blood components separation

1. Blood components: preparation,
preservation,storage and uses
Presenter Dr. J.Lakshmi prameela rani
Moderator – Dr Ramesh Chavan
Dr Ashwini Ratnakar

2. • Blood product: Therapeutic substance prepared from
human blood.
• Whole blood :One unit of non-separated donor blood.
• Blood component: constituent separated from whole blood
by differential centrifugation or that is obtained directly from
donor by apheresis

4. WHY ??
• To avoid wastage of collected whole blood.
• Administration of specific replacement therapy.
• To avoids transfusion of unnecessary blood elements that are not
required by the patient.

6. Blood : Anticoagulant Ratio
• 14 ml of CPD/CPDA is used in preserving 100 ml blood
• 63 ml for a 450 ml collection
• 49 ml for 350 ml collection
• At the end of the collection , venous blood (pH 7.35) mixed
with anticoagulant-preservative solution (pH 5.0 to 5.6) with
resulting pH of 7.05 in the mixture.

9. Methods of blood components separation
• Differential centrifugation of whole blood
• Apheresis

15. • Whole blood is stored in a refrigerator at 4°-6°C.
• Shelf life (If CPDA is anticoagulant) - 35 days.
• Must be ABO identical.
• Transfusion:
-should commence within 30 minutes.
- should complete within 4 hours of starting.
• Transfusion of one unit raises hemoglobin by 1 gm/dl or
hematocrit by 3%.

16. Indications:
• Acute blood loss with hypovolemia
• Exchange transfusion in neonates
• Non-availability of red cell concentrate.
Contraindications:
• Chronic anemia with compromised cardiovascular functions

17. Blood components
• Cellular components:
Red cells:
Packed red cells
Red cells in additive solution,
Leukocyte-poor red cells,
Washed red cells,
Frozen red cells,
Irradiated red cells
Platelets:
Platelet concentrate,
Apheresis platelets

18. • Granulocytes: granulocyte concentrate
• Plasma components:
• Fresh frozen plasma
• Cryoprecipitate

19. • Packed red cells:
-Prepared by removing most of the plasma from one unit of
whole blood.
1. By allowing to sediment overnight in a refrigerator at 2-
6°C
2. Spun in a refrigerated centrifuge.
Red cells(65-80%)+ small amount of plasma(20-35%)
- Hematocrit 70-75%
It has high viscosity and therefore the rate of infusion should
be slow

20. • Transfusion of one unit increases hemoglobin by 1 gm%.
• Indications:
• Chronic severe anemia
• Severe anemia to reduce chance of circulatory overload.
• Anemia in elderly
• Acute blood loss (transfused along with a crystalloid or a
colloid solution)

21. • Red cells in additive solution (Red cell suspension):
• Red cells + minimal residual plasma + additive solution.
(SAGM-- saline, adenine, glucose, and mannitol).
-shelf life - 42 days.

23. • Leukocyte-poor red cells:
Red cells contain < 5 × 106 white cells per bag.
Methods for leukocyte depletion:
1.Leukocyte-reduction filters.
2.Removal of buffy coat.
It should contain at least 85% of original red cells.

24. Indications for leucocyte-poor red cells are:
1.Prevention of HLA immunization in patients who are
likely to receive allogeneic bone marrow
transplantation.
2. Prevention of febrile nonhemolytic transfusion
reactions.
3. Prevention of transmission of cytomegalovirus.

26. • Washed red cells:
washed with normal saline to remove plasma proteins, Ab’s,
white cells, and platelets.
Used for IgA-deficient individuals (has they developed anti-
IgA antibodies, as exposure will lead to anaphylaxis)
Shelf life- 24hrs( if stored at 4-6degrees)
Around 20% red cells are lost

27. • Frozen red cells:
Red cells + glycerol = freeze at -65degrees
Shelf life =10 years.
After glycerolization (washing with saline)-used with in 24hrs(4-
6degrees)
Uses:
 Storage for donor red cells with rare blood groups.
For future autologous transfusion.

28. • Irradiated red cells:
-Gamma-irradiation of red cells inactivates lymphocytes and
prevents graft vs. host disease.
Storage: 4-6degrees for 28 days
Indications:
 Intrauterine or premature neonate transfusions.
 Individuals with immunodeficiency.

29. PLATELET COMPONENTS

33. • Suitable if HLA-matched platelets are required
• If patient has developed refractoriness to platelet transfusion due to
the formation of alloantibodies against HLA antigens.
Platelet refractoriness means poor increment following platelet
transfusion.

34. Buffy coat removal method

35. • Indications
• Bleeding due to decreased platelet production.
• Bleeding in hereditary disorders of platelet function.
• Massive blood transfusion.
• Viral diseases associated with thrombocytopenia.
• Contraindications
• Thrombotic thrombocytopenic purpura.
• Hemolytic uremic syndrome

36. Guidelines for platelet transfusion
Non bleeding patients with failure of platelet production:
Pt count<10,000/ul
Invasive procedure with platelet count<50,000/ul.
Bleeding patients
DIC with<50,000/ul
Active bleeding & Pt count<50,000/ul

38. Plasma components

39. • Solvent/detergent plasma:
-It is increasingly used in clinical practice.
-It lowers the risk of viral transmission –HBV,HCV & HIV.
-Treating the plasma with TNPB and detergent triton X-100, which
inactivates the viruses.
Single donor plasma or AHG poor plasma:
It is the plasma separated from outdated blood or plasma from which
anti haemophilic factors has been separated.
-It contains all stable factors.

40. Indications for fresh frozen plasma:
• Multiple coagulation factor deficiencies
• Disseminated intravascular coagulation.
• Inherited deficiency of a coagulation factor for which
no specific replacement therapy is available.
• Thrombotic thrombocytopenic purpura

41. • Cryoprecipitate contains volume-10-15ml .
- F VIII 80-100units/concentrate
- Von Willebrand factor 40-70% of FFP
- Fibrinogen 150-250mg/concentrate
- F XIII 20-30% of FFP
- Fibronectin 55mg.

42. - Indications for cryoprecipitate :
- Deficiency of fibrinogen
- Deficiency of F XIII
- F VIII deficiency (if F VIII concentrate is not available)
- Von Willebrand disease.

43. PLASMA DERIVATIVES
• Manufactured by fractionation of large volumes of pooled human
plasma.
• Plasma derivatives are:
1. Human albumin solutions.
2. F VIII concentrate.
3.Prothrombin complex concentrate.
4. Immunoglobulins

44. • Human albumin solutions:
• uses are:
1. Replacement fluid in therapeutic plasma exchange.
2. For treatment of diuretic-resistant edema of hypoproteinemia.
F VIII concentrate:
1.It is the treatment of choice for treatment of hemophilia A .
2.Severe von Willebrand disease.

45. • Prothrombin complex concentrate (PCC):
Contains factors II, VII, IX, and X, and also protein C and S.
Uses of PCC are:
1. Deficiency of F IX
2. Inherited deficiency of factors II, VII, and X.
A serious risk of PCC is thrombotic complications due to the presence
of small amounts of activated coagulation factors.

46. • Immunoglobulins:
• They are of two types: specific and nonspecific.
• Specific immunoglobulins:
• They are obtained from donors who have specific high titer IgG
antibodies.
• Anti-RhD immunoglobulin is prepared so it is used for prevention of
sensitization to RhD antigen in Rh negative women giving birth to a
Rh-positive baby.
• Hepatitis B immune globulin
• Varicella-zoster immune globulin.
• Tetanus immune globulin.

47. • Non-specific immunoglobulins:
• These are derived from the pooled plasma of non-selected donors.
Indications:
1. Passive prophylaxis of viral infections like hepatitis, rubella, and
measles.
2.Treatment of hypogammaglobulinaemia.
3.Autoimmune thrombocytopaenic purpura to induce a rise in platelet
count.
4. Neonatal sepsis.

55. Thank you