1. K A U H Blood bank
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2. Blood Banking Department of pathology and laboratory
Blood Bank Consultant: Dr. Mohammad Al-Qudah
Blood Bank supervisor :Wesaam Al-Sheyyab
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3. The rational use of blood and blood products
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4. To discuss the following:
Presentation Aims
To discuss the following:
The various components available from blood
The rational use of blood and its components
Critical issues of blood bank

5. Blood is an amazing fluid! Keeps us warm
Provides nutrients for cells, tissues and organs
Removes waste products from various sites
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6. Origins from Greek ‘haima’ Blood is a life saving fluid
A highly specialised circulating tissue which has several types of cells suspended in a liquid medium called plasma.
Origins from Greek ‘haima’
Blood is a life saving fluid
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7. Wesaam Al-Sheyyab

8. Blood components Packed red cells Platelets Fresh Frozen Plasma
Cryoprecipitate
Albumin
Immunoglobulin
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9. HCV
HIV
HBsAg
HBcAb
Syphilis
12 Month
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10. Blood separation
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11. Blood separation
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12. The Donation Process
Education
Selection
Donation
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13. Blood Collecting
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14. Blood Donation
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15. Infectious Disease Testing
HIV Ag-Ab
Hepatitis B (sAg+core)
Hepatitis C Ag-Ab
Syphilis
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16. Whole Blood It is now used rarely in current practice in Jordan
Almost all whole blood donations are processed to separate red cells, platelets, plasma and cryoprecipitate
Currently whole blood should only be considered in the following scenario
An adult has bled acutely and massively
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17. Packed red cells 250±50 mls. of red cells with plasma removed
Haemoglobin 20g/ 100 ml, PCV 55-75
Expected rise in Hb with 1 unit of red cells is approximately 1g/dL
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18. Indications for Packed Cells
Massive blood loss
Anaemia of chronic disease
Haemoglobinopathies
Perioperative period to maintain Hb> 7 g/dL
No need for transfusion with Hb >10
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19. Platelets 150-400 x109 /L Platelet units can be either
Platelet separated from blood units
Apheresis units
1 Platelet separated from blood units contains 55 x109
1 apheresis unit contains 240x109
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20. Platelet apheresis
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21. Platelets Stored at room temperature Constantly agitated
Only last for 5 days
1 dose of platelets should raise patient’s counts by 30 x109 after 1 hour
Infused in 15 mins
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22. Platelets agitator
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23. Indications for platelet transfusion
BLEEDING due to thrombocytopaenia
Due to platelet dysfunction
Prevention of spontaneous bleeding with counts < 20
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24. Recommended counts to avoid bleeding
Platelet count /ul
Clinical Condition
>
Major abdominal, chest or neurosurgery
>
Trauma, major surgery
>
Minor surgical procedures
>
Prevention/treatment of bleeding in pts
with sepsis, leukemia, malignancy
>
Uncomplicated malignancy, leukemia
>
ITP patients
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25. FFP Fresh Frozen Plasma
Plasma collected from single donor units or by apheresis
Frozen within 8 hours of collection
-18o to -30o C
Can last for a year
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26. FFP 1 unit is 150±50 ml Contains all plasma proteins Indications:
Correction of bleeding due to excess warfarin, Vitamin K deficiency, liver disease
DIC, dilutional coagulopathy
Inherited factor XI deficiency
TTP
Controlled temperature water bath
ABO compatibility
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27. FFP Dose: 15 mls/kg about 3-5 units Given within 24 hours of thawing
Requesting FFP
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28. Frozen Plasma Plasma frozen within 24 hours of collection
Maintains level of plasma proteins except factor VIII
Same indications as FFP
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29. Cryoprecipitate FFP thawed at 4oC and centrifuged
Cryoprecipitate is the by-product
Contains Fibrinogen, Factor VIII, Factor XIII, von Willebrand’s Factor
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30. Cryoprecipitate
Source of Fibrinogen in acquired coagulopathies as in DIC; platelet dysfunction in uremia
Indicated for bleeding in vWD, Factor XIII deficiency (Hemophilia A).
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31. Cryoprecipitate Infused as quickly as possible
Give within 6 hours of thawing
25±5mls; usually 10 units pooled
10 bags contain approx. 2gm of fibrinogen and should raise fibrinogen level to 70mg/dL
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32. Appropriateness of transfusion
May be life-saving
May have acute or delayed complications
Puts patient at risk unnecessarily
‘ The transfusion of safe blood products to treat any condition leading to significant morbidity or mortality, that cannot be managed by any other means’.
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33. Inappropriateness of transfusion
Giving blood products for conditions that can otherwise be treated e.g. anaemia
Using blood products when other fluids work just as well
Blood is often unnecessarily given to raise a patient’s haemoglobin level before surgery or to allow earlier discharge from hospital. These are rarely valid reasons for transfusion.
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34. Inappropriateness of Transfusion
Patients’ transfusion requirements can often be minimized by good anaesthetic and surgical management.
Blood not needed exposes patient unnecessarily
Blood is an expensive, scarce resource. Unnecessary transfusions may cause a shortage of blood products for patients in real need.
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35. ABO
ABO is based on the classification of human blood into four major categories depending on the expression of certain erythrocytes membrane-antigens (Antigen A, Antigen B) and on the presence of certain antibodies (Anti-A & Anti-B) in the sera against the previous antigens.

36. ABO blood grouping system
According to the ABO blood typing system there are four different kinds of blood types: A, B, AB or O (null).
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37. Blood transfusions – who can receive blood from whom?
People with blood group O are called "universal donors" and people with blood group AB are called "universal receivers."
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40. Rh Typing
The classification of human blood, as Rh negative and Rh positive, is dependent on the expression of D (Rh) antigen on red cell membrane.
Immunogenicity:
D > c > E > C > e
Antibodies for Rh antigens are not naturally occurring (except for Anti-D and some Anti-E) and produced due to allo-immunization by transfusion or pregnancy.

45. Blood exchange
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46. Wesaam Al-Sheyyab

47. Thanks ,,,