Blood Components

• Blood products


  Any therapeutic substance prepared from human blood through physical and or chemical means
• Blood components


  • Red cell concentrates
  • Platelet concentrates
  • Granulocyte concentrates
  • Fresh frozen plasma
  • Cryoprecipitate
• Plasma derivatives


  • Albumin
  • Coagulation factors
  • Immunoglobulins
• Requirements for blood component preparation


  • Refrigerated(Cold) centrifuge
  • Triple or quadruple blood bags
  • Plasma extractor
  • Fresh donor blood (<6hrs)
• First centrifugation


  1. 1500rpm for 10mins

  2. Red cell conc. as sediment

  3. Platelet rich plasma (PRP) as supernatant

  4. Use plasma extractor to transfer the PRP into the second bag
• Second centrifugation


  1. 5000rpm for 20mins

  2. Platelet conc. as sediment

  3. Platelet poor plasma as supernatant

  4. Transfer fresh plasma into the third bag
• Blood components in bags


  • Red cell concentrate in first bag
  • Platelet concentrate in second bag
  • Fresh plasma in third bag
• Blood components


  • Whole blood
  • Platelet rich plasma
  • Red cell concentrate
  • Fresh plasma
  • Platelet concentrate
  • Fresh Frozen Plasma
  • Cryoprecipitate
  • Cryosupernatant
  • FVIII conc.
  • Albumin
• Whole blood


  Consists of RBCs, WBCs, platelets and plasma (with anticoagulant)
• Whole blood


  • 1 unit increases Hgb 1 g/dL and Hct 3%
  • Used for patients who are actively bleeding and lost >25% of blood volume
  • Used for exchange transfusion
• Whole blood parameters


  • Plasma hemoglobin
  • Plasma K+
  • Viable cells
  • pH
  • ATP
  • 2,3-DPG
  • Plasma Na+
• Red cell concentrate


  • Hematocrit should be ≤80%
  • One unit increases hematocrit by 3%
  • Once the unit is "opened" it has a 24 hour expiration date!
• Red blood cells


  • RBCs are usually given because of their hemoglobin content
  • They increase the mass of circulating red blood cells in situations where blood loss occurs
• Conditions where RBCs are used


  • Oncology patients (chemo/radiation)
  • Trauma victims
  • Cardiac, orthopedic, and other surgery
  • End-stage renal disease
  • Premature infants
  • Sickle cell disease
• Red cell preservation


  • Optimal additive plasma replacement solution e.g Saline-adenine-glucose-mannitol(SAGM)
  • Storage life is 35-42 days
  • Frozen red cells. Glycerol is added before freezing. Used for storing red cells of rare blood groups
• RBC types


  • Leukocyte-Reduced RBCs
  • Frozen RBCs
  • Deglycerolized RBCs
  • Washed RBCs
  • Irradiated RBCs
• Leukocyte-Reduced RBCs


  • For patients who receive a lot of transfusions to prevent antibody production toward WBC antigens
  • For patients transfused outside of a hospital
  • For patients who have reacted to leukocytes in the past
  • Final unit must have less than 5 x 10^6 WBCs
• Frozen RBCs


  • Glycerol is added to cryoprotect the unit
  • Glycerol prevents cell lysis
  • Freezing RBCs preserves rare units or extends the life of autologous units
• Deglycerolized RBCs


  • RBCs that have had the glycerol removed
  • Thawed at 37°C
  • A blood cell processor washes the cells with varying concentrations of saline
  • Considered "open", expires in 24 hrs.
• Washed RBCs


  • Not effective in reducing WBCs
  • For patients (with anti-IgA) that may react with plasma proteins containing IgA
  • Reactions may be allergic, febrile, or anaphylactic
• Irradiated RBCs


  • Prevents T-cell proliferation that may cause transfusion-associated graft versus host disease (GVHD)
  • GVHD is fatal in 90% of those affected
  • Used for: Donor units from a blood relative, HLA-matched donor unit, Intrauterine transfusion, Immunodeficiency, Premature newborns, Chemotherapy and irradiation, Patients who received marrow or stem cells
• Platelets


  • Important in maintaining hemostasis
  • Help stop bleeding and form a platelet plug (primary hemostasis)
  • People who need platelets: Cancer patients, Bone marrow recipients, Postoperative bleeding
• Preparation of platelet concentrate


  1. RBCs

  2. PRP

  3. Plasma

  4. Platelet concentrate
• Platelets


  • Storage Temperature: 20-24°C for 5 days (constant agitation)
  • Each unit should contain at least 5.5 x 10^10 platelets (platelet concentrate)
  • Each unit should elevate the platelet count by 5-10,000 µL in a 70kg person
• Types of platelets


  • Pooled platelets
  • Platelet, pheresis
• Pooled platelets


  • Used to reach therapeutic dose(4-6 units for an adult)
  • An "open system" occurs when pooling platelets, resulting in an expiration of 4 hours
• Platelet, pheresis


  • Therapeutic dose (from one donor) without having to pool platelets
  • Minimum 3x10^11
  • HLA matched – for those with HLA antibodies
  • Leukocyte reduced - used to prevent febrile non-hemolytic reactions and HLA alloimmunization
• Fresh Frozen Plasma (FFP)


  • Plasma that is frozen within 6 hours of donation
  • Stored at -18°C or colder for 1 year
  • Provides coagulation factors for: Bleeding, Abnormal clotting due to massive transfusion, Patients on warfarin who are bleeding, Treatment of TTP and HUS, Factor deficiencies, ATIII deficiency, DIC when fibrinogen is <100 mg/dL
• FFP thawing


  1. 30-37°C waterbath for 30-45 minutes

  2. Stored 1-6°C and transfused within 24 hours

  3. Needs to be ABO compatible
• Methylene blue treated FFP (MBFFP)


  • Single donation units are treated with methylene blue and light to reduce microbial infectivity
  • The level of functional fibrinogen is lower than in standard FFP(60-80%)
• Solvent-detergent treated plasma (SDFFP)


  • Prepared from pools of 300-5000 plasma donations treated with a solvent and detergent
  • Reduced level of coagulation factors, protein S and anti-plasmin
  • Associated with lower risk of transfusion related acute lung injury and allergic reactions
• Cryoprecipitate (CRYO)


  • Stored at -30°C for up to 12 months
  • Thaw FFP overnight at 4°C
  • The cryoprecipitate is refrozen with about 15ml of plasma
  • When needed it is thawed rapidly at 37°C
  • If thawed, store at room temp for 4 hrs
  • The leftover plasma is called cryoprecipitate reduced or plasma cryo or cryosupernatant
  • Good for TTP
• Cryoprecipitate components


  • von Willebrand's factor (plt. adhesion)
  • Fibrinogen (150 mg in each unit)
  • Factor VIII (About 80 IU in each unit)
  • Fibrinonectin
  • Factor XIII
• Cryoprecipitate


  • Used mainly as a source of fibrinogen
  • 2° treatment for Factor VIII deficiency (Hemophilia A)
  • 2° treatment for von Willebrand's Disease
  • Congenital or acquired fibrinogen deficiency
  • FXIII deficiency
  • A typical adult dose is 10 single donor units containing 3-6g fibrinogen
• Plasma components


  • FFP
  • Thawed FFP
  • Cryoprecipitate
  • Plasma cryoprecipitate, reduced (TTP, FII, V, Vii, IX, X, XI)
• Granulocytes


  • Neutrophils are the most numerous, involved in phagocytosis of bacteria/fungi
  • Although rare, it is useful for infants with bacteremia
  • Prepared by hemapheresis
  • ≥ 1.0 x 10^10
  • Maintained at room temp for 24 hours
• Plasma derivatives


  • Human albumin
  • Human immunoglobulin
  • Clotting factor concentrates e.g factors VII, IX, VII, fibrinogen VWF, protein C and prothrombin complex concentrates
• Albumin


  Restoration and maintenance of circulatory blood volume where volume deficiency has been demonstrated and use of colloid is appropriate
• Immunoglobulins


  • Replacement therapy in antibody deficiency syndromes
  • Prevention of RhD immunization in RhD negative women