The document discusses blood transfusion components, their storage, indications, and administration. It describes how whole blood is separated into red blood cells, platelets, and plasma through differential centrifugation. The main blood components - red blood cells, platelets, fresh frozen plasma, and cryoprecipitate - are summarized in terms of their storage, indications, dosages, and considerations for transfusion. The document also provides guidelines for preparing and administering red blood cell and platelet transfusions.

1. Blood Components
Dosage And Their
Administration
Fadi Khaizaran
Dallaa General Hospital
LD/BB Chief Technicians
Nov 2012

2. History of Transfusions
 Blood transfused in humans since mid-1600’s
 1828 – First successful transfusion
 1900 – Landsteiner described ABO groups
 1916 – First use of blood storage
 1939 – Levine described the Rh factor

3. Transfusion Overview
 Integralpart of medical treatment
 Most often used in Hematology/Oncology, but
other specialties as well (surgery, ICU, etc)
 Objectives
 Blood components
 Indications for transfusion
 Safe delivery
 Complications

4. Blood Components
 Prepared from Whole blood collection or apheresis
 Whole blood is separated by differential centrifugation
 Red Blood Cells (RBC’s)
 Platelets
 Plasma
 Cryoprecipitate
 Others
 Others include Plasma proteins—IVIg, Coagulation
Factors, albumin, Anti-D, Growth Factors, Colloid volume
expanders
 Apheresis may also used to collect blood components

5. Differential Centrifugation
First Centrifugation
Closed System
Whole Blood Satellite Satellite Bag
Main Bag Bag 2
1
First
Platelet-rich
RBC’s Plasma

6. Differential Centrifugation
Second Centrifugation
RBC’s Platelet-rich
Plasma
Second
Platelet Plasma
RBC’s Concentrate

7. Whole Blood
 Storage
 4° for up to 35 days
 Indications
 Massive Blood Loss/Trauma/Exchange Transfusion
 Considerations
 Use filter as platelets and coagulation factors will not be
active after 3-5 days
 Donor and recipient must be ABO identical

8. RBC Concentrate
 Storage
 4° for up to 42 days, can be frozen
 Indications
 Many indications—ie anemia, hypoxia, etc.
 Considerations
 Recipient must not have antibodies to donor RBC’s
(note: patients can develop antibodies over time)
 Usual dose 10 cc/kg (will increase Hgb by 2.5 gm/dl)
 Usually transfuse over 2-4 hours (slower for chronic
anemia

9. Platelets
 Storage
 Up to 5 days at 20-24°
 Indications
 Thrombocytopenia, Plt <15,000
 Bleeding and Plt <50,000
 Invasive procedure and Plt <50,000
 Considerations
 Contain Leukocytes and cytokines
 1 unit/10 kg of body weight increases Plt count by 50,000
 Donor and Recipient must be ABO identical

10. Plasma and FFP
 Contents—Coagulation Factors (1 unit/ml)
 Storage
 FFP--12 months at –18 degrees or colder
 Indications
 Coagulation Factor deficiency, fibrinogen replacement, DIC, liver
disease, exchange transfusion, massive transfusion
 Considerations
 Plasma should be recipient RBC ABO compatible
 In children, should also be Rh compatible
 Account for time to thaw
 Usual dose is 20 cc/kg to raise coagulation factors approx 20%

11. Cryoprecipitate
 Description
 Precipitate formed/collected when FFP is thawed at 4°
 Storage
 After collection, refrozen and stored up to 1 year at -18°
 Indication
 Fibrinogen deficiency or dysfibrinogenemia
 vonWillebrands Disease
 Factor VIII or XIII deficiency
 DIC (not used alone)
 Considerations
 ABO compatible preferred (but not limiting)
 Usual dose is 1 unit/5-10 kg of recipient body weight

12. Granulocyte Transfusions
 Prepared at the time for immediate transfusion (no
storage available)
 Indications – severe neutropenia assoc with
infection that has failed antibiotic therapy, and
recovery of BM is expected
 Donor is given G-CSF and steroids or Hetastarch
 Complications
 Severe allergic reactions
 Can irradiate granulocytes for GVHD prevention

13. Leukocyte Reduction Filters
 Used for prevention of transfusion reactions
 Filter used with RBC’s, Platelets, FFP,
Cryoprecipitate
 Other plasma proteins (albumin, colloid
expanders, factors, etc.) do not need filters—
NEVER use filters with stem cell/bone marrow
infusions
 May reduce RBC’s by 5-10%
 Does not prevent Graft Verses Host Disease
(GVHD)

14. RBC Transfusions
Preparations
 Type
 Typing of RBC’s for ABO and Rh are determined for
both donor and recipient
 Screen
 Screen RBC’s for atypical antibodies
 Approx 1-2% of patients have antibodies
 Crossmatch
 Donor cells and recipient serum are mixed and
evaluated for agglutination

15. RBC Transfusions
Administration
 Dose
 Usual dose of 10 cc/kg infused over 2-4 hours
 Maximum dose 15-20 cc/kg can be given to hemodynamically
stable patient
 Procedure
 May need Premedication (Tylenol and/or Benadryl)
 Filter use—routinely leukodepleted
 Monitoring—VS q 15 minutes, clinical status
 Do NOT mix with medications
 Complications
 Rapid infusion may result in Pulmonary edema
 Transfusion Reaction

16. Platelet Transfusions
Preparations
 ABO antigens are present on platelets
 ABO compatible platelets are ideal
 This is not limiting if Platelets indicated and type specific
not available
 Rh antigens are not present on platelets
 Note: a few RBC’s in Platelet unit may sensitize the Rh-
patient

17. Platelet Transfusions
Administration
 Dose
 May be given as single units or as apheresis units
 Usual dose is approx 4 units/m 2—in children using 1-2
apheresis units is ideal
 1 apheresis unit contains 6-8 Plt units (packs) from a
single donor
 Procedure
 Should be administered over 20-40 minutes
 Filter use
 Premedicate if hx of Transfusion Reaction
 Complications—Transfusion Reaction

18. Time Limits for Infusion
Blood/ Start infusion Complete infusion
blood product
Whole blood/ within 30 min. of within 4 hour
red cells removing pack (less in high
from ambient temperature)
refrigerator
Platelet immediately within 20 min
concentrates
FFP within 30 min within 20 min
18

19.  Is the product clearly prescribed?
 Are any drugs required before or during
transfusion? i.e. antibiotics
 Is the rate of transfusion appropriate?
 Does the patients condition require medical
review prior to transfusion
All patients having a blood transfusion MUST
have a NAMEBAND containing all of their

20. 1st checkers
Registered Nurse/
Midwife, Doctor
2nd Checkers
Any of the above &
Qualified Theatre
Practitioner
or qualified nurse

21. Base line observations – Temperature, pulse
and blood pressure
Further observations (as above) at 15 minutes
A set of observations at the end of transfusion
More frequently if the patient is unwell,
unobservable, unconscious or a child.

22. Ensure the venflon is secure, patent and
there are no signs of inflammation
Give the patient the call bell
Patients should remain in a clinical area for
the duration of the Transfusion
Review the patients fluid balance and
medication.

23. Pre-administration Procedure
Step 1: Check the blood component has been prescribed
Step 2: Undertake baseline observations
Step 3: Undertake visual inspection
LEAKS
DISCOLOURATION
CLUMPING
EXPIRY DATE
If there is ANY discrepancy - DO NOT transfuse

24. Step 1: Ask the patient to tell you their:
Full Name + Date of Birth
Check this information
against the patient’s ID
wristband
Be extra vigilant when checking the identity of the
unconscious / compromised patient

25. Administration Procedure
Step 2: Check the patient’s
– First name
– Surname
– Date of birth
– Hospital number
on the compatibility/
traceability label against
the patient’s ID wristband

26. Administration Procedure
Step 3: Check the compatibility/traceability label with the
blood bag label
Any discrepancies DO
NOT TRANSFUSE !

27. Blood Component Bedside Check Procedure
SURNAME
FIRST NAME(s)
HOSPITAL
NUMBER
D.O.B.BLOOD
GROUP
(Patient and Unit)
DONOR
NUMBER
EXPIRY DATE
Special
Requirements

28.  Stop the Transfusion and seek Medical Input and inform the
Transfusion Laboratory staff
 Check the Blood component matches the patient details
 Replace the unit and giving set with Normal Saline 0.9%
 Send the discontinued unit with giving set attached back to
transfusion capped off at the end with a white venflon cap – and any
previous transfused bags sealed with the blue plugs all in biohazard
bags
 Documentation (complete the checklist)
 Complete a Trust Incident form