Blood donation Pretransfusion testing

◦Modification:
• Selection guideline
‣ Leukoreduction
◦Questionare
• Filtration → WBC < 1 x 10*6 cell/unit → Leukocyte depleted ;
‣ protection for donor
Prevent FNHTR ,HLA alloimmunization , CMV transmission
‣ protection for recipient
• Centrifugation → WBC < 1.2 x 10*9 cell/unit → Leukocyte poor
‣ maintain standard quality
◦Hemoglobinometer/copper sulfate Prevent FNHTR

Blood component
‣ Irradiation
• BLOOD BAG PRESERVATIVES
• Gamma ray/ X-ray
• Irradiation of cellular component
◦RBCs, Platelet
• Inhibit donor T cell lymphocyte proliferation
• Prevent transfusion associated graft-vs-host disease (TA-GVHD)
• Indication :
◦Stem cell/marrow transplantation ,
◦Hematologic malignancies (E.g., Hodgkin disease)
• BLOOD COMPONENTS
◦HLA matched/crossmatched component
◦RBC
◦ Donation from family members
‣ Packed red cell (PRC)
◦Intrauterine transfusion (IUT)
ABocompatibility
‣ Leukocyte poor PRC (LPRC)
◦Prematurity, low birthweight
‣ Leukocyte depleted PRC (LDPRC)
‣ Single donor red cell (SDR)
‣ Washed cellular product
◦ Platelet
• Red cell and platelet can be washed with NSS to remove plasma
‣ Platelet concentrate (PC), Random platelet
• Indication : recurrent severe allergic reaction
‣ Plateletpheresis, Single donor platelet (SDP)
• 1 therapeutic dose: platelet > 3 x 10 * 11
• Minimal WBC contamination
◦WBC < 1 x 10* 6 cell/unit
◦Leukocyte depleted platelet RH aooatransfusion
• Add platelet additive solution (PAS)

‣ Leukocyte depleted platelet concentrate (LDPC)

‣ Pooled platelet concentrate
◦ Plasma
‣ Fresh frozen plasma (FFP) Indication of blood transfusion
• Coagulation factors • RBC
• Albumin ◦anemic symptoms +/-Hb level
• von Willebrand Factor (vWF) ◦Hemorrhagic shock class III, IV
• Protein C, Protein S, Anti-thrombin, ADAMTS13 • Platelet
• Antibody ABo compatibility in newborn
• Newborn/infant <4 months require blood sample from mother, patient
‣ Cryoprecipitate
• Blood typing of the newborn and crossmatch with mother’s serum
• Factor VIII, vWF, Factor XIII, Fibrinogen

‣ Cryo-removed plasma (CRP)

EMERGENCY REQUEST
• Other factors
• FFP • Uncrossmatched group O RBC
◦Rapid reversal of warfarin effect ◦ Promptly issue
◦ Disseminated intravascular coagulation
◦ Massive blood transfusion
• Group specific uncrossmatched RBC
◦Plasma exchange ◦Typing
◦Coagulopathy who are bleeding or at risk of bleeding ◦5 min
• Cryoprecipitate
◦Fibrinogen deficiency
• Group specific, partial/immediate spin crossmatched RBC
◦ Disseminated intravascular coagulation ◦ Typing, antibody screening, crossmatching at RT
◦ Invasive procedure ◦ 15 min
◦Trauma/Massive blood transfusion
◦Hemophilia A, Von Willebrand disease, Factor XIII deficiency