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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

DextroseSupports 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 Coagulation Factors

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 plasma2. 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: 4±2 c ̊

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 : 2 – 10 C ̊ ̊

- Time 12 hrs at the maximum

2- Packed Red Cells

Also called Red Cells ConcentratePlatelets and plasma are removedContents– RBC’s– 20% Plasma

Storage: 4±2 c ̊


Packed Red Cells


Hematocrit : 65 – 75 %

Sampling Frequency : 1% of collection

Confirmation specificity : ≥75%

• Transportation :

- Temperature : 2 – 10 C ̊ ̊- Time 12 hrs at the

maximum

Indication

• Severe anaemia• Aplastic anemia• Sickle cell anemia• Thalassemia majorIndications 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 :



Residual protein g/unit: < 0.5

Sampling Frequency/month : 10 or all components if


Transportation :

- Temperature : 2 – 10 C ̊ ̊- 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


Sampling Frequency : 1%


Storage :

- Closed system : 35 days

- Open system : 6 hrs

Fresh frozen plasma (FFP)Definition:

Plasma separated from freshly drawn whole blood and placed in a deep freezer ( -20 to - 8 C)within 6-8 0 0̊hrs 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 the storage temperature i.e ±2 C4̊ ̊

•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.


Volume: ≥ 150 ml

• Platelets 30 × 10³/ul

• Factor VIII 70 iu – 100iu/unit

Sampling Frequency : 1%


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.– Centrifugation should be done at 22 ± c.2 2̊– Separation should be done within 4h After the

blood is drawn.


Platelets rich plasma Platelets concentrate Apheresis platelets

Storage pH : 6.8± 0.4 Storage Temperature : 22 ± 2 C ̊ Storage duration : - Closed system : 5 days

- Open system : 6 hrs


Platelets concentrate Volume : 55± 10 ml

Platelets count : ≥ 5.5× 10ᴵ⁰/unit WBCs : < 0.2× 10⁹/unit Sampling Frequency : 1%


Continuous Gentle Agitation


• 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.


Platelets concentrate by cytapheresis• Volume : 300 - 500 ml

Platelets count : ≥ 3× 10ᴵᴵ/unit WBCs : < 5× 10⁶/unit Sampling Frequency : 1%


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 -18 c or less. ̊

• A bag of cryoprecipitate should be contain on the average about ≥ 80 units of AHF/unit and Fibrinogen ≥ 150mg.

• The shelf life is 12 month, when store at -18 C ̊and for 7 years at – 65 C. ̊


• Cryo-precipitated • Technical information: - Cryoprecipitate if thawed but not used

immediately, may be kept at C for a maximum 4 4̊period of 4 hrs. If still not used, the unit should be discarded it must not be refrozen.

- Maximum storage period:12 months at – 18 C ̊ 7 years at – 65 C ̊

Cryo-precipitated

• Transportation:- Every effort must be made to maintain the

core temperature of the cryoprecipitate at the minimum of – 18 C during transit . ̊

- 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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