BLOOD COMPONENTS

Lecture: 06

WASEEM ABBAS
Lecturer – DMLS
The University of Lahore-Islamabad Campus
Introduction
• Whole blood which is a mixture of cells, which can be separated into
different blood components namely:
• Packed red blood cell (PRBC) concentrate
• Platelet concentrate
• Fresh frozen plasma
• Cryoprecipitate
• Cryosupernatant
• Each blood component is used for a different indication; thus the
component separation has maximized the utility of one whole blood unit.
• Different components need different storage conditions and temperature
requirements for therapeutic efficacy.
Advantages
1. Separation of blood components is done on CRYOFUGE.
2. Separation of blood into its constituent parts allows for optimal
survival of each part (according to its temperature requirement)
3. Component preparation allows transfusion of only that specific
portion of the blood product that the patient requires
PRINCIPLE OF COMPONENT PREPARATION

Blood bags used for phlebotomy have integral, sterile, aseptic bags
(satellite bags) attached to the main collection bag
• 450 + 45 ml donor blood is collected into the primary bag
• Primary bag contains appropriate anticoagulant/preservative.
• Selected components can be transferred into satellite through a closed
system
• Using centrifugation force whole blood separates in layers

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1. Bags are spun in centrifuge --- separating
components within primary bag ---
platelet rich plasma rises to the top ---
RBC sinks to the bottom
2. Platelet rich plasma (PRP) is forced in
bag B, (RBC remain in bag A)
3. Bag A is separated from bags B & C &
stored at 4 – 5°C
4. Bag (B & C) spun again longer & harder
than initial spun plasma & platelets are
separated in bag B, plasma rises to the
top, Platelet sink to the bottom
5. Plasma is forced into bag C, bag B & C
are separated, bag B contains a platelet
concentrate in 50 ml plasma
6. Plasma in bag C can be made into FFP or
other product
Whole Blood
• Contains RBCs and plasma with a haematocrit level of approx. 38%
• Provide both oxygen-carrying and volume expansion.
• Platelets, white cells and labile clotting factors do not survive in whole
blood rarely used for transfusion.

Whole blood: 450 + 45 ml blood

Anticoagulant: CPDA–1 (citrate-phosphate-dextrose-adenine-1)
Storage temperature: 1 – 6°C
Uses: very few patients with severe trauma or major surgical patients.
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Red Cell concentrates(RCC)
To provide transfusion products for each patient’s specific need e.g. red
blood cells are further categorized according to individual needs
 RCC (Packed RBC)
 Washed RBC
 Leukocyte reduced RBC
 Irradiated RBC
RED CELLS CONCENTRATE (PACKED RBC)

Packed red blood cells, also known as packed cells, are red blood cells
that have been separated for blood transfusion
Prepared by removing most of the plasma unit of whole blood
Storage: 1 – 6°C for 35 days
Uses: preferred product for patient with:
 Symptomatic anaemia
 Exchange transfusion for new born
 Hemoglobin level is less than usual (<7–8 g/dL).

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LEUKOCYTE REDUCED RBC
Leukoreduction is the removal of white blood cells (or leukocytes) from the
blood or blood components supplied for blood transfusion. After the removal
of the leukocytes, the blood product is said to be leukoreduced.
• Reduction of 70 – 99% WBC from red cells.
• Leukocyte removal filters may be used at the bedside, in a hospital blood bank, or in a
blood collection center.
• Significantly diminishes or prevents many of the adverse transfusion reactions
associated with donor white blood cells.
• Leukocyte can cause NHTRF in sensitized patients (to foreign HLA antigen)
• Reduces risk of CMV, EBV, HTLV-1
• Prevention of febrile transfusion reactions

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WASHED RBC
- Removed leukocytes, platelets & plasma
- It removes 70 – 95% leukocytes & 14 – 15% RBC
USES:
Patients with severe allergic or febrile reactions to red cells
Especially useful in --- IgA deficient individuals with anti-IgA
Expiry of the product: 24 hours from the time of preparation

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FROZEN/DEGLYCEROLIZED, RBC

USES: Storage of blood from a rare donor (rare phenotypes)

Autologous units stored for future surgery
Storage: For 10 years from date of phlebotomy at -65 to -80°C
Cryoprotective agents: Freezing of RBC require addition of
cryoprotective agent prior to freezing – to prevent cellular damage or
hemolysis
e.g. Hydroxyethyl starch (HES)

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RE-JUVENATED, RBC
RBC stored at 1 – 6°C lose – 2,3DPG & ATP
Special solution is added to expired RBCs up to 3 days after expiration
to re-store 2,3 DPG and ATP levels to pre-storage levels.

Rejuvesol: Red blood cell processing solution

pH 6.7 – 7.4 used for RBC
Sodium pyrovate up to 3days
Inosine past their
Adenine original
Sodium phosphate expiration date
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REJUVESOL

• Rejuvesol restores 2,3 DPG & ATP levels

• RBC are incubated with rejuvenating solution at 37°C for 01 hour
• RBC are washed to remove the solution before transfusion or
glycerolization
• Excellent for preserving rare units of blood

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PLATELETS
Random Platelets:
• Single unit of platelet --- raise recipient’s platelet count by 2 –
10x109/L
• Random donor platelet : 5.5x1010/L
• Kept on platelet agitator for 4 – 5 days
• pH ≤ 6.0
• Stored at 20-24 °C with continuous agitation
• Suspended in plasma: 40-70mL
• Shelf life: 5 days

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NEED OF PLATELETS TRANSFUSION DEPENDS ON

• Patient’s with platelet count

• Prolonged bleeding time
• Thrombocytopenic patients
(Due to decreased production and decreased function of platelets)
• Patients with radiation and Chemotherapy

Platelet transfusion effectiveness should be monitored by:

• Platelet count at --- 1 hour after transfusion to patient
• Platelet count at --- 18 – 24 hours after transfusion
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PREPARATION OF RANDOM PLATELETS

It is a two-step process:
First step: Using low speed centrifugation (light spin)
• To separate RBC from the plasma
• It allows the platelets to remain in the upper portion of the collection
bag – (PRP)
• PRP – is spun at high velocity (hard spin) which forces platelets to the
bottom of the bag, the plasma on the top is expressed into another bag
• Platelet bag is kept at temperature 20 – 22°C on platelet agitator

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PLATELET APHERESIS
The process of collecting only platelets
during a cytopheresis is called platelet
apheresis
• May be used in any patient who require
platelet transfusions e.g. Dengue patients
• Effective in patient refractory to random
donor platelets who require HLA
matching platelet products
• Apheresis product contains equivalent of
5 – 8 random platelet bags
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QC & SHELF LIFE
• 20 – 24°C temperature
• Constant agitation – for 5 days after phlebotomy
• On the 5th day – pH 6.0 or higher,
• Platelet count 3.0x1011/L in 75% of units tested
• Therapeutic equivalent to five to eight random platelet units.

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FRESH FROZEN PLASMA (FFP)

It is the plasma separated from whole blood & frozen within 8 hours
of phlebotomy
• FFP contains plasma proteins plus all coagulation factors
• Labile factors FV & FVIII
Storage: -18°C or below for 1 year
• FFP contains at least 180 ml of donor plasma & 80 IU FVIII
• FFP is prepared in the transfusion service by thawing the product at
37°C in a water bath
• Transfuse the product soon after thawing
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USES OF FFP
• As a replacement of isolated factor deficiency for which commercially
prepared factors are not available
• In severe massive transfusions
• Used to treat conditions in which there are low blood clotting factors
(INR>1.5) or low levels of other blood proteins.
• People on warfarin therapy

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CRYOPRECIPITATE
The cold insoluble precipitate recovered from controlled thaw of FFP is
called CRYOPRECIPITATE
Storage: -18°C for 1 year

COMPONENTS OF CRYOPRECIPITATE
• FVIII
• Von-willebrand factor (vWF)
• FXIII .
• Fibrinogen .
• Fibronectin
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USES OF CRYOPRECIPITATE
• Bleeding associated with FVIII deficiency (Hemophilia-A), vWF, DIC
• Fibrinogen or FXIII replacement
• Cryoprecipitate used in combination with thrombin as --- fibrin glue
applied to a wound at surgical site.

Reference: https://www.youtube.com/watch?v=tCJBdWOA3Ok

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 Primary goal of component therapy

Right component to the

right patient in right
quality at the right time!