BLOOD COMPONENTS AND THEIR USES

1. BLOOD COMPONENTS

2.  In 1818, James Blundell, a British obstetrician
performed first successful transfusion of
human blood for treatment of PPH.
 The first records of the voluntary blood donation
initiative in India can be traced back
to 1942, during the time of World War II
when the first blood bank was established
in Kolkata, West Bengal

3.  In the past whole blood was the only preparation that could be administered to replace red
cells,platelets,coagulation factors.
 In addition to what the patient required, this lead to administration of unwanted cells or plasma
constituents .
 Large volume of whole blood needed to achieve satisfactory replacement of particular
component.
 With this significant advancement of blood component separation, one unit of blood can be
utilized for preparation of different components and thus can benefit more than one patient.

4. The most commonly used blood components are-
• Whole blood
• Packed cells
• Platelet concentrate
• Fresh frozen plasma
• Cryoprecipitate
Others include-
• leukodepleted packed cells
• Platelet rich plasma
• Platelet poor plasma
• Fresh plasma

5. Whole blood-
 Whole blood is the unmodified blood
collected from the donor.
 450ml of blood is collected from the
donor which is added to 63ml of
CPD(Citrate phosphate dextrose)
or CPDA-1 anticoagulant.
 It can be stored at 1-6°C for 21-35 days.
 Most commonly used in blood loss conditions e.g. trauma

6. PACKED RED BLOOD CELLS(PRBC)
 After removal of plasma, 100ml of CPD is added to the product for long term
storage.
 It can be stored for 35 days at 1-6°C
 Rate of transfusion-3ml/kg
 It minimises the cardiac overload due to transfusion.
 It is used in conditions like chronic anemias, where there is no loss of blood
volume but of haemoglobin only
 One unit raises Hb by 1gm %

7. PLATELET CONCENTRATE-
 Used in thrombocytopenia and drug induced haemorrhage
 Platelet transfused at dose of 0.1unit /kg , when the platelet count drops
below 20,000 or episode of bleeding
 Platelet stored at 4°C should be used within 48hrs and when stored at room
temperature can be used upto 5 days.
 One platelet concentrate can increase platelet count upto 10000plt/cumm in
one hour.

8. FRESH FROZEN PLASMA(FFP) -
 Fresh frozen plasma obtained is rapidly frozen and stored at -40°C
 It contains all coagulation factors.
 1 unit of FFP increases the clotting factors levels by 3%
 To maintain prothrombin time at normal levels, dose of FFP is 15ml/kg
 It can be stored for 2 years.
 Uses-severe liver disease with abnormal coagulation function, congenital
clotting factor deficiency ,deficiency following warfarin therapy ,DIC, massive
transfusion

9. CRYOPRECIPITATE-
 When FFP is allowed to thaw at 4°C, a visible supernatant layer develops
which is called cryoprecipitate
 rich in factor VIII and fibrinogen
 stored at -40°C and can be used for 2 years
 Used to raise fibrinogen levels at a dose to make plasma fibrinogen level
150mg/dl
 Used in inherited deficiency of factor VIII, fibrinogen, von Williebrand’s
disease.

10. PLATELET RICH PLASMA -
 It contains 5.5x109 /L platelets in 50ml plasma.
 Single donor platelet is prepared by plateletapheresis containing 3x109 /L
platelets in 200ml of plasma.
 One single donor platelet is equal to 8units of random donor platelet.
HEMAPHERESIS-It is a procedure in which blood is withdrawn from the donor and
anticoagulant and desired component if separated from it. The remaining blood
is returned back to donor.

11. COMPLICATIONS OF BLOOD
TRANSFUSION-
 Febrile reactions
 Allergic reactions
 Acute haemolytic reactions-most dangerous complication
-due to ABO incompatibility
 Transfusion related acute lung injury(TRALI)
 Transfusion related graft vs host reaction
 Congestive cardiac failure
 Air embolism
 thrombophlebitis

12. MASSIVE BLOOD TRANSFUSION
 It is defined as replacement or transfusion of blood equivalent to patient’s
blood volume in <24 hrs corresponding to that particular age or single
transfusion of blood more than 2500ml continuously.
 It may be used in severe trauma associated with liver, vessel,cardiac,
pulmonary,pelvic injuries or during surgical bleed (primary haemorrhage on
the table)of major surgeries.

13. Adverse effects of massive blood
transfusion
 Severe electrolyte imbalance(hypocalcemia, hypercalcemia,acidosis)
 Coagulopathy-altered platelet and coagulation factors-dilutional
thrombocytopenia
 Citrate toxicity ,hyperammonaemia
 Hypothermia
 Poor Oxygen delivery- due to reduced 2,3 DPG
 Infections
 Incompatibility and transfusion reactions
 ARDS,DIC ,CCF