Whole Blood or the mother unit, is the most common blood received in Blood Banking
In the initial process,
From mother unit of whole blood, it will undergo initial centrifugation in order to separate PRBCs and PRP
Once separated, plasma will be expressed out (into another bag)
In the initial process, centrifugation has the same size of washing machine
In the initial process, not only one bag is used.
There is also a Satellite bag, where the components will go to once it is being processed
Initial process
Plasma is expressed out to form fresh frozen plasma
Packed RBCs will be expressed to another bag to become PRBCs
Initial process
Plasma depends on storage, it can be fresh frozen plasma or stored plasma
Fresh frozen plasma and stored plasma difference is the freezing time within the approved period
PRBC is the most common unit issued to patient
Whole blood is rarely issued to patient
We can derive platelet concentrate coming from 1 unit of whole blood
Usually undergo two or more spinning procedure or centrifugation
Plasma after light spin = platelet rich plasma
PRP will undergo hard spin = platelet poor plasma
Whole blood is the most common and is used for replacement of mass RBC and plasma volume
Basically, it is the immediate blood from donor
Whole blood is diluted into an anticoagulant to blood ratio of 1:8
It is important to maintain at this ratio because if we undercollect, there will be imbalance in ratio and there will be excess citrate and can cause hypocalcemia.
Whole blood
Coagulant usually used is citrate
Additives for RBC metabolism during storage are Glucose, adenine, phosphate
Use of whole blood is limited to a few clinical condition
It is rare to give to recipients
Whole blood cannot be given immediately because there are anticipated or predicted antigens and antibodies per ABO type
1 unit of Whole Blood = increase Hematocrit by 3-5% or Hemoglobin by 1-1.5 g/dL (for typical 70 kg adult)
In Pediatric patients,
1 unit of Whole Blood = 8 mL/kg will increase, hemoglobin by 1 g/dL and hematocrit by 3-4%
It is important to get the weight of pediatrics patient
In whole blood, increase in Hgb and Hct may not be apparent until 48-72 hours
Acid citrate dextrose is the most common anticoagulant used in WB.
It has citrate and dextrose (glucose solution)
Shelf life of anticoagulants Acid citrate dextrose, Citrate Phosphate dextrose, and Citrate Phosphate-2 dextrose is 21 days
Shelf life of anticoagulant Citrate phosphate dextrose adenine is 35 days
Shelf life of anticoagulant Additive solutions (AS-1), Nutricel (AS-3), and Optisol (AS-5) is 42 days
Additive solutions are not inherent to blood bag, it is added to extend the shell life for refrigerated blood
Additive solutions (AS-1,3,5), a mixture of glucose, adenine and normal saline, provide nutrients to stabilize cell membrane and maintain the level of 2,3 DPG, which minimizes storage lesions
Level of 2,3 DPG for stored blood is very important because it has inverse relationship with oxygen affinity of hemoglobin
↑ 2,3 DPG = ↓ oxygen affinity of hemoglobin
Storage lesions are effect or damage to RBC due to storage because RBC is organic material and may deteriorate overtime
Additive solutions:
AS-1 and AS-5 contains mannitol as a membrane stabilizer
AS-3 contains citrate and phosphate as a membrane stabilizers
Modified whole blood is a whole blood void of cryoprecipitated
Modified whole blood
Hematocrit provides approximately 38%
Stored at 1-6 °C
Stored for 21 days (ACD and CPD) or 35 days
To inhibit T-cells proliferation, irradiation is required in order to kill your T-cells, which is to prevent TA-GVHD which can be fatal to patient
Dose of radiation is enough to kill your T-cells but maintains the viability of other cells particularly red blood cells
25 gamma rays is an indicator to the center of blood product to kill these T-cells