Reasons of blood collection, preparation, and storage
1-Study viability and function.
2-prohibit physical changes.
3-Eliminate the contamination of bacterial.
? The solutions of anticoagulants preservative
The anticoagulant blocks blood clotting whereas preservatives supply the appropriate nutrients for cell metabolism during storage. The heparin works as anticoagulant and must be transferred within 48 hours.
Anticoagulant/preservatives approved for whole blood storage are:
Citrate Phosphate Dextrose (CPD) Citrate Phosphate 2 Dextrose (CP2-D) Citrate Phosphate Dextrose Adenine (CPD-A1)
Storage Time 21 days 35 days
Temperature 1-6 C 1-6 C
make glycolytic activity slow so that dextrose is not quickly consumed
Adenine None Added adenine gives substrate from which RBCs can generate ATP during storage, improves viability
Volume 450 mLs or 500 mLs + 10% 450mLsor500mLs +10%
Dextrose – enhances continuing ATP generation via glycolytic pathway
Citrate – blocks coagulation by binding ionized calcium which is needed for coagulation cascade
? Additive solutions
1. The system has an essential bag that attached to satellite bags, and one of them has AS-3, AS-5, 3 formulations AS-1, and the additive solution.
2. Unit drawn into the primary bag having CPD anticoagulant.
3. Platelet rich plasma is taken out, and a second preservative solution is added to the RBCs to make the storage of red cells up to 42 days and has a final hematocrit of 66%. The second solution consists of adenine, saline, mannitol (SAGMAN), and glucose.
4. Within 72 hours of collection, plasma must be taken out and AS added.
Changes may occur during blood storage
1. Expiration date.
o Maximum storage time results in 75% recovery
o 75% recovery means that at least 75% of the transfused cells will remain in the recipient’s
circulation 24 hours after transfusion.
2. Storage lesion
1. Shows the measurement of biochemical changes that can occur when blood is stored at 1-6 C.
2. The curve of Oxygen dissociation is affected by the biochemical changes and may lead to an increase in the affinity of hemoglobin for oxygen.
* Low 2,3-DPG levels give greater affinity for oxygen making less O2 release.
* pH drops due to cellular metabolism, leads to 2,3-DPG levels to fall.
* After transfusion stored donor RBCs make ATP and 2,3-DPG levels.
*Few platelets that function are left, and number of viable red cells will decrease.
3. Clinically, storage lesion is important for patients and infants who need massive transfusion.
4. Some of biochemical changes can occur are:
* ATP decreases
* Potassium increases in plasma
* pH decreases
*2,3 DPG decreases
*Plasma hemoglobin increases in plasma.
* Sodium decreases in plasma.
? Preparation of components
1. Unit should be collected within 15 minutes to block the partial activation of coagulation system.
2. Blood components draw into a bag attached to satellite bags to prevent a hermetic seal breaking when components are removed.
3. The component must be transfused within 24 hours that are stored at 1-6 C if hermetic seal is broken, or must be transfused within 4 hours if they are stored at 20-24 C.
4. In component preparation, platelets must be taken out within 8 hours of collection and blood must be not cold.
? Centrifuge blood by “light” spin (2000xg, 3″).
? Cut the integral seal and extract the top layer, which is platelets rich plasma, to a satellite bag and seal it. Place a primary bag with RBCs at 1-6 between the primary, and the satellite bag.
? By using a “heavy” spin (5000 x g, 5 minutes), centrifuge platelet rich plasma.
? Place the supernatant platelet-poor plasma inside the second transfer bag and seal it.
? Place plasma at -18 C or lower, and platelets are stored at 20-24 C with steady agitation.
The coming component are routinely prepared from one unit of whole blood:
1. Red blood cells (RBC)
2. Frozen plasma (FFP)
3. Single donor plasma (SDP)
4. Cryoprecipitate (CRYO)
5. Platelets (PC or RD PC)
• Cellular Blood Components
1. Whole Blood (WB)
* The clinical indications of using WB are limited.
* used to correct acute hypovolemia for massive transfusion
* seldom used today
*because ABO antibodies present in plasma, WB must be ABO identical
2. Red Blood Cells (RBCs)
*utilize to treat blood loss during surgery and symptomatic anemia
* Hematocrit is 60% for additive (ADSOL) and 80% for non-additive (CPD)
* centrifuge WB and remove supernatant plasma.
3. Red Blood Cells Leukocyte Reduced
* Leukocytes present in blood product can enhance adverse effects during transfusion or non-hemolytic reactions.
* the presence can make some other reactions like fragmentation of granulocytes and micro aggregates.
* Historically, indicated only for patients who had 2 or more febrile transfusion reactions. These days, a usually ordered, popular component.
4. Washed Red Blood Cells (W-RBCs)
* In the washing, platelets, plasma proteins, micro aggregates, and WBCs are removed to prevent urticarial reactions.
*The IgA deficient patient with anti-IgA antibodies is required this product.
*prepared by a washing machine that washes cells three times with saline.
*two kinds of labels:
_ Leukocyte Poor WRBCs, QC in needed to make sure that 85% of WBCs is removed.
_ Washed RBCs. There is no need for QC.
* Expires 24 hours when unit is entered
5. Frozen Red Blood Cells; Deglycerolized Red Blood Cells (D-RBC)
* frozen blood is used for autologous transfusion, to preserve rare types, or stock for civilian natural disasters.
* anticoagulant preservative is used in blood drawing.
? glycerol is added, and plasma is taken out
? unit is centrifuge after equilibration to take out glycerol and frozen.
? 10 years if it is frozen
? 24 hours after deglycerolization
? low glycerol -120 C, liquid nitrogen.
? high glycerol -65 C.
• Plasma Components
1. Fresh Frozen Plasma (FFP)
*used to replace non-labile and labile coagulation factors in bleeding patients.
*within 8 hours of collection, must be frozen
? frozen – 7 years stored at