-Life: RBC and plasma ; WBC and platelets not viable after 24hr storage . Labile clotting factors significantly decreased after 2 days of storage . Hct 35%(dilution by anticoagulant). Blood 450mL. CPD or CPDA-1 anticoagulant 63mL. Approximate Volume : 520mL. Shelf-Life: ACD,CPD __21days at1-6ْC. CPDA-1 35days at 1-6ْC clinical Indications Most useful in massive blood loss such as accidents and burns .

Packed red blood cells Characteristics: Approximate Volume : Packed RBC with reduced plasma volume; WBC platelets, and coagulation factors as for whole blood. Hct 69%. Approximate Volume : 260mL. Shelf-Life: ACD,CPD __21days at1-6ْC. CPDA-1 35days at 1-6ْC clinical Indications Most useful for symptomatic anemia is present; chronic anemia, bleeding

Washed red blood cells Characteristics: Approximate Volume : RBC. No plasma, minimal platelets. 70-80% WBC removed if manual wash .90% WBC removed if automated wash. Hct adjustment as per amount of saline added. 5% loss of red cells due to wash procedure. Approximate Volume : 250mL. Shelf-Life: 24 hr at1-6ْC. After wash. clinical Indications Increased red cell mass as for packed red cells .Most useful for preventing febrile and allergic reactions due to leukocytes or plasma proteins and for preventing anaphylactic reaction in IgA- deficient recipients .

Frozen deglycerolized red blood cells. Characteristics: RBC, no plasma , no platelets, removal of 95% of WBC. Hct adjustment as per amount of saline added. Up to 20% of red cells lost due to procedure. Approximate Volume : 250mL. Shelf-Life: 10 years at-65ْC or colder . 24 hr at1-6ْC. After wash clinical Indications Most useful for supply of rare blood, inventory control, and autotransfusion. Also, as per washed red blood cells.

Leukocytes-depleted blood components • Leucocytes in the blood units may cause infections and non-haemolytic transfusion reactions to the recipients. • Therefore, leucocytes are removed from blood components by filtering through leucocytes specific filters prior to transfusions. • This process called leucocytes depletion. • Examples of infections transmitted by leucocytes in blood products: Creutzfeldt-Jakob disease (CJD) and CMV.

platelet concentrate Characteristics: Approximate Volume : Shelf-Life: Platelets(5.5 ×10 ); some WBC (i.e., lymphocytes), 50mL of plasma , few RBC (less than 0.5% Hct). Approximate Volume : 50mL. Shelf-Life: 5 Days at room temperature (20-24ْC) constant, gentle agitation. clinical Indications : Used for quantitative or qualitative platelet disorders. May be used when bleeding (slow ooze) due to severe thrombocytopenia.

Fresh frozen plasma Characteristics: Approximate Volume : Shelf-Life: Plasma proteins, all coagulation factors, complement. Approximate Volume : 200 to 260 mL. Shelf-Life: 1 year at -18ْC , or colder . clinical Indications: 1) coagulation deficiencies and haemorrhage conditions (massive blood loss, infection or surgery of the liver). - 2) acquired coagulation factor deficiencies such as DIC.

Cryoprecipitate • Cryoprecipitate is a source of factor VIII and fibrinogen extracted from single donor plasma. • It is prepared by slowly thawing FFP at 4C. This process precipitate and enrich a fraction of FFP with factor VIII. • Cryoprecipitate is used mainly for patients with DIC and patients with factor VIII deficiency.

Cryoprecipitate Characteristics: Approximate Volume : Shelf-Life: 80 units of factor VIII, other plasma proteins, von Willebrand factors XIII, fibrinogen(200mg), fibronectin. Approximate Volume : 10 to 15 mL. Shelf-Life: 1 year at -18ْC , or colder . Clinical Indications Most useful for von Willebrand disease, Factor XIII deficiency, or hypofibrinogenemia. Cryoprecipitate should not be used for a newly diagnosed hemophilia A case, because there are factor concentrates available that have been modified to eliminate the AIDS virus and possibly hepatitis.

Upper Right: Lower Right: Left: Freezer filled with FFP and Cryo. Upper Right: Refrigerator with RBC units. Lower Right: Platelet Storage.

Temperature Monitoring System for blood product storage Temperature chart and alarm system

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