Q4iii: Understand the process of collection & production of blood and its components

  • Blood products = therapeutic substances prepared from human blood
    • Blood components = red cells, platelets, FFP, cryoprecipitate
    • Plasma = albumin, coag factors, immunoglobulins

Donor Assessment

  • Confidential intr: PMHx, risks of HIV, malaria, hepatitis, CID
  • Examination temp., pulse, BP
  • Hb level

Blood Collection

  • Whole blood is collected by venepuncture
  • Can be donated every 12 weeks
  • 470mL aseptically collected
    • First 30mL to tubes for testing
    • Rest into sterile blood packs
  • Whole blood undergoes LEUKODEPLETION (removes 99.9% WCC) to ↓risk transfusion reactions
  • Whole blood is centrifuged & separated → plasma + red

Blood Components

Platelets

  • Packed platelets = 1 unit drawn from 1 donor of whole blood; 4 – 6 ‘pooled’ from different donors
  • Platelet apheresis = plasma collected in sterile closed system which collected plasma & returns blood to donor

FFP

  • From single whole blood donation
  • Frozen within 8hrs
  • Stored 1yr ≤ -25°C to minimise loss of F V & VIII
  • Thawed in H2O bath ~20 mins
  • Used immediately or can be stored @ 4°C to use <24hrs

Cryo

  • FFP is thawed to 4°C → precipitates to form insoluble mixture rich in VIII, vWF, fibrinogen
  • 1 unit from whole blood → 10 units prepared in 1 pooled bag

RBC

  • From centrifuging whole blood into anticoagulant
  • Suspended in additives → SAGM
    • Sodium chloride = isotonicity
    • Adenine → ATP substract
    • Glucose → E substrate
    • Mannitol = free radical scavenger & membrane stabiliser
    • γ irradiation → inactivates ↑ LCs to prevent GvHD (esp for immunocompromised)
    • Shelf life 42 days
    • Cells, which survive first 24hr remain viable for rest of their life expectancy

Blood Storage

Product

Whole blood

Additive

CPDA1

Temp

4°C

LOS

35 days

Rarely used in Aus

Match

ABO

Rh

XM

Product

PRBC

Additive

SAGM

Temp

2 – 6°C

LOS

42 days

Match

ABO

Rh

XM

Product

Platelets

Additive

–

Temp

20 – 24°C

LOS

5 days, constant agitation

Match

ABO

Product

FFP

Additive

–

Temp

≤ – 25°C

LOS

Frozen within 8hrs to preserve V & VIII activity: 12 months

Match

ABO

Product

Cryo

Additive

–

Temp

≤ – 25°C

LOS

12 months

Match

ABO

Plasma Derivatives

Albumin

  • Plasma – (cells + coag factors)
  • Mostly albumin is left → 4% & 20%
  • Heat treated to kill viruses

Immunoglobulin

  • IM doses of Ab for patients with deficiencies
  • Taken from pooled plasma or donors with specific high titres for certain Abs

IVIG

  • From the pooled plasma for 1000 – 10,000 donors