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Blood component new

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MLT LECTURES BY TANVEER TARA
MLT LECTURES BY TANVEER TARA

This document discusses quality control in blood component preparation. It describes the different types of blood bags used to separate blood into components like red blood cells, plasma, and platelets. It explains the centrifugation process and parameters for various blood products. Quality assurance parameters are provided for whole blood, packed red cells, fresh frozen plasma, platelet concentrates, cryoprecipitate, and leukocyte-reduced red blood cells. The importance of component separation and uses of specific blood products are also summarized.

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Blood component new
QUALITY CONTROL IN BLOOD COMPONANT PREPAPRATION
Blood components Importance of component separation  Separation of blood into component allows optimal survival of each constituents  Component separation allows transfusion of only specific desired component to the patient  Transfusion of only the specific constituent of the blood avoids the use of unnecessary component  By using blood components several patient can be treated with the blood from one donor
Blood bags • Single blood bag: – Whole blood
• Double bags: – Backed red cells – plasma
• Triple bags: – Packed cells – Plasma – Platelets
• Quarterly bags: – Packed cells – Plasma – Platelets – Plasma factors
Action of ingredients of anticoagulant solution. Citrate Prevents coagulation by chelating calcium Sodium di- phospate Prevents fall in pH Dextrose Supports ATP generation by glycolytic pathways Adenine , extends the shelf life of RBC to 35 days.
Blood Products Red Cell Concentrates Platelet Concentrates Granulocyte Concentrate Fresh Frozen plasma Cryoprecipitate Cryopoor plasma Stored plasma Albumin Immunoglobulin Plasma Derivatives Plasma Components Cellular Components Blood
Centrifugation This is the first step of blood preparation • Depend on 2 factors: – Speed of centrifugation – Duration of centrifugation. 1. Light spin • 4170 /g/2min = platelet rich plasma 2. Heavy spin • 5000 /g / 7min = leukocyte-poor RBC, or cell free plasma. • 5000/g / 5min = backed cell and platelet concentrate. • 4170/ g / 10min = cryoprecipitate
Preparation of blood components from whole BloodPreparation of blood components from whole Blood
1- Whole Blood: • Contents – RBC’s – WBC’s – Platelets – Plasma – Clotting factors – Storage:
Whole blood remains a choice for major trauma, for rapid GIB (gastrointestinal bleeding), and for other clinical situations that benefit from simultaneous administration of red cells, volume replacement, and coagulation factors Sever burns
Product Quality Assurance Parameters WHOLE BLOOD  Volume : 450 + 50 ml • Transportation : - Temperature : - Time 12 hrs at the maximum
2- Packed Red Cells Also called Red Cells Concentrate Platelets and plasma are removed Contents – RBC’s – 20% Plasma Storage:
Product Quality Assurance Parameters Packed Red Cells  Volume : 280 + 50 ml  Hematocrit : 65 – 75 %  Sampling Frequency : 1% of collection  Confirmation specificity : ≥75% • Transportation : - Temperature : - Time 12 hrs at the maximum
Indication • Severe anaemia • Aplastic anemia • Sickle cell anemia • Thalassemia major Indications in surgery • Organ transplantation • Cardiac surgery • Other surgeries.
PRBC Dose of blood transfusion =10ml/kg Cardiac failure = 3-5ml/kg Rate of Blood Transfusion = 3ml/kg/hr Transfusion temperature: room Temperature
Washed red cells • It’s convenient but expensive. • Washed RBCs are free of almost all traces of plasma, most WBCs, and platelets. • They are generally given to patients who have severe reactions to plasma
Product Quality Assurance Parameters  Washed Packed Red cells :  Volume : 280 + 60 ml  Hematocrit : 65 – 75 %  Residual protein g/unit: < 0.5  Sampling Frequency/month : 10 or all components if  Confirmation specificity : ≥75%  Transportation : - Temperature : - Time 12 hrs at the maximum
Leukocyte-poor red cells : • Can be prepared by several techniques: – Double centrifuge – Heavy spin. – Filtration: passing the blood through a nylon filter which is an efficient method for removal of granulocytes. Heparin is the anticoagulant used for this procedure. (WBC-depleted RBCs)
Product Quality Assurance Parameters  Leucodepleted RBCs :  WBCs count /unit : < 5× 10⁶  Hematocrit : 50 – 70 %  Sampling Frequency : 1%  Confirmation specificity : ≥75%  Storage : - Closed system : 35 days - Open system : 6 hrs
Fresh frozen plasma (FFP) Definition: Plasma separated from freshly drawn whole hrs of blood collection . Technical Information: Separation of plasma should be effected within 6 hrs of blood collection and before the red cells is cooled to
•Contents – Clotting factors – Fibrinogen, factor VIII – Prothrombin – Albumin – Globulins
Product Quality Assurance  Fresh Frozen Plasma :  Donor unit must not be refrigerated prior to component preparation  FFP once thawed must not be refrozen  Transportation Every effort must be made to ensure that the prescribed core temperature is maintained through out the transit period.
Product Quality Assurance Parameters  Volume: ≥ 150 ml • Platelets 30 × 10³/ul • Factor VIII 70 iu – 100iu/unit  Sampling Frequency : 1%  Confirmation specificity : ≥75%
Platelet concentrate • Preparation: – Platelet-rich plasma is separated by light spin from erythrocyte. – Platelet conc. is then obtained by a heavy spin of platelet rich plasma. – – Separation should be done within 4h After the blood is drawn.
Product Quality Assurance Parameters Platelets rich plasma Platelets concentrate Apheresis platelets  Storage pH : 6.8± 0.4  Storage Temperature :  Storage duration : - Closed system : 5 days - Open system : 6 hrs
Product Quality Assurance Parameters Platelets concentrate Volume : 55± 10 ml  Platelets count : ≥ 5.5× 10 ⁰/unitᴵ  WBCs : < 0.2× 10⁹/unit  Sampling Frequency : 1%  Confirmation specificity : ≥75%  Continuous Gentle Agitation
Product Quality Assurance Parameters • Must be prepared prior to storage of the collected unit or within 8 hrs of its storage in the refrigerator. • Platelets Storage cabinet which are thermo statistically controlled and have an agitator • Infusion duration should not be > 30 minutes
Platelet concentrate Platelet concentrates are increasingly being prepared by automated devices that harvest the platelets (or other cells) and return unneeded components (eg, RBCs, plasma) to the donor. This procedure, called cytopheresis, provides enough platelets from a single donation (equivalent to 10 random platelet units) for transfusion to an adult, which, because it minimizes infectious and immunogenic risks, is preferred to multiple donor transfusions in certain conditions.
Blood component new
Product Quality Assurance Parameters Platelets concentrate by cytapheresis • Volume : 300 - 500 ml  Platelets count : ≥ 3× 10 /unitᴵᴵ  WBCs : < 5× 10⁶/unit  Sampling Frequency : 1%  Confirmation specificity : ≥75%  Continuous Gentle Agitation
– Factors VIII and XIII, Fibrinogen and von Willebrand factor (vWF)v. – It also contains fibronectin Indications – Hemophilia A – Fibrinogen deficiency – Factor XIII deficiency • Disseminated intravascular coagulation
7- Cryoprecipitated
7- Cryo-precipitated Preparation: • Cryoprecipitate is a concentrate prepared from FFP, it should be frozen within 4h and stored at • A bag of cryoprecipitate should be contain on the average about ≥ 80 units of AHF/unit and Fibrinogen ≥ 150mg. •
Product Quality Assurance Parameters • Cryo-precipitated • Technical information: - Cryoprecipitate if thawed but not used period of 4 hrs. If still not used, the unit should be discarded it must not be refrozen. - Maximum storage period:
Cryo-precipitated • Transportation: - Every effort must be made to maintain the core temperature of the cryoprecipitate at the - If the unit thaws in transit, it must be transfused immediately. It should neither be stored nor should be refrozen. - It is best to discard cryoprecipitate thawed in transit rather then trying to preserve it.
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Blood component new

  • 2. QUALITY CONTROL IN BLOOD COMPONANT PREPAPRATION
  • 3. Blood components Importance of component separation  Separation of blood into component allows optimal survival of each constituents  Component separation allows transfusion of only specific desired component to the patient  Transfusion of only the specific constituent of the blood avoids the use of unnecessary component  By using blood components several patient can be treated with the blood from one donor
  • 4. Blood bags • Single blood bag: – Whole blood
  • 5. • Double bags: – Backed red cells – plasma
  • 6. • Triple bags: – Packed cells – Plasma – Platelets
  • 7. • Quarterly bags: – Packed cells – Plasma – Platelets – Plasma factors
  • 8. Action of ingredients of anticoagulant solution. Citrate Prevents coagulation by chelating calcium Sodium di- phospate Prevents fall in pH Dextrose Supports ATP generation by glycolytic pathways Adenine , extends the shelf life of RBC to 35 days.
  • 9. Blood Products Red Cell Concentrates Platelet Concentrates Granulocyte Concentrate Fresh Frozen plasma Cryoprecipitate Cryopoor plasma Stored plasma Albumin Immunoglobulin Plasma Derivatives Plasma Components Cellular Components Blood
  • 10. Centrifugation This is the first step of blood preparation • Depend on 2 factors: – Speed of centrifugation – Duration of centrifugation. 1. Light spin • 4170 /g/2min = platelet rich plasma 2. Heavy spin • 5000 /g / 7min = leukocyte-poor RBC, or cell free plasma. • 5000/g / 5min = backed cell and platelet concentrate. • 4170/ g / 10min = cryoprecipitate
  • 11. Preparation of blood components from whole BloodPreparation of blood components from whole Blood
  • 12. 1- Whole Blood: • Contents – RBC’s – WBC’s – Platelets – Plasma – Clotting factors – Storage:
  • 13. Whole blood remains a choice for major trauma, for rapid GIB (gastrointestinal bleeding), and for other clinical situations that benefit from simultaneous administration of red cells, volume replacement, and coagulation factors Sever burns
  • 14. Product Quality Assurance Parameters WHOLE BLOOD  Volume : 450 + 50 ml • Transportation : - Temperature : - Time 12 hrs at the maximum
  • 15. 2- Packed Red Cells Also called Red Cells Concentrate Platelets and plasma are removed Contents – RBC’s – 20% Plasma Storage:
  • 16. Product Quality Assurance Parameters Packed Red Cells  Volume : 280 + 50 ml  Hematocrit : 65 – 75 %  Sampling Frequency : 1% of collection  Confirmation specificity : ≥75% • Transportation : - Temperature : - Time 12 hrs at the maximum
  • 17. Indication • Severe anaemia • Aplastic anemia • Sickle cell anemia • Thalassemia major Indications in surgery • Organ transplantation • Cardiac surgery • Other surgeries.
  • 18. PRBC Dose of blood transfusion =10ml/kg Cardiac failure = 3-5ml/kg Rate of Blood Transfusion = 3ml/kg/hr Transfusion temperature: room Temperature
  • 19. Washed red cells • It’s convenient but expensive. • Washed RBCs are free of almost all traces of plasma, most WBCs, and platelets. • They are generally given to patients who have severe reactions to plasma
  • 20. Product Quality Assurance Parameters  Washed Packed Red cells :  Volume : 280 + 60 ml  Hematocrit : 65 – 75 %  Residual protein g/unit: < 0.5  Sampling Frequency/month : 10 or all components if  Confirmation specificity : ≥75%  Transportation : - Temperature : - Time 12 hrs at the maximum
  • 21. Leukocyte-poor red cells : • Can be prepared by several techniques: – Double centrifuge – Heavy spin. – Filtration: passing the blood through a nylon filter which is an efficient method for removal of granulocytes. Heparin is the anticoagulant used for this procedure. (WBC-depleted RBCs)
  • 22. Product Quality Assurance Parameters  Leucodepleted RBCs :  WBCs count /unit : < 5× 10⁶  Hematocrit : 50 – 70 %  Sampling Frequency : 1%  Confirmation specificity : ≥75%  Storage : - Closed system : 35 days - Open system : 6 hrs
  • 23. Fresh frozen plasma (FFP) Definition: Plasma separated from freshly drawn whole hrs of blood collection . Technical Information: Separation of plasma should be effected within 6 hrs of blood collection and before the red cells is cooled to
  • 24. •Contents – Clotting factors – Fibrinogen, factor VIII – Prothrombin – Albumin – Globulins
  • 25. Product Quality Assurance  Fresh Frozen Plasma :  Donor unit must not be refrigerated prior to component preparation  FFP once thawed must not be refrozen  Transportation Every effort must be made to ensure that the prescribed core temperature is maintained through out the transit period.
  • 26. Product Quality Assurance Parameters  Volume: ≥ 150 ml • Platelets 30 × 10³/ul • Factor VIII 70 iu – 100iu/unit  Sampling Frequency : 1%  Confirmation specificity : ≥75%
  • 27. Platelet concentrate • Preparation: – Platelet-rich plasma is separated by light spin from erythrocyte. – Platelet conc. is then obtained by a heavy spin of platelet rich plasma. – – Separation should be done within 4h After the blood is drawn.
  • 28. Product Quality Assurance Parameters Platelets rich plasma Platelets concentrate Apheresis platelets  Storage pH : 6.8± 0.4  Storage Temperature :  Storage duration : - Closed system : 5 days - Open system : 6 hrs
  • 29. Product Quality Assurance Parameters Platelets concentrate Volume : 55± 10 ml  Platelets count : ≥ 5.5× 10 ⁰/unitᴵ  WBCs : < 0.2× 10⁹/unit  Sampling Frequency : 1%  Confirmation specificity : ≥75%  Continuous Gentle Agitation
  • 30. Product Quality Assurance Parameters • Must be prepared prior to storage of the collected unit or within 8 hrs of its storage in the refrigerator. • Platelets Storage cabinet which are thermo statistically controlled and have an agitator • Infusion duration should not be > 30 minutes
  • 31. Platelet concentrate Platelet concentrates are increasingly being prepared by automated devices that harvest the platelets (or other cells) and return unneeded components (eg, RBCs, plasma) to the donor. This procedure, called cytopheresis, provides enough platelets from a single donation (equivalent to 10 random platelet units) for transfusion to an adult, which, because it minimizes infectious and immunogenic risks, is preferred to multiple donor transfusions in certain conditions.
  • 33. Product Quality Assurance Parameters Platelets concentrate by cytapheresis • Volume : 300 - 500 ml  Platelets count : ≥ 3× 10 /unitᴵᴵ  WBCs : < 5× 10⁶/unit  Sampling Frequency : 1%  Confirmation specificity : ≥75%  Continuous Gentle Agitation
  • 34. – Factors VIII and XIII, Fibrinogen and von Willebrand factor (vWF)v. – It also contains fibronectin Indications – Hemophilia A – Fibrinogen deficiency – Factor XIII deficiency • Disseminated intravascular coagulation
  • 36. 7- Cryo-precipitated Preparation: • Cryoprecipitate is a concentrate prepared from FFP, it should be frozen within 4h and stored at • A bag of cryoprecipitate should be contain on the average about ≥ 80 units of AHF/unit and Fibrinogen ≥ 150mg. •
  • 37. Product Quality Assurance Parameters • Cryo-precipitated • Technical information: - Cryoprecipitate if thawed but not used period of 4 hrs. If still not used, the unit should be discarded it must not be refrozen. - Maximum storage period:
  • 38. Cryo-precipitated • Transportation: - Every effort must be made to maintain the core temperature of the cryoprecipitate at the - If the unit thaws in transit, it must be transfused immediately. It should neither be stored nor should be refrozen. - It is best to discard cryoprecipitate thawed in transit rather then trying to preserve it.

Editor's Notes

  1. The separation of blood into components means that patients can be treated with the specific fraction of blood that they lack. This reduces the chances of adverse reactions to unnecessary administration of blood constituents and ensures that more than one patient can be treated using blood from one donor.
  2. unless life threatening.