Blood components

1. Whole Blood, BloodComponents & BloodDerivatives
Dr Shahin Hameed
JR Pathology
AIMS

2. BLOOD PRODUCTS
Whole blood
One unit of donor blood collected in a suitable anticoagulant-
preservative solution and which contains blood cells and plasma.
Blood components
A constituent separated from the whole blood, by differential
centrifugation of one donor unit or by apheresis.
Blood derivatives
A product obtained from multiple donor units of plasma by
fractionation.

3. WHOLE BLOOD
• BLOOD COMPONENTS
– Packed red cells
– Granulocyte concentrate
– Platelet concentrate
– Cryoprecipitate
– Fresh frozen plasma
• BLOOD DERIVATIVES
– F VIII concentrate
– F IX concentrate
– Albumin
– Immunoglobulins
– Prothrombin complex
concentrate

4. WHOLE BLOOD
• One unit of blood collected in a suitable anticoagulant solution.
• Haematocrit 35-45% and haemoglobin 12.0gms/dl.
• Contains no functionally effective platelets and no labile coagulation factors.
• Storage temperature: 2-6oC in appropriate blood bank refrigerator.
• Shelf-life: 35 days (in CPDA-1)
• Indication: Acute massive blood loss, Exchange transfusion, Non-availability
of packed red cells
• Risk of volume overload in patients with chronic anaemia and compromised
cardiovascular function.

6. BLOOD COMPONENTS
Red cells
Packed red cells
Red cells in additive soution
Leucocyte-poor red cells
Washed red cells
Frozen red cells
Irradiated red cells
Platelets
Platelet concentrate
Granulocytes
Granulocyte concentrate
Plasma
Fresh frozen plasma
Cryoprecipitate

7. TEMPERATURE AND DURATION OF STORAGE
OF BLOOD PRODUCTS
• Whole blood, Packed red cells: 2-6oC for 35 days
• Platelet concentrates: 20-24oC for 3 days with continuous
agitation
• Fresh frozen plasma: below -25oC for 1 year
• Cryoprecipitate: below -25oC for 1 year

8. PACKED RED CELLS (RED CELL CONCENTRATE)
• Red cells from which most of plasma has been removed.
• Haematocrit 55-75% or haemoglobin 20mg/dl.
• Raises haemoglobin by 1 gm% or haematocrit by 3 %
• Storage temperature: 2-6oC and shelf-life 35 days (in CPDA)
• Indication: replacement of red cells in anaemia and in acute and
massive blood loss (along with crystalloid or colloid)
• Volume: 250ml

9. RED CELLS IN ADDITIVE SOLUTION
(RED CELL SUSPENSION)
• Commonly used additive solution is SAGM (saline, adenine, glucose
and mannitol).
Advantages:
• Maximum amount of plasma can be removed for preparation of
plasma components.
• Shelf life increases from 35 days to 42 days.
• Flow of infusion is improved due to reduction in viscosity
Indications similar to those for packed red cells
Contraindication for exchange transfusion in neonates

10. LEUCOCYTE-POOR RED CELLS
• These are the red cells from which most of the white cells
have been removed
• By definition, leucocyte depleted red cells should contain
less than 5 X 106 white cells per bag
Indications:
• To avoid sensitization to HLA antigens
• To avoid febrile transfusion reactions in persons who require
repeated tansfusions or who have earlier been sensitized to
white cell antigens
• To reduce the risk of transmission of CMV infection

11. WASHED RED CELLS
• Packed red cells can be washed with normal saline
to remove plasma proteins, white cells and platelets
• IgA-deficient individuals

12. FROZEN RED CELLS
• Red cells can be stored frozen for up to 10 years
• To prevent haemolysis of red cells during freezing and
thawing, a cryoprecipitate agent such as glycerol is added
Indications:
• Donor red cells with rare blood groups can be stored frozen
for recipients who have developed antibodies against
frequently occuring red cell antigens
• Red cells can be stored frozen for future autologous
transfusion, if blood group is rare

13. IRRADIATED RED CELLS
Transfusion of gamma-irradiated red cells is indicated
for prevention of graft vs. host disease

14. PLATELETS
•Obtained either from single donor units of whole blood by
centrifugation or by plateletpheresis
•Platelets prepared from whole blood donation are supplied either as a
single unit or as a pooled unit (i.e. platelets obtained from 4-6 donor
whole blood units are ‘pooled’ together in one bag)
•Platelets obtained from plateletpheresis are supplied as one pack of
single donor platelet
•Storage: 20-24oC with constant agitation up to 72 hours
•Common indications : thrombocytopenia due to decreased platelet
production and hereditary platelet function defect

15. PHERESIS
Donor pheresis is a procedure in which a suitable donor is connected to
an automated cell separator machine through which whole blood is
withdrawn, the desired blood component is retained, and the
remainder of the blood is returned back to the donor. Depending on the
component that is separated and removed, the procedure is called as
platelet pheresis, leucopheresis ..
Therapeutic pheresis consists of removing the undesired blood
component and returning the remaining blood portion to the patient’s
circulation. The undesirable component is discarded. Examples are
therapeutic plasmapheresis in hyperviscosity syndrome in plasma cell
dyscrasias, and leucapheresis in hyperleucytosis in AML or CML

16. GRANULOCYTE CONCENTRATE
• Rarely used
• Granulocytes for transfusion can be obtained either from a
single donor unit by differential centrifugation or by
leucapheresis.
• Indication:
Patient with severe neutropenia with documented bacterial
or fungal infection, which is not responding to appropriate
antibiotic therapy.

17. FRESH FROZEN PLASMA
• Plasma separated from whole blood within 6 hours of
collection and then rapidly frozen to -25oC or lower
• Contains all the coagulation factors
• Storage: at -25oC or lower up to 1 year
• Volume: 200-300 ml
• Indications: Multiple coagulation factor deficiencies (liver
disease, warfarin overdose), disseminated intravascular
coagulation, and massive blood transfusion

18. CRYOPRECIPITATE
• Prepared by slowly thawing 1 unit of FFP AT 4-6oC
• Storage: ??
• Contains F VIII (about 80 units), von Willebrand
factor, fibrinogen, F XIII, and fibronectin

20. BLOOD DERIVATIVES
• Human albumin solutions
• F VIII concentrate
• F IX concentrate
• Prothrombin complex concentrate
• Immunoglobulins

21. HUMAN ALBUMIN SOLUTIONS
• Prepared by cold ethanol fractionation of pooled
plasma
• Available as 5% and 20% solutions
• Heat-treated (at 60oC for 10 hours) to inactivate any
contaminating viruses
• Used as a replacement fluid in therapeutic plasma
exchange, and treatment of diuretic-resistant oedema
of hypoproteinaemia

22. F VIII CONCENTRATE
• Prepared by fractionation from large pools of donated plasma
• Supplied as a freeze-dried powder in vials
• During manufacturing process, it is treated with heat and chemicals to
destroy lipid-enveloped viruses like HIV, HBV, HCV and HTLV
• Stored in refrigerator at 2 to 6oC
• Before administration, it is reconstituted as per manufacturer’s directions and
given intravenously
Indications for the treatment of:
Hemophilia A
Severe von Willebrand disease.

23. PROTHROMBIN COMPLEX CONCENTRATE
• Contains factors II, IX and X, and sometimes also F VII.
Indications:
• Inherited deficiency of F II, IX and X
• Haemophilia A with inhibitor antibodies against F VIII and
who are nonresponsive to F VIII concentrate

24. IMMUNOGLOBULINS
Prepared by cold ethanol fractionation of pooled plasma
Used for passive immunization against infections
Two types:
Non-specific or Normal immunoglobulins:
Prepared from pooled plasma of non-selected donors
Composed of antibodies against infectious agents that are prevalent in donor
population
Indications:
Passive prophylaxis against hepatitis A
Congenital or acquired hypogammaglobulinaemia
Autoimmune thrombocytopaenic purpura to temporarily raise platelet count
Specific Immunoglobulins:
Prepared from donors who have specific high titer IgG antibodies
Includes:
Specific immunoglobulins for passive prophylaxis against hepatitis B
Anti-RhD immunoglobulin.