08 Blood & Blood Components

Manual - Collection in a bag.

Automated - Collection on an apheresis machine.

Collection of blood in a bag.

Collection of blood using an apheresis machine.

Volume variations: Larger for apheresis.

Quantity of cellular elements: Larger for apheresis.

Manufacturing process: More manipulation in processing manual collections.

Volume variations are ______ for apheresis compared to manual blood collection.

The quantity of cellular elements is ______ for apheresis compared to manual collection.

The manufacturing process involves ______ manipulation in processing manual collections.

Quantity of cellular elements larger for apheresis

Collection on an apheresis machine

Collection in a bag

Non Leukocyte-reduced (Non LR)

Leukocyte-reduced (LR)

Non LR-RBCs

Leukocyte-reduced RBCs (LR-RBCs)

Washed RBCs (W-RBCs)

Frozen/Deglycerolized RBCs (F-RBCs / Deglyc-RBCs)

Whole blood can be categorized into _______ and _______ based on leukocyte reduction.

Washed RBCs are also known as _______.

Frozen RBCs are also referred to as _______ or _______.

Non-Washed WB

B) Leukocyte Reduction

Deglycerolization

A component of blood consisting of white blood cells with granules.

Non-Leukocyte Reduced (Non-LR)

Leukocyte Reduced (LR)

Made from whole blood donation.

Commonly referred to as "Random."

Collected via an apheresis machine.

Stored at cooler temperatures for specific uses.

Platelet concentrates made from whole blood donations are commonly called _______.

______ platelets are collected using an apheresis machine.

Platelet products include _______, _______, and _______ platelets.

Plasma Platelets

Platelet Concentrates

Using an apheresis machine

➢ Fresh Frozen Plasma (FFP)

➢ Plasma Frozen within 24 hrs from collection (PF24)

➢Cryoprecipitate (Cryo)

➢ NEW-Freeze-Dried Plasma (FDP)

An anticoagulant preservative used in blood collection bags.

A variation of CPD with double dextrose for blood preservation.

An anticoagulant preservative with acidic properties.

Includes adenine to extend the shelf life of stored blood.

Include:
AS-1 (Adsol)
AS-3 (Nutricel)
AS-5 (Optisol)

_______ is an anticoagulant preservative that includes adenine for longer blood storage.

AS-1, AS-3, and AS-5 are examples of _______ solutions used in blood collection bags.

CP2D stands for _______.

AS-1

To extend RBC shelf life.

ACD

These anticoagulant preservatives have a 21-day expiration.

CPDA-1 has a 35-day expiration.

Additive solutions have a 42-day expiration.

It is illegal to use blood products:

Past the expiration date.

Exceeding applicable temperature ranges.

Products exceeding these parameters are unsuitable for transfusion.

CPDA-1 has a _______ expiration period

Additive solutions can preserve blood for _______ days.

Blood products that exceed temperature ranges are _______ for transfusion purposes.

21 days

Additive solutions have the longest expiration of 42 days.

They are unsuitable for transfusion purposes.

↓ Glucose

↓ ATP (causes ↑ Hemoglobin O₂ affinity)

↓ 2,3 DPG (declines rapidly after 1-2 weeks, causing ↑ Hemoglobin O₂ affinity)

↓ pH

↑ K⁺ in the supernatant

↑ Free Hemoglobin

Irreversible shape deformity

↑ Osmotic Fragility

A decrease in __________ during RBC storage leads to an increase in hemoglobin oxygen affinity.

Morphological changes in RBCs during storage include __________ shape deformity.

As RBCs are stored, __________ levels in the supernatant increase.

↓ Glucose

Decreases rapidly after 1-2 weeks

Increased osmotic fragility

K⁺

↓ Glucose

↓ pH

↑ Lactate dehydrogenase (LDH)

Very fragile/fragmentation; degranulation occurs

Clumping of platelets without continuous rotation

Irreversible shape deformity from discoid to spherical

Decreased in-
vivo recovery, survival, and function

A significant biochemical change in stored platelets is a decrease in __________.

Morphological changes in stored platelets include __________ shape deformity from discoid to spherical.

In stored platelets, an increase in __________ is a biochemical change.

They decrease

Degranulation and fragility

Platelets clump together

Discoid to spherical shape

No morphological changes occur because plasma products do not contain cellular elements.

Deterioration of heat-labile coagulation factors (e.g., Factor V and Factor VIII).

Plasma products do not contain __________, so no morphological changes occur.

During plasma storage, heat-labile coagulation factors such as __________ and __________ deteriorate.

Plasma contains no cellular elements

Factor V and VIII

Deterioration of heat-labile coagulation factors

❑ RBC: ≈ 120 days

❑ Platelets: ≈ 10 days

❑ WBCs: ≈ 1-3 days

❑ Coag Factors (half-life): ≈ hours

Plasma coagulation factors can be further manufactured into separate pharmaceutical products.

These blood derivatives can be lyophilized (freeze-dried) or liquid.

Pharmaceutical blood derivatives must have a prescription to use.

Plasma coagulation factors are manufactured into separate __________ products.

Blood derivatives can be found in two forms: __________ or __________.

To use pharmaceutical blood derivatives, a __________ is required.

Manufactured into pharmaceutical products

Lyophilized and liquid

Prescription

Trauma or massive bleed

hypovolemia

carrying capacity to vital organs, e.g., brain, heart, liver, kidneys, etc.

400 - 500 ml

1 - 6°C

ACD, CPD, or CP2D - 21 days

1 - 10°C

RBCs, Plasma, WBCs, & Plts

None

The Joint Trauma System, the Defense Committee on Trauma, and the Armed Services Blood Program have endorsed LTOWB as the resuscitation product of choice for treating hemorrhagic shock in casualties.

Of the 103 U.S. Level 1 Trauma facilities

57 are using LTOWB.

95 are using Group A plasma.

Acute Hemorrhaging: Trauma or massive bleeding.

Volume Replacement: For hypovolemia.

Increased Oxygen-Carrying Capacity: To vital organs such as the brain, heart, liver, and kidneys.

In 2021, LTOWB was endorsed as the product of choice for treating __________ shock in casualties.

THOR data indicates that __________ U.S. Level 1 trauma facilities are using LTOWB.

LTOWB increases oxygen-carrying capacity to vital organs such as the __________, heart, liver, and kidneys.

Low-Titer O Group Whole Blood

Joint Trauma System, Defense Committee on Trauma, and Armed Services Blood Program

Volume replacement in hypovolemia

400 - 500 ml

1 - 6°C

21 days

1 - 10°C

RBCs, Plasma, WBCs, and Platelets

A & B hemagglutinin titer must be < 1:256 (can be lower for more conservative titer).

Must be labeled as "Low Titer."

14 days only. After 14 days, plasma is removed, discarded, and RBCs are retained with the expiration date adjusted based on anticoagulant preservation.

The volume of LTOWB is __________ ml.

LTOWB must be stored at a temperature of __________°C.

The expiration for LTOWB with CPD, ACD, or CP2D is __________ days.

LTOWB quality control requires the A & B hemagglutinin titer to be __________.

1 - 10°C

RBCs, plasma, WBCs, and platelets

Plasma is removed, discarded, and RBCs are retained.

400 - 500 ml

1 - 6°C

CPD or CP2D: 21 days

CPDA1: 35 days

1 - 10°C

RBCs, Plasma, WBCs, and Platelets

< 5 × 10⁶ WBCs

≥ 85% RBC Recovery in at least 95% of the units tested

The volume of LR Whole Blood is __________ ml.

LR Whole Blood must be stored at __________°C.

The expiration of LR Whole Blood using CPDA1 is __________ days.

Quality control for LR Whole Blood requires WBC count to be less than __________.

1 - 10°C

85%

CPD or CP2D

21 days

35 days

42-day expiration

Additive solutions include Adsol, Nutricel, or Optisol

42-day expiration

WBCs removed and additive solution added

RBCs with ACD, CPD, or CP2D have a __________-day expiration.

RBCs with additive solutions have a __________-day expiration.

Leuko-reduced RBCs have WBCs removed and use an additive solution for a __________-day expiration.

35 days

Adsol, Nutricel, Optisol

Removal of WBCs and addition of an additive solution

❑ Anemia condition

❑ Less volume; helps prevent hypervolemia

❑ Increase oxygen-carrying capacity to vital organs

❑ 98% of blood transfusions is using this product

❑ Leuko-reduced RBCs are majority of the blood made / available

❑ 1 unit of RBCs raises Hgb ~ 1 gm/dL or Hct ~ 3%

300 ml

1 - 6°C

42 days

1 - 10°C

RBCs, plasma, residual WBCs, additive solution, & Plts

Must add additive solution to RBCs within 3 days from collection when temp is maintained at 1-6°C.

No Hct QC on additive RBC product as final product Hct after adding the additive solution is 55 - 65%

Additive-RBCs have a volume of approximately __________ mL.

The expiration period for Additive-RBCs is __________ days.

The final product hematocrit (Hct) after adding the additive solution is __________ to __________%.

1 - 6°C

RBCs, plasma, residual WBCs, additive solution, and platelets

Within 3 days

Same as RBCs but with additional advantages.

Helps reduce Febrile Transfusion Reactions and Transfusion-Related Acute Lung Injury (TRALI) due to the lack or reduced number of WBCs and platelets (Plts) in the product.

Helps reduce the recipient's immune response to develop antibodies (Abs) against WBCs and platelets (Plts).

LR-RBCs help reduce __________ Transfusion Reactions and Transfusion-Related Acute Lung Injury (TRALI).

LR-RBCs reduce the recipient's immune response to develop antibodies (Abs) against __________ & __________.

Helps reduce Febrile Transfusion Reactions

TRALI

They lack or have reduced WBCs and platelets.

300 mL

1-6°C

42 days

1 - 10°C

RBCs & additive Sol't; essentially no WBCs or Plts

➢ < 5x106 WBCs & ≥ 85% RBC Recovery in at least 95% of the units tested