Blood Component Therapy

Muhammad Abdullah

Blood Component Therapy

• A major advance in the field of blood banking has been the development of blood component therapy

• The basic philosophy is based on the concept that patients are best treated by administration of the specific fraction of blood that they lack

Scheme for separation of whole blood for component therapy.

Whole Blood

• • WHOLE BLOOD is Unseparated blood containing an anticoagulent – preservative solution….

• 1 unit of whole blood contains…..• •450ml of Donor Blood.• •50ml of Anticoagulent-Preservative Solution.• •Haemoglobin approx.12g/ml & Haematocrit 35%-45%.• No Functional Platelets…..•Since it is not sterilized , capable of transmitting any agent present in

cells or plasma which has not been detected by routine screening…

• However whole blood transfusion has significant over packed cells as

• coagulation factor rich…• And if fresh more metabolically active….• Stored b/w +2 and +6 Deg. C in blood bank

refrigerator…• Transfusion should be started within 30 min.of

removal from refrigerator and completed within 4 hrs. b/c changes may occur due to red cell metabolism..

Indications

• Red cell replacemant in acute blood loss with hypovolaemia

• Exchange transfusion• Contraindications• Chronic anemia..• Incipient Cardiac failure…

Packed Red Cells

• Packed red cells are cells that are spun down and concentrated.

• 1 unit of packed red cell is approx.330ml and has a haematocrit of 50 – 70 %..

• They are stored in SAG-M (Saline-Adenine-Glucose-Mannitol) to inc.shelf life upto 5 weeks at 2-6 deg. C …

• It carries same infection risk as whole blood.

Indications

• Replacement of cells in Anemic pt.• Also used with crystalloid and colloid solutions in

acute blood loss conditions.

Platelets

• Platelets are supplied as pooled platelet concentrate containing about 250 x 10 9 cells per litter.

• Platelets are stored at room temp. and have a shelf life of only 5 days.

• Are usually given to pt. of thrombocytopenia or with platelet dysfunction who are bleeding and undergoing surgery and in pt. with bone marrow failure…

• Not Indicated in……. Pt. with ITP , TTP ,untreated DIC and in cases of Hpersplenisim..

Complications

• Febrile and allergic urticarial reactions are common especially pt. receiving multiple transfusion…

• Bacterial contamination, mainly from platelet concentrates, is the third leading cause of transfusion-related deaths.

Fresh Frozen Plasma

• FRESH FROZEN PLASMA IS RICH IN plasma proteins especially ( V and VIII ) coagulation factor..

• IT IS SEPARATED FROM WHOLE BLOOD AND STORED AT-40TO-50 DEG. C WITH 2 YEAR SHELF-LIFE.

• Indications..• IT IS THE FIRST LINE THERAPY IN THE TREATMENT OF

COAGULOPATHIC HAEMORRHAGE…• Replacement of isolated factor deficiencies…

• In cases of antithrombin- III deficiency. • Treatment of Immunodeficiencies .• Treatment of thrombotic thrombocytopenia purpura.• Massive blood transfusion (rarely and only when factors V

and VIII are less than 25% of normal) .• Liver disease.

• Precautions…• Acute allergic reactions , severe life threatening

anaphylactic reactions ,

Cryoprecipitate

• Cryoprecipitate :Cryoprecipitate contains factor VIII:C (i.e.,

procoagulant activity), factor VIII:vWF (i.e., von Willebrand factor), fibrinogen, factor XIII, and fibronectin, which is a glycoprotein that may play a role in reticuloendothelial clearance of foreign particles and bacteria from the blood.

• Cryoprecipitate should be administered through a filter and as rapidly as possible.

• The rate of administration should be at least 200 mL/hr, and infusion should be completed within 6 hours of thawing.

• Indication : Haemophilia A ,Von Willbrand’s disease,Fibrinogen deficiency,Factor XIII deficiency.

Thank you...