Description of different Plasma Components

1. PLASMA COMPONENTS
Presenter – Dr Sowmya.S.M
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2. COMPONENTS OF BLOOD
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3. 3 BLOOD COMPONENTS

4. WHAT IS PLASMA??
 Clear, straw-coloured liquid portion of blood that suspends all the
other parts of the blood.
 It is the single largest component of human blood, comprising
about 55 percent.
 It contains water, salts, enzymes, antibodies and other proteins.
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5. COMPOSITION
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7. ACTIONS
 Intravascular fluid part of extracellular fluid.
 Protein reserve.
 Solvent for nutrients, electrolytes, gases and other substances.
 Plays a vital role in an intravascular osmotic effect that keeps
electrolytes in balanced form and protects the body from infection and
other blood disorders.
 Helps maintain blood pressure and regulates body temperature.
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8. HOW IT IS SEPERATED??8

9.  Different specific gravities of blood components.
 RBCs: 1.08 – 1.09
 Platelets: 1.03 – 1.04
 Plasma: 1.02 – 1.03
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10. DIFFERENT PLASMA COMPONENTS
 Fresh frozen plasma
 Frozen plasma
 Thawed plasma
 Cryoprecipitate-reduced
 Cryoprecipitate
 Coagulation factors – Factor VIII, IX, XIII and VIIa
 Albumin
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11. FRESH FROZEN PLASMA
 Plasma separated from whole blood.
 Frozen within 6-8 hours of collection.
 Rapid freezing of plasma preserves the
labile coagulation factors at maximum levels.
 Stored at ≤ –20°C for up to one year
 Or at ≤ –65°C for up to 7 years
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12. PREPARATION OF FFP
 Whole blood - double/triple – CPD/CPDA or special bag system with
additive solution – SAGM
 Balance the bags and placed in centrifuge.
 Centrifugation – 5000 rpm for 5 min at 4°C (Heavy spin).
 Separate plasma into satellite bag using plasma extractor.
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13.  Label with unit number and blood group before separation.
 Cut the tubing between two seals
 Place the plasma at -20°C or lower within 6 hours of collection.
 FFP from a standard donation of whole blood (450ml) usually measures
175-250 ml.
 It contains 70-80 units/dl of Factor VIII, Factor IX, vWF and other plasma
clottting factors.
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Weigh and balance the units
and centrifuge

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Separated plasma Express plasma to satellite bag

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Seal the tubes and separate
Plasma stored at -20°C or lower

17. BEFORE ISSUE…
 Before transfusion, it is thawed over 20 to 30 mins at 30 to 37°C.
 A water bath is used for thawing.
 The entry ports need to be protected from contamination during this
process.
 Transfused immediately or stored at 4°C (1–6°C) for 24 hours – “FFP
thawed”
 After 24 hours, the words “fresh frozen” should be removed and
labelled as “Thawed plasma”.
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18. INDICATIONS
 Multiple coagulation factor deficiencies – liver disease, DIC,
coagulopathies.
 Reversal of coumarin drug effect.
 Use in antithrombin deficiency.
 Immunodeficiency syndromes.
 Raised PT and INR
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19. DOSE AND ADMINISTRATION
 Accepted dose of FFP transfusion is 12-15ml/kg.
 However dose depends on the underlying clinical disease.
 Post transfusion assessment of patient’s coagulation parameters like
PT, aPTT or specific factor asssay is important for monitoring.
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20. FROZEN PLASMA
 Separated from whole blood within 8 - 24 hours of collection.
 The level of the labile clotting factors, factors VIII and V is lower in FP,
than in FFP.
 Adequate – treatment of mild to moderate coagulation factor
deficiencies.
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21. SOLVENT/DETERGENT-TREATED
PLASMA The thawed plasma is treated with solvent tri-n-butyl phosphate (1%)
and detergent Triton X-100 (1%)
 Removed after treatment and the sterile-filtered plasma is refrozen.
 ADVANTAGES: Significantly inactivates the lipid enveloped viruses
(e.g. HCV, HBV, HIV).
 But not the non lipid enveloped viruses - hepatitis A and parvovirus.
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22. CRYOPRECIPITATE
 Precipitate of fresh frozen plasma (FFP) when it is
thawed at 4°C (1°C - 6°C) and then centrifuged,
collected, and refrozen.
 It is rich in fibrinogen, factor VIII (80–100 u), vWF,
fibronectin, and factor XIII.
 It revolutionized the treatment of hemophilia and
von Willebrand disease.
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23. 02/11/2016olusola.ajayi@aaua.edu.ng ajayicomputer@gmail.com ajsoftengr@gmail.com
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24. 02/11/2016olusola.ajayi@aaua.edu.ng ajayicomputer@gmail.com ajsoftengr@gmail.com
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25.  It contains 80-100 units of F VIII, 100-250 mg of fibrinogen, 50-60mg
of fibronectin and 40-70% of vWF and 20 – 30% F XIII.
 Although this product contains small amounts of isohaemagglutinins,
it is not necessary to perform compatibility testing prior to
administration.
 Neonates should receive only ABO-compatible cryoprecipitate.
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26.  Each unit – 10 to 15ml.
 SHELF LIFE: Frozen:1 yr
Thawed: 6 hr
 STORAGE: 18°C or lesser
 BEFORE ISSUE:
Thawed over 20 to 30 mins at 30 to 37°C in water bath.
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27. INDICATIONS
 Hemophilia A
 von – Willebrands disease
 Congenital fibrinogen deficiency
 Factor XIII deficiency
 Acquired Factor VIII deficiency – eg: DIC, massive transfusion
 Used as local/topical hemostatic agent.
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28. USAGE
 Dosage - relatively subjective
 Monitored by serial measurements of plasma fibrinogen.
 One unit will increase the fibrinogen by 5 to 10 mg/dl in an average
sized adult.
 Cryoprecipitate has been used with a source of thrombin as a
topical haemostatic agent as well
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29. CRYOPRECIPITATE-DEPLETED FRESH-FROZEN
PLASMA
(CRYOSUPERNATANT)
 The remaining thawed plasma of FFP that is left after Cryoprecipitate is
separated is called cryoprecipitate reduced (cryo-poor) plasma or
cryosupernatant.
 All the factors like fibrinogen, factor VIII, von Willebrand’s factor (vWF),
factor XIII and fibronectin, are reduced in the cryo-poor plasma.
 It is deficient in the pathogenic ultra-large multimers of vWF but contains
vWF-cleaving metalloprotease.
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30.  STORAGE: –18°C or colder.
 SHELF LIFE: one year from the whole blood collection date.
 INDICATIONS: treatment of refractory thrombotic thrombocytopenic
purpura
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31. FACTOR VIII CONCENTRATES
 Prepared from large volumes of pooled
plasma or in the form of recombinant FVIII
using DNA technology.
 When prepared from pooled plasma,
techniques used to inactivate or eliminate
viral contamination include pasteurization,
solvent/detergent treatment, and
monoclonal purification.
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32.  Factor content per unit volume is 10 – 40 times greater than plasma.
 Stored at 4°C in a home refrigerator.
 INDICATIONS:
 Hemophilia A
 Hemophilia B
 Persons deficient in factor VIII.
02/11/2016
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33. FACTOR IX CONCENTRATES
 Prepared from pooled plasma.
Available in three forms:
 Prothrombin complex concentrates
 Factor IX concentrates
 Recombinant Factor IX.
02/11/2016
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34.  INDICATIONS:
Treatment of Factor IX deficiency or Hemophilia B
Treatment of Factor XI Deficiency (Hemophilia C)
 Also contains Factor II, VII and X in concentrated form.
 Vials contains 500 units of Factor X.
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35. FACTOR XIII CONCENTRATES
 There are currently two plasma-derived virus inactivated factor XIII
concentrates.
 Fibrogammin P
 Factor XIII concentrate
 Single-use vial contains 1000 – 1600 IU of lyophilised concentrate
 STORAGE: AT 2 - 8°C
 SHELF LIFE: 36 months
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36. ALBUMIN
 Albumin is the quantitatively dominant plasma protein.
 MW - 66kDa, water-soluble protein.
 Synthesized in the liver at a rate of about 15 g/day.
 Half-life of around 25 days.
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37. PREPARATION
 Commercially available albumin preparations are obtained from
plasma fractionation, according to Cohn and Oncley or Kistler and
Nitschmann.
 Albumin is obtained as fractionV in Cohn process.
 These are subsequently pasteurized for virus inactivation.
 These solutions contain either 3.5–5% or 20–25% albumin at a purity
of 95–98%.
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38.  Preservative: None
 Protein composition: ≥96% of the total protein in the final
product must consist of albumin.
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39. PLASMA FRACTIONATION PROCESS
The Cohn process: Based on the differential precipitation
of plasma proteins by manipulation of ethanol concentration
and ph of a low-ionic-strength solution maintained at a
subzero temperature.
02/11/2016
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41. DOSE
 According to the American Hospital Formulary Service(AHFS) Drug
Information guide, a typical initial adult dose of albumin is 25 g.
 Can be repeated in 15 to 30 minutes depending on the patient’s
response.
 Up to 250 g of albumin may be infused in a 48-hour period.
 The infusion rate should be based on the patient’s condition.
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42. ADMINISTRATION
 Albumin should be inspected for turbidity prior to administration.
 Administration must begin within 4 hours of entry into the container.
 Because blood group isohemagglutinins are removed from albumin
products, albumin is given without regard to ABO type
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43. INDICATIONS
 Hypoalbuminemia - liver dysfunction, malnutrition, and
malabsorption.
 Thyrotoxicosis
 Pancreatitis
 Protein-losing gastroenteropathy
 Nephrotic syndrome.
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44. FIBRIN GLUE AND SEALANTS
 This results from a mixture of fibrinogen source (FFP, PRP,
heterologous or autologous cryoprecipitate) with bovine thrombin.
 The hemostasis is achieved with action of thrombin on fibrinogen.
This is widely used during surgery to stop bleeding immediately.
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45. -THANK YOU45