Whole blood- red cells suspended in a protein solution Wastage More side effects Not available in western countries Components Specific Therapy More patients can be benefitted Increased shelf life
Whole blood
Red cells
Granulocytes
Plasma
Platelets
Fractionated products
Cryoprecipitate
Albumin
Blood Products
Whole blood Red cell component Platelet component Plasma products Component Fresh frozen plasma (FFP) Liquid plasma derivatives Albumin
Red blood cell Single donation conc./suspension unit (PC) (PRBC) Washed Red Cells Conc. Pooled unit
Leucocyte Single donor Cryoprecipitate depleted red cells apheresis platelets (SDAP) Frozen red cells - irradiated PRBC - irradiated PC Cryo poor plasma Viral inactivated plasma
Composition
Preparation
Whole blood
1 unit increase Hb by Volume (ml) Maximum storage time at 2-60C Advantages Disadvantages
PRBC
Indications-
Component of choice for virtually all patients with a deficit of oxygen carrying capacity, e.g., blood loss or anemia. Transfusion Trigger>10 gm/dl- Probably no transfusion required 7-10 gm/dl- Transfusion may be requierd <7 gm/dl- Transfusion is usually required
Storage lesions
Viability
2-3 DPG Levels Potassium plasma Hb
Washed RBC
Washed with NS
Removes 99% of plasma proteins, electrolytes and
Washed RBCs
Indications IgA Deficient individuals Repeated allergic reactions Intrauterine transfusion Pts with T activated cells Very occassionaly- severe autoimmune hemolytic anaemia
Leukodepleted RBC
< 5 x 10 6Leukocyte/unit
Reduce the risk of
1. Febrile non hemolytic reactions 2. CMV Transmission 3. HLA Allo-immunization leading to platelet refractoriness.
Leukodepleted RBC
1. Filteration Prestorage leukodepletion Leukodepletion at time of issue Bedside leukodepletion 2. Buffy Coat Removal
enterocolitis, pancytopenia, hypocellular marrow, Instrument- Blood irradiator Dose- 25Gy Irradiation indicated for1. all relative donors 2. immunocompromised patients 3. neonates undergoing exchange transfusion 4. Pts with Hodgkins disease 5. Pt of CLL receiving fludarbine phosphate
Platelets Transfusion
Indications Bleeding d/t thrombocytopenia/abnormal platelet functions Prophylactically- 10,000/cumm instable pts. Platelet transfusion trigger -50,000/cumm for most surgeries. Neurosurgery/ophthalmic surgery- 100,000/cumm
count by 5-10K in the average adult; Dose:1 unit platelet concentrate per 10 kg body weight or 1 unit apheresis platelets Patients repeatedly transfused - alloimmunized and refractory to platelet transfusion-HLA matched or cross-matched platelets may be required
Platelets Transfusion
Contraindications ITP Platelet refractoriness TTP Heparin induced thrombocytopenia