• Classification

What to Remember
• Preparation
• Components
• Storage
• Expiration
• Indication
 A. Components that contain red
blood cells
B. Components that do not
Classification

contain red blood cells

C. Commercially prepared blood
derivatives
 A. Components that contain red
blood cells
1. Whole blood or modified whole
Classification

blood
2. Red blood cells
3. Leukocyte reduced RBCs
4. Washed RBCs
5. Deglycerolized RBCs
 B. Components that do not
contain red blood cells
1. FFP
Classification

2. Cryoprecipitated antihemophilic
factor
3. Platelet concentrate (random
platelets or six pack)
4. Platelets, pheresis
(single donor platelets)
5. Granulocytes, pheresis
 C. Commercially prepared blood
derivatives
1. Factor VIII concentrates (available
Classification
as recombinant factor VII and
plasma derived factor VIII)
2. Factor IX concentrate (available as
high purity plasma derived factor
IX concentrate and prothrombin
complex concentrate)
3. Albumin solutions
4. Plasma protein fraction
5. Immune serum globulin
6. Antithrombin III conc.
7. Rh Immune globulin
Example
 • RBCs – sedimentation or
centrifugation (heavy or light)
Prep’n, Comp,
Storage, Exp

Plas
WB
ma

Plas
ma
RBC
RBC
 • RBCs – sedimentation or
centrifugation (heavy or light)
Prep’n, Comp,
– 75% to 80% hematocrit
Storage, Exp
 • RBCs modified – 100 ml
additive solution (e.g. adenine
Prep’n, Comp,
saline) is added from a satellite
Storage, Exp
bag after removal of plasma

Additive
solution
 • RBC aliquots
• The acute side effects of
transfusion may be greater for
Prep’n, Comp,
Storage, Exp
small children
• Neonates are especially vulnerable

• Long-term side effects of

transfusion for children are
particularly important, as majority
will live for decades afterwards.
Volume
Anemia in the first 24 h Hb 12 g/dl
(Hct c. 0.36)
Cumulative blood loss in 1 week 10%BV
neonate requiring intensive care

Neonate receiving intensive care Hb 12 g/dl

Acute blood loss 10%

Chronic oxygen dependency Hb 11 g/dl

Late anemia, stable patient Hb 7 g/dl

Choice of ABO group for
blood products for
administration
to children
 ABO blood group to be
transfused
Patient’s Red Cells Platelets FFP
ABO Group
O First Choice O O O
2nd Choice - A A/B or AB
A First Choice A A A or AB
2nd Choice O* O* -
B First Choice B B B or AB
2nd Choice O* O* -
AB First Choice AB AB AB
2nd Choice O A A
3rd Choice O*
Investigations on the maternal sample:
• ABO and RhD group
• Screen for the presence of atypical red cell
antibodies

Investigations on the infant sample:

• ABO and RhD
• DAT on neonate’s red cell
• if no maternal serum is available, do an IAT
on infant’s serum
Suspect hemolytic disease of the
newborn:
If positive DAT on the neonate’s red cells
or presence of an atypical red cell
antibody in maternal or neonatal serum

In such cases, special serological

procedures will be necessary to allow
selection of appropriate blood
Level IV evidence, grade C recommendation
Br. Committee for Standards in Hema.2003
 Irradiation of components to a
minimum dose of 25 Gy
- PRBC for large volume
Irradiation

transfusions
- IUT transfusions
- platelet transfusion from first or
second degree relatives
- granulocytes
 • Leukocyte reduced RBCs –
filtration or washing
Prep’n, Comp,
Storage, Exp
White Cell Filter LRF-XL

Priming
 • Washed RBCs – manual or
automated; removal of WBC,
Prep’n, Comp,
platelets and plasma
Storage, Exp
 • Frozen RBCs – high
concentration of glycerol w/in 6
Prep’n, Comp,
days of collection (up to 10 yrs)
Storage, Exp
 • Deglycerolized RBCs
– thaw from -65°C
Prep’n, Comp,
– Wash with decreasing
Storage, Exp
concentrations (starting with 12%
NSS)
– Suspend in 0.2% dextrose
– Use within 24 hours
 • FFP
– heavy spin of whole blood at 4°C
Prep’n, Comp,
– separate plasma at -18°C or
Storage, Exp
lower within 8 hours of collection
– Contains all coagulation factors

Plas
FWB
ma

FFP

RBC
RBC
 • Cryoprecipitated AHF
– Thaw FFP between 1 to
6°C to slush cons
Prep’n, Comp,
Storage, Exp
– Centrifuge at 1 to 6°C
(heavy spin) FFP
– Hang in inverted
position or placed in a
plasma expressor so
that approx. 90% of
cryo-poor plasma is Cryo
removed (refreeze at -
poor
-18°C & label as cryo-
poor )
 • Cryoprecipitated AHF
– 10 to 15 ml supernantant plasma
Prep’n, Comp,
contains cryoprecipitate
Storage, Exp
– Contains fibrinogen, factor VIII,
factor XIII, vWF, fibronectin
– Refreeze at -18°C or lower
– Transfuse within 6 hours upon
thawing
 • Platelet concentrate
– Separate fresh whole blood (<8
Prep’n, Comp,
hours) that has been kept at RT
Storage, Exp
before the separation
– Light spin for pRBC
– Platelet rich plasma is centrifuged
using heavy spin at 20°C

FFP
RBC
 • Commercially derived products
– Plasma fractionation
Prep’n, Comp,
• Ethanol fractionation
Storage, Exp
• Affinity chromatography
• Ion exchange chromatography
– Plasma derivatives
• Recombinant DNA technology
(factor VIII)
 • Depends on:
– Need of patient
– Transfusion reactions
Indication/s
 • Autologous
Types of Donation
• Allogeneic
• Pheresis
 MCS+ System Over View
Air Bag
nti-coagulant Solution
Final Product Bags

WBC Pall Filter

Plasma Bag

SPM filter
DPM Filter