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Blood Component Therapy
Salwa I HindawiMSc FRCPath CTM
Director of Blood Transfusion ServicesKAUH . Jeddah
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RBC Agglutination
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ABO typePt Cells Pt Serum
vs vs
anti-A anti-B Acells Bcells
A + 0 0 + 40%
B 0 + + 0 11%
AB + + 0 0 4%
0 0 0 + + 45%
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BLOOD COMPONENT THERAPYIt is the transfusion of specific blood components
required by the patient.
Principles Use blood products only when it is essential.
Replace only the deficient component, if
possible. Identify the cause and nature of the deficiency
and if possible, treat it.
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Wholeblood
Platelets
rich
plasma
1stcentrifugation
Platelets
concentrate
Wholeblood
Wholeblood
2ndcentrifugation
Fresh plasma
FFP for
clinical use
FFP for
fractionation
Optimal additive
solution
Red cells in
OAS
Cryoprecipitate
RedCell
concentrate
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Blood COMPONENTS AVAILABLE
FROM THE BLOOD BANK Whole blood
Packed RBCs
Platelets
Single donor platelets (Apheresis)
Fresh Frozen Plasma (FFP) Cryoprecipitate
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Indication for Red Blood Cells
Transfusion Red blood cells are
component of choiceto maintain anadequate supply ofoxygen to meettissue demands.Oneunit increase thehaemoglobin levelby 1g/dL in a 70kgrecipient.
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Indication for Transfusion ofWhole Blood
Fresh whole blood 30-40% of their bloodvolume.
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Indication for red blood cells
Transfusion Symptomatic anaemia
Acute blood loss>30-40% of blood volume.
Pre-operative Hb< 8g/dl and operativeprocedure associated with major blood loss.
Evidence of inadequate oxygen delivery.
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Administration and Dose
Red blood cells transfusion has to be grouped specific
& Rh specific, if not one of alternative compatiblegroup.
This component must be administered through a
suitable transfusion set (170 mM filter).
Dose of 4ml/kg raises venous Hb by about 1g/dl.
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Specifications
Whole blood volume 450mls+63mls of CPD-A1
anticoagulant. Packed RBCs volume 250mls50mls.
Hct=0.55-0.75.
Anticoagulant CPD-A1 store at 4c2cfor 35 days.
SAG-M for 42 days.
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Cont, Platelet Transfusion
In acute D.I.C (Disseminated intravasculr coagulation).
In neonatal alloimmune thrombocytopenia (NAIT) fromdonor known to be negative for the appropriate HPA or
mother platelet. Platelet function disorders or thrombocytopenia
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Administration of PlateletConcentrate:
ABO compatible platelet are preferred but not necessary.
Platelet concentrate should be transfused as soon as possibleafter reaching the ward with standard blood transfusion setswith 170 mm filters.
The transfusion should normally be completed within 30minutes.
Observation during platelet transfusion should include pulse&temperature before& after transfusion.
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Indications For The Use Of FFP
Definite indication:
Replacement of single factor deficiencies
Immediate reversal of warfarin effect
Vitamin K deficiency
Acute disseminated intravascular coagulation
Thrombotic thrombocytopenic purpura Inherited deficiencies of inhibitors of
coagulation:at, protein S, protein C.
CI esterase inhibitor deficiency
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Conditional uses of FFP
FFP is only indicated in the presence of bleedingand disturbed coagulation.
Massive transfusion
Liver disease
Cardiopulmonary bypass surgery
Special Paediatric indications:sever sepsis, DIC.
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Administration of FFP
1unit of FFP= APPROXIMATELY 200 ML Dose = 12-15 ml/kg Should be administered within 2 hours of thawing.
PT & PTT used for monitoring in addition to the clinicalassessment.
ABO compatible FFP should be used. Compatibility testing isnot required.Group O should only be given to group O recipient.
Group A or B FFP can be given to group O recipient.Group AB FFP should be reserved for group AB recipients andfor emergencies.
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Administration of Cryoprecipitate
1 unit of cryo= approximately 10-20ml Adult dose equivalent to 10 units of cryo For factor replacement the dose can be calculated
according to the volume of the factor in theconcentrate. Fibrinogen 150-300mg/pack Von Willebrand factor 80-120u/pack Factor V111c 80-120u/pack Factor X111 20-30% of factor X111 present in the
FFP. Should be ABO compatible to avoid risk of haemolysis
caused by donor antiA or antiB. Should be administered within 4 hours of thawing.
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Platelet, Apheresis
An adult dose of Platelets prepared from
anticoagulated blood which is separated intocomponents by apheresis machine with retention
of the platelets and a portion of the plasma.
The remaining elements may be returned to the
donor
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Specification
Volume 200800 mls
Platelet count > 240 x 109/ unit
Leucocyte count < 5 x 108/ unit
PH at end of shelf life 6.4-7.4Availability: On request.
Shelf life storage: 5 days at 22 2c gentlyagitated
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