Overview Of Blood Components

By

Dr: Abdelrahman Saeed

Consultant Blood Transfusion Medicine
King Fahd Hospital Al-Madina
Core topics
1. Blood components – why should be used ?
2. Blood Components includes :
◦ Whole blood
◦ Cellular component
A. Packed Red Blood Cells
B. Platelets
C. Granulocytes
◦ Plasma component
A. Fresh Frozen Plasma
B. Cryoprecipitate
C. Plasma Cryoprecipitate Reduced
 Blood components

 Transfusion therapy in the past was largely dependent on

the use of whole blood.

 The aim in modern transfusion therapy is to use the

specific component that is clinically indicated.
Blood components why should be used?

 Transfusion of the specific part of blood that the patient

needs which reduce The risk of circulatory overload.
 A concentrated form of the required fraction can be
administered to the patient.
 One unit of blood can serve more than one patient.
 Conserves blood resourses.
 Storage temprature of each blood comonent is different.
Blood Components
 Whole blood
 Cellular component
 Packed Red Blood Cells, (PRBC)
 Platelets

 Granulocytes

 Plasma component
 Fresh frozen plasma (FFP)
 Cryoprecipitate

 Plasma Cryoprecipitate Reduced

Whole Blood
Whole Blood
 With hematocrit of 36% to 44%.
 WB is most often separated into components and is rarely
used for transfusion directly.
(Clinical indications extremely limited)
 Components, especially platelets and clotting factors
deteriorate within hours of donation
 Factor V and factor VIII (labile factors) decrease with
storage.
 This makes whole blood unsuitable product for treatment of
hemostatic disturbances when stored beyond 24 hrs.
Whole Blood
 Indications
1. Exchange transfusion in neonates.

2. In open heart surgery.

3. In massive transfusion.

 Precautions
1. Must be ABO & RH compatible

2. Warming with a proper warming device is indicated

3. Best if transfused as early as possible after donation

4. Risk of volume overload must always in mind

Packed Red Blood Cells
Packed Red Blood Cells
 Prepared after WB Centrifugation with removing of
supernatant plasma.
 Hematocrit is approximately 80% with no additive, 60%
with additive (SAGM).
 Expiry date according to the anticoagulant preservative
solution used.
 One unit of PRBC will raise HB in an average sized adult
who is not bleeding by approximately 1gm/dl or HCT by
3%.
 In neonates, a dose of 10-15mls/kg is generally given, and
will increase the hemoglobin by about 3gm/dl.
Packed Red Blood Cells

 Indication
1. Used to treat symptomatic anemia and routine blood
loss during surgery.

2. Red cells exchange.

3. Patients with chronic anemia.

4. Patients with acute blood loss.

Packed Red Blood Cells

 Precautions
1. ABO and RH compatible

2. Usually a slow transfusion (no real need for

warming)
 Contraindications:
1. For volume replacement

2. To enhance wound healing

3. For nutrition
Random Donor Platelet Concentrate
Preparation of platelet concentrate

Plasma

RBCs PRP

Platelet
concentrate
Random Donor Platelet Concentrate
 Prepared from a single unit of whole blood.
 The two major methods used in preparing platelets from
WB:
 Buffy Coat

 Plasma Rich Platelet (PRP)

 Single unit of platelet are normally suspended in 40 mL to

70 mL of plasma, although studies have shown good survival
rates when platelets are stored in plasma volumes of 35 mL
to 40 mL.
Random Donor Platelet Concentrate
 Platelet stored at 20-24 C° with constant agitation.

 Due to storage at RT it is the most likely component to be

contaminated with bacteria.
 Therefore, platelet shelf life is limited to
 5 days in the United States
 3 days in Japan
 4 days in Germany
 7 days in most EU
 5 days here in Saudi Arabia.
Random Donor Platelet Concentrate
 Because of their metabolic requirements, platelets must be
continuously agitated during storage.
 This action keeps platelets suspended in the storage
media, ensuring effective exchange of oxygen, carbon
dioxide, and lactic acid between the platelets and the
suspending media.
 Long periods of static storage of platelets interrupts this
dynamic process and can result in lactic acid production
with a decrease in pH.
Random Donor Platelet Concentrate

 During transport to hospitals from long-distance blood

center, platelets are not agitated , Instead they are secured
in a shipping system.

 Studies have shown that platelets are not damaged when

they are stored without agitation for 24 hours.

 Platelets must be stored and shipped at 20 to 24 °C.

Random Donor Platelet Concentrate
 Indications: prevention and cessation of bleeding
1. Severe Thrombocytopenia (less than 10,000 or 20,000
depending on institution)
2. Moderate Thrombocytopenia (less than 50,000) with
bleeding
3. Surgery or invasive procedure with Moderate
Thrombocytopenia (less than 50,000)
4. Bleeding with qualitative platelet defect
5. Massive Transfusion Protocols (MTP)
 Random Donor Platelet Concentrate
Contraindications:
1. Idiopathic Thrombotic Thrombocytopenic Purpura (ITP)

2. Thrombotic Thrombocytopenic Purpura (TTP)

Dosage:
1. Therapeutic dose for adults is 4-6 units platelet
concentrates
2. One unit random donor platelet should increase platelet
count between 5,000 – 10,000/cc3
Single Donor Platelet Concentrate
Apheresis Platelet Concentrate
 Single Donor Platelet Concentrate

 Platelets are obtained by Apheresis procedure.

 Apheresis procedures are intended to collect large numbers

of platelets from an individual providing a more potent
product with fewer donor exposures for the patient.

 AABB Standards requires that an apheresis platelet

component contain at least 3 × 10¹¹ platelets in 90% of
sampled units.
 Single Donor Platelet Concentrate
 With newer technology and more efficient processes, higher
yields of platelets may be obtained from one donor, and the
original apheresis unit may be split into multiple units, each of
which must meet minimum standards.
 For allo-immunized patients who do not respond to random
allogeneic platelets, transfusions of platelets from an
apheresis donor selected on the basis of a compatible
platelet cross-match or that are matched for HLA antigens
may be the only way to achieve a satisfactory post-
transfusion platelet increment.
Single Donor Platelet Concentrate

 Plateletpheresis donors may donate more frequently

than whole-blood donors but must meet all of the other
criteria for whole-blood donation.

 The interval between donations should be at least 2

days, and donors should not undergo plateletpheresis
more than twice in a week or 24 times in a rolling 12-
month period.
Single Donor Platelet Concentrate

 Donors who have taken antiplatelet medications that

irreversibly inhibit platelet function are deferred for
specific intervals before donation:

 2 days for aspirin or aspirin containing medications.

 14 days for ticlopidine

 Single Donor Platelet Concentrate

 One unit is a therapeutic dose which equivalent to 6-8

RD-PC.

 Store at 20-24 C° with agitation for 5 days.

 Advantage:
 Decrease donor exposure.
 Obtain HLA matched platelets for patients who are
refractory to RD-PC.
 Prevent platelet refractoriness from occurring.
Granulocytes
Granulocytes
 Although it is possible to prepare granulocytes from fresh
WB, current practice is to collect granulocytes by Apheresis.

 The use of granulocyte transfusions has been controversial

for a number of years.

 Recently, there has been renewed interest in granulocyte

transfusion therapy because much larger cell doses may be
obtained from donors who have received recombinant
colony-stimulating factors.
Granulocytes

 Expiration date is 24 hours but best to infuse ASAP.

 Store at 20-24 C°.
 Must be irradiated and of course must not be filtered
 Primary use is for patients with neutropenia who have
bacterial infections documented by culture, but are not
responding to antibiotics.
 Best success with this component has been with babies
 Daily transfusions are necessary.
Fresh Frozen Plasma
 Fresh Frozen Plasma (FFP)
 FFP is plasma collected either from :
 Single unit WB collection after centrifugation.
 By Apheresis.
 FFP must be placed in the freezer within 8 hours of
collection.
 Expiration
 1 year stored at < -18 C°

 7 years stored at < -65 C°

 FFP contains normal amounts of all coagulation factors, anti

thrombin, and ADAMTS13.
 Fresh Frozen Plasma (FFP)
 Indication
 To replace labile and non-labile coagulation factors in massively
bleeding patients
 Treat bleeding associated with clotting factor deficiencies when
factor concentrate is not available.
 Precaution
 Must be ABO compatible.

 Thawed in 30-37C° plasma thawer.

 Once thawed, has a shelf life of 24 hours at 1 to 6 C°. and can be

held longer than 24 hours but must be relabeled as Thawed
Plasma, and it can be stored for an additional 4 days at 1 to 6 C°.
 Cryoprecipitate
Anti-Hemophilic Factor
Cryoprecipitate ,Anti-Hemophilic Factor
 Cold-insoluble protein that precipitates when FFP is
thawed to 1 to 6 C° then collected by centrifugation
 Supernatant plasma is transferred into another bag and
the precipitate is re-suspended in a small amount of
residual plasma, then the precipitate is refrozen .
 AABB Standards requires that Cryoprecipitated AHF
contain at least:
 80 international units (IU) of Factor VIII per unit.
 150 mg of fibrinogen per unit.
 It also contains the vWF, Factor XIII and fibronectin.
 ADAMTS13 levels are normal in Cryoprecipitated .
Cryoprecipitate ,Anti-Hemophilic Factor

 Thawed Cryoprecipitated AHF is stored at room

temperature (20-24 C°), during which the mean rates of
decrease of Factor VIII levels at 2, 4, and 6 hours are
approximately 10%, 20%, and 30%, respectively.
 Thawed cryoprecipitate should not be refrozen.
 Cryoprecipitated AHF from blood groups A and B has
higher levels of Factor VIII compared to that derived from
blood group O donors (about 120 vs 80 IU per bag,
respectively).
Cryoprecipitate ,Anti-Hemophilic Factor
 Indication
1. Hypo-fibrinogenemia (≤ 100 mg/dl)

2. Dys-fibrinogenemia

3. Disseminated intravascular coagulopathy DIC.

4. Von Will-brands disease

5. Treatment of hemophilia (if concentrated factor not

available)
6. Factor XIII deficiency - rare
Cryoprecipitate ,Anti-Hemophilic Factor

 Storage Temperature
 Frozen -18 C or lower

 Thawed - room temperature

 Expiration:
 Frozen 1 year

 Thawed 6 hours

 Pooled 4 hours

 Best to be ABO compatible

Plasma Cryoprecipitate Reduced
 Plasma Cryoprecipitate Reduced
 Plasma Cryoprecipitate Reduced is a by-product of
cryoprecipitate production

 Has a shelf life of one year from the date of collection at

–18 C° storage.

 The product contains a normal level of Factor V (85%)

 Even after the removal of cryoprecipitate, the product has a

fibrinogen level of about 200 mg/dL
Plasma Cryoprecipitate Reduced

 Used to treat patients with thrombotic thrombocytopenic

purpura.
 The levels of the following coagulation factors have been
demonstrated to be normal:
 I, VII, X, α2-antiplasmin, antithrombin, protein C, and
protein S.
 Factor VIII, von Willebrand factor (vWF), fibrinogen, and
Factor XIII are decreased
conclusion
 The aim in modern transfusion therapy is to use the
specific component that is clinically indicated.
 Must know the indication of each blood component.
 Whole blood
 Packed Red Blood Cells

 Platelets

 Granulocytes

 Fresh frozen plasma

 Cryoprecipitate

 Plasma Cryoprecipitate Reduced

Thank you……..