:

. .
-


/
/

 ;

)

)



(blood product):

(blood component):

(, ,
)

 (labile)

1. Whole Blood (WB)
2. ()
packed Red Blood Cells (pRBCs)
3. Platelet
Rich Plasma (PRP)
4. Fresh
Frozen Plasma (FFP)
5. - Frozen Plasma (FP)
6.
7.
 (medicinal)
/

1.
2.

3.E

4.
5.
6.
7.


(Fresh) frozen
plasma (F(FP)

F Vlla*

F Vlll*

Cryo
supernatant
plasma (CSP)
F lX*

*


1.

2.
3.

1. 1492
8
2.
A.
Libanius 1615
3. 1914

Albert Hustin
4. 1952
C.Walter (CPD) 21
5. 1979 CPDA-1, 35
6. 1983 42


(
)

(
)


8-48
 (Anticoagulants)
CPD CPD-A
21 35

1-6 C 1-6 C

ATP
450 +/- 10%
ATP (
)
( )


[additive solution (AS)]
CPD


72
SAGM:
Saline
Adenine
Glucose
Mannitol
H 42

()
66%
 :

:
(,
)

1. CPD citrate, phosphate, dextrose (21 )

2. CP2D citrate, phosphate, double dextrose and
additive solution 3 (42 )
3. CPDA, CPDA1 citrate, phosphate, dextrose,
adenine (35 )
4. SAG-M sodium chloride, adenine, glucose,
mannitol (42 )


, Ca

pH,

P ( )

,
ATP


,
,

,

(Greenwalt T., 2006; Transfusion)



pH
Hb
2,3-DPG
GSH
SNO-Hb

PS


()
2,3-DPG
NADPH
K+ pH
Ca+2 Na


,

RBCs

;

 Fresh or Old Red Blood Cells?




15



(

)



platelet rich plasma
(PRP)
PRP
platelet poor plasma
8
1-4 C

-


1


1


1
PRP
PRP 2
PRP
o



;
1. Packed RBCs
2. Fresh frozen plasma (FFP)
3. Cryoprecipitate (CRYO)
4. Platelet Rich Plasma (PRP)
PC (platelet concentrate)
RD PC (random donor platelet
concentrate)

;
1.

2.

1-6 C
PRP 22-24 oC ()
Cryo, FP, FFP -18 oC
Granylocytes 22-24 oC
 Component Storage ()

Red blood cells: 1-6C

Platelets: 22-24C, with continuous agitation
Plasma:
FFP: -18C (after thawing ~ 1-6C for 24 hours)
FP: -18C (after thawing ~ 1-6C for 24 hours)
CSP: -18C (after thawing ~ 1-6C for 24 hours)

Cryoprecipitate: -18C (after thawing ~ 20C for 4

hours)

: American Association of Blood Transfusion



Packed Red cells: 42 days, collected in

CP2D/AS-3 35 days,
collected in CPDA-1
Platelet Rich Plasma: 5 days with continuous
agitation
Cryo: 12 months at -18C or
4 hours after thawing

Plasma: 12 months at -18C or

(FFP/FP/CSP) 24 hours after thawing


pRBCs

FFR, FP, CRYO
 PRP



 Whole Blood (WB)







WB


 ()
1.
,
/
2. 200 200-350 ml Ht 55%-80%
3. M Hb 1 g/dL
2-24h (
,
,
Hb RBCs,
RBCs)
4.
110-120 ,
1%
5. O
58


1.
450 mL
63 mL (citrate, phosphate,
double dextrose - CP2D)
2.


3. 100 mL AS-3

4. Ht
55% 42
5.
Canadian/ American Blood Services


buffy coat removed, BCR
1.


2.
20-60 ml

3. : 24
+20 C +24 C
+ 2 C +6 C
4.
25050 ml, 10-30 ml,
<1.2 x109,
< 20 x 109


1.

1 24

2.

 buffy coat


()

1.

2. WBCs

3.
RBCs

4. :

5. <1.0 x109,
WBCs
Leukocyte Reduction

1.

2. HLA-
3.
4.
5.

Washed Red Blood Cells (W-RBCs)

1. ,
,

2. -

(
)
3. : , Hct 65-75%,
40g Hb, <1.2 x 109
<30 mg
4. +2 C
+6 C
5.
24

Cell Washer to Prepare Washed Cells
 - Frozen Blood


1. ,
7 ,

2. ,


3. : (
- )
4.
60C 80C (140C 150C
) 10
5. +2 C
+6 C

24
6. : /
,

Rejuvenated Red Blood Cells

2,3-DPG ATP

24
10

 CD34
1.
2.
3.
:

CGU-GM
BFU-E
CFU-GEMM
 CD34
1. CD34

2.

3. :
G-CSF

Plevixafor

Platelet Rich Plasma (PRP)

1. PRP

2. -
55
x 109 , 50 mL

3. 5


Platelet Rich Plasma (PRP)

1.

,

2.

3. , 5


25 50 x 109 /L


Plasma

RBCs PRP

Platelet
concentrate

Pooling Platelets
6-10
= 4

PRP

250
ml

 - Granulocytes

Lymphocyte Monocyte

Neutrophils Eosinophils Basophils



gram





24

20-24 C


 Fresh Frozen Plasma (FFP)

1.

< -30C
2.

3. 200-
250mL 400-600
mL (FFPA)
4. 8
/ FFP,
1
 Fresh Frozen Plasma (FFP)
1. FFP

-18C 8

2. FFP
,

3.
4. FFP 225ml
ABO
5. Rh

6. -18C


V VIII
 Fresh Frozen Plasma (FFP)
1. FFP 37C ()
(20-30 )
24 1- 6 C

2. FFP
20%

FFP
100%
vCJD


ABO RhD
, ,

 Frozen Plasma (FP)
1. FP

-18C > 8

2. FP

3. FP 225ml
-18C

;
 - Pooled
Plasma

2500

19 V

Pooled Plasma





 Human albumin
Unit 4.5% solution or 20% solution
Various volumes
Active Human albumin
constituents
include:
Other constituents Sodium: 130150 mmol/
include: Other plasma proteins
Stabiliser varies with product
Licensed Albumin core SPC covers both 45% and
indications 20% products
Restoration and maintenance of circulating
blood volume where volume deficiency has
been demonstrated and use of a colloid is
Prescribing and appropriate.
20% solution: hyperoncotic risk of fluid
administration overload.
5% solution: use carefully if patient is at risk
Storage of sodium
Room retention.
temperature
 Human
immunoglobulin
Intramuscular Intravenous
Unit Varies with product and supplier
Active Human IgG from a large pool Human IgG from a large pool
constituent of unselected donors or from of unselected donors
s donors with high levels of anti
include: RhD or anti-viral antibodies
Other Other immunoglobulins Other immunoglobulin classes
constituent Other plasma proteins Other plasma proteins
s include: Stabilisers vary with product
Licensed IM / SC immunoglobulin IV immunoglobulin
indications normal Replacement therapy
Replacement therapy antibody deficiency
antibody deficiency syndromes.
syndromes. Prevention of RhD
Hepatitis A prophylaxis. immunisation in RhD negative
Prevention of RhD women.
Prescribing immunisation
Must never bein RhD by
given negative
IV Treatment of immunological
Closely observe
and women.
route. disorders.
manufacturers instructions
administrati on infusion rate and dose.
on
Storage Follow suppliers instructions. Follow suppliers instructions.
 Clotting factor concentrates

Factor VIII Factor IX Prothrombin complex

concentrate
Unit Typically 2501000 iu in each vial

Active constituents Factor VIII; Factor IX Factors II, IX, X; some

include: some products contain factor VII
products
contain vWF plasma proteins are present
Other constituents include: Other human

Licensed indications Factor VIII * Factor IX * Prothrombin complex

Treatment Treatment concentrate *
and and Treatment and
prophylaxis of prophylaxis of prophylaxis of bleeding in
bleeding in bleeding in patients with single or
patients with patients with multiple congenital
haemophilia A haemophilia deficiencies of factors IX,
and von B. II or X (and VII), Partial or
Willebrand complete reversal of
Prescribing and disease.
Should be used anticoagulant
under the guidance therapy).
of a specialist
administration clinician.
Storage Follow suppliers instructions.
 Others
FEIBA (factor VIII bypassing activity)
concentrate
Factor VII
Antithrombin
Fibrinogen
Fibrin sealant
VW factor concentrate
Protein C
C1 esterase inhibitor
Recombinant products
Factor VIII, IX, VIIa, activated protein C
See suppliers information
 Cryoprecipitate (CRYO), Factor VIII or
Anti-Hemophilic Factor (AHF)

VIII
Fibrinogen
Von Willebrands
A 6-10
FFP

To
1-6 C
Cryo


Cryoprecipitate (CRYO), Factor VIII or
Anti-Hemophilic Factor (AHF)

Cryoprecipitate
(VIII, vW)
Thaw at 30-37C
FFP Store at RT 4 hrs

Plasma cryoprecipitate, reduced

(TTP, FII, V, Vii, IX, X, XI)
Frozen Thawed Refrozen with 24 hrs of
within 8 FFP separation
Store at 18C 1 yr
hours
5 day expiration at 1-6C
 Cryoprecipitate (CRYO), Factor VIII or
Anti-Hemophilic Factor (AHF)

:
-18 C

:
1
6
4



Cryoprecipitate volume 15ml

Irradiation of Blood Components

Irradiation of Blood Components

-

-
Graft Versus Host Disease (GVHD)

GVHD -

GVHD

Irradiation of Blood Components
:
,
,

,

-


28

-

inimum 25 Gy
>50 Gy



:



FFP/FP


PRP



1. :



2.

3.


WB pRBC
()
24
PRPs

< 6


()





PRPs
20-24 C


 Standard ISBT 128 - Label Format

Unique Donation Number

& Static Text
13 digit unique Donation
Number (plus flag &
manual check
characters)
Blood centre name,
address, licence number
Static legal text
Product Code &
Description
Includes donation type
(e.g. autologous,
directed)
Includes divisions (e.g.
for pediatric use)
Includes modifier and
attribute information
(e.g. washed, irradiated)
Standard ISBT 128 - Label Format

Blood Group
More prominent
May indicate intended use
May indicate Rh, Kell
phenotypes
Expiry Date
Time also shown if other
than midnight
Special Testing/
Characteristics (Optional)
Red Cell Phenotype
CMV status
Special information, e.g.
antibodies present
In eye readable and,
optionally, bar code format
 Communication is Key!
Communication is key to a successful ISBT 128
Implementation
Anyone who handles blood components or enters/
records donation information is potentially
impacted
Lab staff
Systems administrators
Logistics staff
Nursing staff
Physicians
Patient records office
Hospital education office
Senior management
Outside agencies
 VIP


Lost in Transfusion