Blood Products and Handling
Types of blood products and handling of blood products:
The blood bank mainly deals with four different types of blood components: RBCs, platelets, plasma, and cryoprecipitate. Handling and proper care of the blood components is very important.
RBCs:
Red blood cells can be given in a few different forms.
1. Packed red blood cells
a. This is the most commonly given red cell product, and it is RBCs with plasma removed.
2. Whole blood
a. Whole blood can be used in trauma situations but whole blood is rarely used now because of the availability of ala carte components.
3. Leukocyte reduced red blood cells
a. This blood product has leukocytes removed through a filtration process. This technique can remove cytomegalovirus (CMV) and also prevent non-hemolytic febrile reactions in patients who react to white cell products like cytokines.
The shelf life of RBCs depends on the preservative added.
CPD, CP2D = 21 days
CPDA-1 = 35 days
AS 1, 3, or 5 = 42 days
Glycerol = 10 years from date of phlebotomy (not freeze date)
An important calculation to be aware of is the equation to calculate the number of blood units to be screened given negative antigen frequencies and the amount of units needed. The equation you can use is: (% negative antigen frequency / 100 = units needed / x). Then you solve for x and round up to the next whole number for the number of units to be screened. If the patient has more than one antibody, multiply the negative frequencies of both antigens and use that number in the equation above.
Plasma:
1. Fresh frozen plasma (FFP)
a. Red cells and plasma are separated by centrifugation. Plasma needs to be frozen within 8 hours of collection. FFP is good for one year when frozen at less than -18⁰C. Once thawed, FFP is good for 24 hours when stored at 1-6⁰C. Plasma is frozen because coagulation factors will degrade at room temperature.
2. Cryoprecipitate:
a. Cryoprecipitate is a product of fresh frozen plasma. When FFP is thawed at 1-6⁰C, and insoluble portion of plasma called “cryo” forms. Cryo consists of factor 8, 13, fibrinogen, and vWF. Cryo needs to be refrozen within 1 hour and can be stored for one year at less than -18⁰C. When using cryo, it must be used within 6 hours of being thawed and within 4 hours if being pooled. Cryoprecipitate is mainly used to administer a high fibrinogen dose using a small volume.
Platelets:
1. Platelets are stored at 20-24⁰C (~68-75⁰F). Platelets have a shelf life of 5 days with agitation.
The main two components for administering platelets are platelets from plateletpheresis and from whole blood. Plateletpheresis is a process where a donors platelets are separated from the rest of the blood and the rest of the blood is returned to the donor. Plateletpheresis gives a more concentrated amount of platelets and yields 3.0 x 10^11 per unit; whereas, platelets from donor whole blood yields about 5.5 x 10^10 per unit.
A plateletpheresis unit will raise a patient’s platelet count by 20,000-60,000/uL. Whole blood platelets will raise a patient’s platelet count by 5,000-10,000/uL.