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Blood bank vs Blood center
- blood bank: in a hospital. performs compatibility testing and prepares components for transfusion
- blood center: "donation center". screens, draws donors. performs testing on donor blood and delivers to blood bank
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where is the source for blood
only human beings
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is there such as a thing as zero risk blood
no such thing
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what are the plasma derivatives
- albumin 5% and 22&
- plasma protein fraction
- factor VIII concentrate
- immunoglobulins
- fibrinogen
- coagulation factors
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what are the plasma components
- fresh frozen plasma
- single donor plasma
- cryoprecipitate
- cryo-poor plasma
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what are the cellular components
- red cell concentrate
- leukocyte reduced red cells
- platelet concentrates
- leukocyte reduced platelets
- platelet apheresis
- granulocyte apheresis
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what are the advantages of using blood components as opposed to whole blood
- incrs in shelf life
- decrs hazards of whole blood tansfusion
- optimal utilization of every blood donation
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preservatives of whole blood
- stored in 1- 6 C
- CPD: "citrate phosphate dextrose". 21 days
- CPD A-1: 35 days
- CPS AS-1: 42 days
- ACD: "acid citrate dextrose"
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How packed RBCs are collected
- removal of 80% plasma by centrifugation
- stored the same as whole blood
- expected net gain: 1- 1.5 g/dl per unit, 3-5% hct
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expected net gain of whole blood
- 1-1.5 g/dl per unit
- 3-5% hct
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advantages of PRBCs (packed RBCs)
- reduced risk of circulatory overload, important for cardiac patients
- decreased Anti ABOs in O units, makes then more truly universal donor ready
- more neutral pH and citrate levels
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processing of leukocyte reduced RBCs
- 99.9% removal of WBCs
- not more than 5x10^6 WBC
- retention of 85% RBC mass
- stored the same as whole blood
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advantages of leukocyte reduced RBCs
- get rid of HLA antibodies
- decrs febrile transfusion reactions
- decrs CMV transmission (CMV carried in WBCs)
- decrs Graft vs Host disease reaction
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processing and storage of washed RBCs
- unit is spiked and cells are washed with saline to remove IgA antibody
- somewhat leuko reduced but not as effective as filtering
- all plasma removed
- stored 1- 6 C
- use within 24 hrs of opening unit
- expected net gain: same as whole blood
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advantages of washed RBCs
- removal of all plasma proteins
- useful with patients who have experienced allergic reaction, or IgA deficient people
- may decrease viral transmission
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disadvantages of washed RBCs
- more expensive
- open unit, therefore 24 hr expiration may lead to contamination
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processing and storage of frozen RBCs
- must be processed within 6 hrs of draw by adding 40% glycerol (membrane stabilizer/antifreeze) followed by a slow freeze
- shelf life of 10 years
- when thawed, glycerol must be removed (toxic)
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advantages of frozen RBCs
- advantages: most WBCs, plts, and all proteins are removed during deglycerolized process
- may be used interchangeably with washed RBCs.
- rare donor and autologous units may be collected adn stored for long periods of time
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disadvantages of frozen RBCs
- more expensive
- open unit, 24 hr expiration once deglycerolized
- contamination
- expected gain: 1-1.5 g/dl
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process when frozen RBC are thawed
- RBC mass recovery must be 80% of original
- not more than 1% residual glycerol
- at least 70% RBC viability 24 hrs post transfusion
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preparation, storage and expiration of granulocyte concentrates
- prepared by cytopheresis
- donor prepared by administrating cortisol and hydroyethystarch (facilitates WBC separation)
- stored at RT, 20-24 C
- expiration time is 24 hrs
- ABO/Rh compatible
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what are granulocyte concentrates used for
- <500 WBC /mm3
- active infection (fever)
- not responding to antibiotics
- myeloid hypoplasia with reasonable chance for survivial
- neutropenia
- chemotherapy
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preparation of platelet packs from random donor
- prepared with 6 hrs of draw
- whole blood light spin.
- put prp (platelet rich plasma) into satellite bag, hard spin,
- express all but 50-65 ml plasma into satellite bag,
- let plts rest for 2 hrs
- must have at least 5.5 10^10 plts in the 50 to 65 ml plasma
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storage, expected net gain of platelet packs
- storage: RT with constant agitation for 5 days
- expected net gain: 5000 to 10,000 mL for singe pack. usually 4 to 8 packs pooled 30,000 to 60,000 mL for one treatment
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random donor platelet packs are used for?
- thrombocytopenia <50,000 mL
- pt getting chemotherapy
- DIC
- massive transfusion
- if pt becomes refractory to platelets will need to give single donor packs
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preparation of platelet packs from single donor
- at least 3x10^11 plts in 300 ml
- storage: RT with constant agitation for 5 days
- may also be ABO/Rh compatible or HLA compatible
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preparation of fresh frozen plasma
- must be processed within 8 hrs of draw,
- separated from the prp (platelet rich plasma)
- 1 unit: 400 mg of factor I suspended in 50 to 250 mL plasma
- storage: -18C for 12 months, 1 - 6 C for 24 hrs once thawed
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use for fresh frozen plasma
- multiple factor deficiencies
- massively transfused
- liver disease
- DIC
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cryoprecipitate, and use
- is the cold insoluble portion of plasma that precipitates when FFP is thawed between 1- 6 C
- used primarily for fibrinogen replacement, factor I or 13 deficiencies
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storage of cryoprecipitate
- -18 c for 1 year
- RT for 6 hrs once thawed
- 4 hrs if pooled
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