kenketsu

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kenketsu

  1. 1. BLOOD & BLOOD PRODUCTS
  2. 2. Whole Blood Red Blood Plasma Cells Platelets Fresh Frozen CryoprecipitateLeuko-reduced PlasmaRBCWashed RBC DerivativesIrradiated RBC Albumin Immunoglobulin Factors VIII & IX
  3. 3.  Compose of RBC, plasma, WBC, platelets Restores blood volume and oxygen carrying capacity Maximise use of WB: Preparation of specific blood components and plasma derivatives Platelets not functional and clotting Factors V and VIII are greatly reducedIndication Extensive bleeding to replace the loss of both red cell mass and plasma volume Massive transfusion: such as major trauma case, certain surgical procedures
  4. 4. Cellular Components – Red Blood Cell Products PlateletsPlasma Components – Fresh Frozen Plasma CryoprecipitatePlasma Derivatives – Albumin Immunoglobulin Factors VIII, IX
  5. 5. Cellular Components – Red Blood Cell Products PlateletsPlasma Components – Fresh Frozen Plasma CryoprecipitatePlasma Derivatives – Albumin Immunoglobulin Factors VIII, IX
  6. 6.  Most plasma removed from whole blood Provide oxygen-carrying capacity without unnecessary volume Platelets removed Lack of clotting factors in RBC: 1 FFP given every 4 units transfused. High volume transfusions result in decreased clotting factorsIndication Anaemia Blood loss during surgery Thalassaemia
  7. 7.  Washed with sterile normal saline to remove most of the plasma proteins, antibodies and platelets Not leukoreduced –some leukocytes removed but not enough to prevent alloimmunization Shelf-life of 24hrs – preparation in an open system and most of the anticoagulant-preservative solution removed.Indication Patients with recurrent febrile reactions Urticarial reactions Anaphylactic reactions
  8. 8.  Prepared by filtration method: Reduce leukocyte count to less than 5 x 106Indication Prevent febrile nonhaemolytic transfusion reactions due to donor leukocytes Decrease post-transfusion reactions due to HLA alloimmunization Reduce transmission of CMV infections, since CMV lives in WBCs
  9. 9.  Gamma irradiation inactivates donor lymphocytes Graft vs host disease (GVHD) is reduced in immunocompromised or immunodeficient patientsIndications Prevention of post-transfusion GVHD eg bone marrow transplant recipients
  10. 10. RAD-SURE indicatorsshow if a blood bag isirradiated or not
  11. 11.  Anticoagulants - Prevent blood clotting Preservatives - Provide cells with nutrients during storage; maintain red cell viability and function
  12. 12. CPDA-1 Citrate – Anticoagulant (binds to calcium) - Calcium essential component of clotting cascade - Binding to calcium decreases clotting ability Phosphate – Maintain 2,3-diphosphoglycerate (2,3-DPG) levels in red cell - 2,3-DPG essential for movement of oxygen from RBCs to body tissues Dextrose – Sugar substrate needed to generate ATP Adenine – Synthesis of ATP allowing longer shelf life of 35 days
  13. 13. SAGM – Sodium chloride, Adenine, Glucose and Mannitol Nutrition source for red cells Supports integrity of red cell membrane to reduce haemolysis Maintain high ATP levels in RBCs Extending shelf life from 35 to 42 days Lowers viscosity = faster transfusion
  14. 14.  Compose of platelets, WBC and plasma Aid in clotting Viable for 5 days Maintained at 20-24°C with constant agitation Cold temperatures and lack of agitation decrease the viability of the plateletsIndications Massive bleeding or undergoing invasive surgery Platelet dysfunction Thrombocytopenia - ↓ platelet count
  15. 15. Cellular Components – Red Blood Cell Products PlateletsPlasma Components – Fresh Frozen Plasma CryoprecipitatePlasma Derivatives – Albumin Immunoglobulin Factors VIII, IX
  16. 16.  Plasma Contains all coagulation factors including labile Factors V and VIII No platelets and RBCs Stored at -30°C for up to 12 monthsIndications Treat bleeding due to coagulation factor deficiencies eg. massive transfusion Plasma exchange – Treatment of TTP (Thrombotic thrombocytopenic purpura ) patient’s plasma is replaced by donor plasma
  17. 17.  Fibrinogen Factors VIII and XIII von Willebrand’s factor Prepared by freezing plasma at -70°C followed by thawing at 4°C. Once thawed, the precipitate that forms is centrifuged to sediment the cryoprecipitateIndications Fibrinogen deficiency Treatment of hemophilia A (Factor VIII deficiency) von Willebrand’s disease Massive haemorrhage
  18. 18. Cellular Components – Red Blood Cell Products PlateletsPlasma Components – Fresh Frozen Plasma CryoprecipitatePlasma Derivatives – Albumin Immunoglobulin Factors VIII, IX
  19. 19.  Prepared by fractionation of plasma No coagulation factors or blood group antibodies 5% and 20% albumin solutionsIndications Hypovolaemia – decrease in blood plasma due to burns, bleeding. Eg. Severe burns, act as volume expansion by replacing protein loss from burn site Hypoalbuminaemia - Liver failure
  20. 20.  Compose of IgG antibodies – used in replacement IgG therapy Maintain adequate antibody levels to prevent infections and confers passive immunityIndications Treatment of hypoglobulinaemia (reduced gamma globulins) or agammaglobulinaemia (absent) Autoimune diseases such as immune thrombocytopenia
  21. 21.  Prepared from fractionation of plasma that contains Factor VIII Product treated to reduce risk of viral transmissionIndicationControl bleeding in haemophilia A patients with: congenital Factor VIII deficiency acquired Factor VIII deficiency Factor VIII inhibitors
  22. 22.  Compose of: Factors II, VII, IX and X. Factor IX makes up 5% of this productIndication Hemophilia B( Factor IX deficiency) Congenital Factor VII or X deficiency Factor IX inhibitors
  23. 23. Granulocyte concentrate Composed of: granulocytes, RBCs, WBCs, plasma, platelets Shelf-life 24hrs at 20-24°CIndication Severe neutropenia with severe bacterial or fungal infections Fever unresponsive to antibiotic therapy
  24. 24. Rh Immune Globulin (RhIg) Protect Rh-negative mother who is pregnant with Rh-positive infant Usually given in pregnancy and immediately after birthIndication Prevention of Rh(D) HDN
  25. 25. AND MORE!!! Antithrombin IIIAlpha-1-proteinase inhibitor Fibrinogen Thrombin Protein C (Too many to list)
  26. 26. Types of blood donation: Whole blood donation Apheresis donation: Plasma or platelet donationAdvantage of apheresis donation Donations can be made every month (whole blood donations - 3mths) Allows larger amount of platelets to be collected from a single donor compared to whole blood donations Minimise patient’s exposure from multiple donors’ blood

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