Blood products

BLOOD PRODUCTS

Jesil Mary John

Intern

DEFINITION

PACKED CELLS

• It is obtained by centrifuging whole blood at 2000-2300 g for 15-20 minutes.

• It is used in chronic anaemias, in old age, in children, thalassemia, sickle cell disease.

• It minimises the cardiac overload due to transfusion.

• It can be stored for 35 days at 1°C-6°C.

PLASMA

• obtained by centrifugation.

• indication”:

burns,

hypoalbuminaemia,

severe protein loss

• can be fractionalised into different fragments:

• Human albumin 4.5%:
• obtained after repeated fractionations
• can be stored for several months in liquid form at 4°C.

b. Fresh frozen plasma (FFP):

b. Fresh frozen plasma (FFP):

• Fresh plasma rapidly frozen and stored at –40°C.
• contains all coagulant factors.
• 1 unit of FFP increases clotting factors levels by 3%.
• can be stored for 2 year.
• Rh positive FFP can be transfused to Rh negative
• Uses:
• Severe liver disease with abnormal coagulation function.
• Congenital clotting factor deficiency
• Deficiency following warfarin therapy,
• DIC,
• massive transfusion

c. Cryoprecipitate:

c. Cryoprecipitate:

• fresh frozen plasma allowed to thaw at 4°C, visible white supernatant layer develops, called as cryoprecipitate
• rich in Factor VIII and fibrinogen
• stored at minus 40°C
• can be kept for 2 years.

d. Fibrinogen

• obtained by organic liquid fractionation of plasma
• stored in dried form.
• Indication: DIC and afibrinogenaemia.
• risk of transmitting hepatitis

PLATELET RICH PLASMA

• obtained by centrifugation freshly donated blood at 150-200 g for 15-20 minutes.

PLATELET CONCENTRATE

• prepared by centrifugationof platelet rich plasma at 1200-1500 g for 15-20 minutes.
• Used in
• thrombocytopenia
• drug (aspirin, clopidogrel) induced haemorrhage.
• Storage -20 to 240 C
• Shelf life : 5 days

PROTHROMBIN COMPLEX CONCENTRATE (PCC)

• derived from pooled plasma which contains factors II, IX and X
• used in emergency reversal of warfarin therapy in uncontrolled haemorrhage.

SAG-M BLOOD

• A proportion of donations will have plasma removed and will be replaced by crystalloid solution of SAG-M.
• S — Sodium chloride.
• A — Adenine.
• G — Glucose anhydrate.
• M — Mannitol.
• Advantages
• This allows good viability of cells
• But it is devoid of any protein
• It is very useful in anaemias

Precautions

Precautions

• For every 4 units of SAG-M blood, one whole blood.
• Later for every two units of SAG-M blood, one unit (400 ml) of 4.5% human albumin be given.
• Coagulation status and platelet count should be checked regularly.
• After grouping and cross matching, 540 ml of blood is transfused in 4 hours (40 drops per minute), using a filtered drip set.
• One litre of blood has 350 mg Iron.
• Normal excretion of iron - 1 mg/day.
• Iron overload occur after many transfusions.
• Iron excretion increased by desferrioxamine infusion

BLOOD SUBSTITUTES

• Human albumin 4.5%

no risk of transmitting hepatitis.

• Dextrans are useful to improve plasma volume.

They are polysaccharides of varying molecular weights.

a. Low molecular weight dextran (40,000 mol wt.) (Dextran 40, Rheomacrodex).

• Dextran 40 is very effective in restoring blood volume immediately.
• But small molecules are readily excreted in kidney and so effect is transitory.
• It may be useful in prevention of sludging in kidney and hence renal shut down.

b. High molecular weight dextran (Dextran 110 and Dextran 70)

• Less effective but long acting and so useful to have prolonged effect

RECYCLED BLOOD

• In major surgeries if there is significant blood loss, patient’s bled blood is carefully sucked out through a sterile system , filtered and reused again to the patient.
• This will reduce the number of transfusions.

ARTIFICIAL BLOOD

ARTIFICIAL BLOOD

1. Perfluorocarbon (Fluosoleda) - abiotic substitute as synthetic oxygen carrier.

• It has got high affinity for O2.

• It is inert.

• It is biocompatible.

2. Stroma free haemoglobin –

• biomimetic haemoglobin based substitute.

3. Chelates which reverse bound O2.

• Intraoperative–salvage of blood: On table blood is collected, washed, filtered and transfused.

• Used in trauma

ERYTHROPOIETIN

• injection 1000-3500 units preoperatively also used to increase the RBC count.
• It is used in CRF patients who are on haemodialysis.
• It is given twice weekly but it is costly,

Thank you…………