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Premium member Presentation Transcript PowerPoint Presentation: Blood components Dr. Abdullah AljedaiPowerPoint Presentation: Introduction • Whole blood unit obtained from donors is separated in the donor processing area of blood bank into various components. • This allow for effective use of donated blood and lowers the exposure risk of the transfused patient. • Blood is composed of plasma and blood cells. • Plasma contains vital proteins such as coagulation factors, fibrinogens, albumin, and globulin (including immunoglobulins). • The clinical requirement of a patient determines which blood product should be transfused.PowerPoint Presentation: Blood components • Blood components and products are obtained by donors. • A donated blood unit consists of around 450- 500 ml of blood mixed with anticoagulant. • An alternative process for the collection of blood is that of apheresis , which uses cell separation equipment and centrifugation.PowerPoint Presentation: Blood components • Blood components available from whole blood include: • Red cell concentrates (packed RBCs). • Platelets concentrates. • Fresh frozen plasma • Cryoprecipitate • Products derived fro pooled plasma: • (human albumin, immunoglobulins, coagulation factor concentrates)PowerPoint Presentation: Blood is collected as whole blood, as shown below Processing of blood componentsPowerPoint Presentation: packed red blood cells (PRBC's) is prepared by light centrifugation PRBC's Plasma + platelets light centrifugationPowerPoint Presentation: PRBC's Plasma + platelets heavy centrifugation PRBC's platelet rich plasma fresh frozen plasma plateletsPowerPoint Presentation: Red cell concentrates • Red cell concentrates are obtained by centrifugation and removal of plasma. • Red cells contain the oxygen carrying molecule haemoglobin. • A solution of citrate, phosphate, dextrose-adenine (CPD-A) is used as anticoagulant in the blood unit. • Citrate prevents blood from clotting by removing calcium ions. • Adenine is required to maintain the metabolic activity of red cells in the blood pack. • Red cell concentrates in CPD-A are kept @ 2-6 C and their shelf life is 35 days.PowerPoint Presentation: • As the blood ages, the 2,3-DPG levels and the oxygen carrying capacity are reduced. • The shelf life of red cell concentrates can be increased by using preservative substances to prolong the activity of 2,3-DPG and maintain the ATP level required by RBCs. • An example of theses is SAGM (Saline, Adenine, glucose and mannitol). Red cell concentratesPowerPoint Presentation: Leukocytes-depleted blood components • Leucocytes in the blood units may cause infections and non-haemolytic transfusion reactions to the recipients. • Therefore, leucocytes are removed from blood components by filtering through leucocytes specific filters prior to transfusions. • This process called leucocytes depletion. • Examples of infections transmitted by leucocytes in blood products: Creutzfeldt-Jakob disease (CJD) and CMV.PowerPoint Presentation: Plasma derived components • Plasma is separated from whole blood by high centrifugation. • Aspiration of plasma components is performed in a ‘cosed system’ to prevent infection of the blood. 1)Human albumin is important as a binding protein. It is also critical for providing osmotic activity and maintaining blood in blood vessels. • Human albumin is produced from plasma and treated to inactivate viruses and bacteria before it is given to burns patients. 2) Immunoglobulins: produced from standard donation or apheresis. • Can be stored for 12 months at 4-6 C. • Indicated for patients with immunodeficiecy conditions (SCID). 3) Coagulation factors: - Factor VIII can be derived from plasma to treat haemophilia A patients. - Recombinant factor VIII is now available. - Factor VII and factor IX concentrates are also of clinical use.PowerPoint Presentation: Fresh frozen plasma (FFP) • FFP is produced from single donors. • Plasma is harvested within 6 hours of donation from the red cells and rapidly frozen @ -70 C, and stored @ -30 to maintain coagulation factors at optimum conditions. • FFP is leucodepleted and may be virally inactivated before being given to patients. • Clinical indications: - 1) coagulation deficiencies and haemorrhage conditions (massive blood loss, infection or surgery of the liver). - 2) acquired coagulation factor deficiencies such as DIC. - Compatibility: - Only compatible FFP should be given (ABO specific or AB units) to prevent transfusion reactions.PowerPoint Presentation: Cryoprecipitate • Cryoprecipitate is a source of factor VIII and fibrinogen extracted from single donor plasma. • It is prepared by slowly thawing FFP @ 4C. This process precipitate and enrich a fraction of FFP with factor VIII. • Cryoprecipitate is then stored @ -30. • Cryoprecipitate is used mainly for patients with DIC and patients with factor VIII deficiency.PowerPoint Presentation: Platelets concentrates • Platelets are essential for preventing blood loss by forming the platelet plug at the site of damaged vessel wall. • Patients lacking platelets are prone to bruising and bleeding. • Platelets concentrates are prepared from platelets rich plasma by aspiration into another satellite pack. • 4 packs pooled to provide one adult unit. • Platelets units can also be collected by plasmapheresis. • Platelets are stored @ RT for 5 days. • Platelets units should be leucodepleted before transfusion. • Blood group-specific platelets should be given.PowerPoint Presentation: Transfusion requirements for massive blood loss • Surgical haemorrhage or traffic accidents cause severe blood loss. • Patients who had massive blood loss has 3 major requirements: replacements of the lost volume of blood and to provide oxygen carrying capacity, and replacement of lost coagulation factors. • Blood volume is replaced by whole blood or soloutions such as (human albumin, saline). • Oxygen carrying capacity is provided by giving whole blood or packed RBCs (red cell concentrates). • Coagulation factors are replaced by giving fresh frozen plasma.PowerPoint Presentation: • To compensate for blood loss during surgery a ‘top up’ of packed RBCs is needed. • Fresh frozen plasma may be required post surgery as well to compensate for coagulation factors. Transfusion requirements pre and post surgeryPowerPoint Presentation: Transfusion requirements for certain blood diseases • Certain blood disorders such as leukaemia and aplastic anaemia require supportive therapy to correct for anaemia and low platelets count. • Supportive therapy can be achieved by giving various blood products such as packed RBCs, platelets concentrates, and coagulation factors.PowerPoint Presentation: Component Majorindications Volume(ml) Wholeblood Symptomaticanemiawithlargevolumedeficit 750 Redbloodcells(RBCs) Symptomaticanemia 330 RBCs(washed) Symptomaticanemia Severallergicreactions 180 RBCs(Leukocyte- reduced) Symptomaticanemia FebrilereactionsduetoWBCantibodies ReduceCMVtransmission ReduceHLAalloimmunization 330 Platelets Thrombocytopeniaorplateletfunctionabnormality Bonemarrowhypoplasia 60 Plateletsphersis CrossmatchedandorHLAmatched 300 Platelets(WBC reduced) Preventionoffebrilereactions PreventionofHLA-alloimmunization 300 Granulocytespheresis Neutropenia(resistanttoantibiotics) 220 Freshfrozenplasma Coagulationfactorsdeficiency TTP 220 Thawedplasma Deficiencyofstablecoagulationfactors 220 Cryoprecipitate Hypofibrinogenemia FactorXIIIdeficiency 15 Clinical indications for blood components therapy You do not have the permission to view this presentation. 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