PARTS OF THE BLOOD

Blood is the fluid circulating

in the body that carries
nutrients and oxygen,
removes waste products
and fights infection
• Red Blood Cells
• Plasma
• White Cells
• Platelets
 RED BLOOD CELLS
Red blood cells carry oxygen to the body’s organs and tissues.
The inside of the red blood cell is filled with the protein haemoglobin.
 PLASMA
• Blood cells float in a straw-
coloured liquid called plasma

• Plasma consist of water and

many dissolved substances
required in the body
 WHITE BLOOD CELLS

White blood cells attack

invading microbes that cause
disease
They do this in two ways:
1. One type of white blood cell produces chemicals called
antibodies.
These antibodies lock on to proteins called antigens on the
surface of the microbes.
2. Another type of white blood cell digests any microbes the
antibodies lock on to.
 PLATELETS
Platelets are
• bits of cell broken off large cells

They
• help blood to clot
• and stop bleeding at cuts.
 BLOOD GROUPS IN DETAIL
Blood group Group A: Group B: Group AB: Group O:

Antigens Has Has Has Has neither A nor B

You have certain A B A and B antigens
proteins (called antigens antigens antigens
antigens) on the
surface of your red
blood cells:

Antibodies Against B antigens Against A Against no Against A and B

Your blood plasma – Anti-B antigens – Anti-A antigens antigens – Anti-A, B
contains certain
antibodies which
would attack red
blood cell antigens
that you do not
have:

Can donate to: Can donate to Can donate to Can donate to Can donate to all
Only those with Group A and Group Group B and Group Group AB groups
antibodies that will AB AB
NOT react with the
antigens in the
donated blood.
e.g. Group A donor
can only donate to
recipients without
Anti-A

Can receive from: Can receive from Can receive from Can receive from Can only receive from
Only those whose Group A and Group Group B and Group all groups Group O
antigens will NOT O O
react with its own
antibodies.
e.g. Group A
 TRANSFUSION
MEDICINE

• Purpose, Indications, Types

and Complications
 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
 PURPOSE
• TO INCREASE CIRCULATORY
BLOOD VOLUME
• TO INCREASE HAEMOGLOBIN
LEVEL
• TO PROVIDE PLASMA CLOTTING
FACTORS TO CONTROL BLEEDING
• TO COMBAT INFECTIONS DUE TO
DECREASE OR DEFECTIVE WHITE
CELLS OR ANTIBODIES
 INDICATIONS
• AFTER SURGERY
• TRAUMA
• HAEMORRHAGE
• SEVERE ANAEMIA
• HAEMOPHILIA
• LEUKOPENIA
• AGRANULOCYTOSIS
• THROMBOBLASTOSIS FETALIS
 TYPES OF BLOOD TRANSFUSION

• HOMOLOGUS TRANSFUSION
• AUTOLOGOUS TRANSFUSION
• TRANSFUSION OF PLASMA
EXPANDERS & BLOOD COMPONENTS
DONOR ELIGIBILITY CRITERIA

Who can donate?

• Age: 18 - 60 years
• Weight : > 45 kgs
• Hemoglobin level: >12 gms/dl for men
and 12.5 gms/dl for women
• In good health
 DEFERRAL CRITERIA
WHO CANNOT DONATE
Life long 1 year 6 Months
х Abnormal bleeding o Surgery o Tattooing or body
disorder piercing
х Heart, Kidney, Liver o Typhoid
Disorder o Dental extraction
х Thyroid disorder o Dog bite
o Root canal treatment
х Epilepsy, Mental
disorders o Unexplained weight
loss o Malaria
х Tuberculosis,
Leprosy,
o Continuous low o Vaccination
х Asthma grade fever

х Cancer

х Insulin dependent
diabetics
 DEFERRAL CRITERIA

Female donors cannot donate blood……

• During pregnancy
• After delivery for one year
• When lactating
• During menstrual period and for 7 days there after

Male donors cannot donate blood……

• If consumed Alcohol in the previous 24 hours
 PRE-DONATION INFORMATION

• Blood is taken ONLY from Voluntary Donors

• Using sterile, disposable blood bags & instruments
• Donated Blood is tested and separated into components
benefiting 3-4 patients
• It is safe to donate every 3 months

• It is quick and safe.

• It doesn’t hurt.
• It saves 3 to 4 lives
 MEDICAL EXAMINATION

• Blood test for:

– Blood grouping
– Hemoglobin
• Blood pressure
• Pulse
• General physical examination
BLOOD DONATION PROCEDURE

The Donor Must ….

have had good rest /

sleep

have had light meal

be mentally prepare
 VOLUME OF BLOOD
COLLECTION
Donor Blood Amount Used for
Weight collected

45 kgs -55 350ml Single bag Whole Blood

kgs

> 55 kgs 450 ml Double / Blood

Triple bag Components
 POST DONATION ADVICE
• Drink lots of fluids for next 24 hours
• Avoid smoking for one hour & alcohol till after a meal
• Don’t use elevator to go up immediately after donation
as it will make blood rush to your feet & make you dizzy!
• Avoid highly strenuous exercises & games for a day
• If you feel dizzy, lie down & put your feet up. You will be
alright in 10-20 mins.
• Remove band-aid after 4 hours. If it bleeds, apply
pressure & reapply band-aid. If bruised and painful,
apply cold-pack 4 to 5 times for 5 mins each. The bruise
is due to blood seeping into the surrounding tissue. It will
take a few days to get reabsorbed.
 TESTING AT BLOOD BANK FOR
TRANSFUSION TRANSMISSIBLE INFECTIONS
(TTIS)

Blood collected at the BDC is screened using

highest quality screening tests for 6 TTIs

• HIV 1
• HIV 2
• Hepatitis B
• Hepatitis C
• VDRL (syphilis)
• Malaria
COUNSELING FOR “REACTIVE”
DONORS
If a blood sample tests positive for any
TTI, then….
• Tests are repeated in duplicate
• Complete confidentiality is maintained
about the test results
• ONLY the donor is informed, counseled &
encouraged for further testing
• Referrals to health experts are provided
along with follow-ups
BLOOD PRODUCTS / COMPONENTS
& THEIR USES
Blood collected is screened for TTIs (infections) & IF
SAFE, is separated into components & stored for issue
to patients.

• Whole blood
– For Exchange Transfusion in Babies
– Accident Victims
– Complicated Delivery cases
– Some specific surgeries

• Blood Components
– Red Cells (for anemia)
– Fresh Frozen Plasma (for clotting disorders, burns)
– Platelets/Platelet rich plasma (for cancer, dengue)
– Cryoprecipitate (for clotting disorders)
– Cryo Poor Plasma (for burns)
 BENEFITS TO DONOR OF BLOOD
DONATION

Health benefits:
Regular donation (2-3 times a year….)
Lowers cholesterol
Lowers lipid levels
Decreases incidence of heart
attacks, strokes
Donor is also eligible to receive
one FREE unit of blood if needed
for
Self
Spouse/ Child/ Parents, and
Even friends
 DIFFERENTIAL
CENTRIFUGATION
FIRST CENTRIFUGATION
Closed System

Whole Blood Satellite Bag Satellite Bag

Main Bag 1 2
First

Platelet-rich
RBC’s Plasma
 DIFFERENTIAL
CENTRIFUGATION
SECOND CENTRIFUGATION

RBC’s Platelet-rich
Plasma
Second

Platelet Plasma
RBC’s Concentrate
 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
 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
 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
 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%
 RBC TRANSFUSIONS
PREPARATIONS

• Type
– Typing of RBC’s for ABO and Rh are determined for both donor
and recipient

• Crossmatch
– Donor cells and recipient serum are mixed and evaluated for
agglutination
 TRANSFUSION
COMPLICATIONS

• Acute Transfusion Reactions (ATR’s)

• Chronic Transfusion Reactions
• Transfusion related infections
 ACUTE TRANSFUSION
REACTIONS

• Hemolytic Reactions (AHTR)

• Febrile Reactions (FNHTR)
ACUTE HEMOLYTIC TRANSFUSION
REACTIONS (AHTR)

• Occurs when incompatible RBC’s are transfused into a recipient who

has pre-formed antibodies (usually ABO or Rh)
• Antibodies activate the complement system, causing intravascular
hemolysis
• Symptoms occur within minutes of starting the transfusion
• This hemolytic reaction can occur with as little as 1-2 cc of RBC’s
• Labeling error is most common problem
• CAN BE FATAL
 WHAT TO DO?
IF AN AHTR OCCURS

• STOP TRANSFUSION
• CAB
• Maintain IV access and run IVF (NS or LR)
• Monitor and maintain BP/pulse
• Give diuretic
• Obtain blood and urine for transfusion reaction workup
• Send remaining blood back to Blood Bank
 FEBRILE NONHEMOLYTIC
TRANSFUSION REACTIONS (FNHTR)

• Definition--Rise in patient temperature >1°C (associated

with transfusion without other fever precipitating factors)
• Occurs with approx 1% of PRBC transfusions and approx
20% of Plt transfusions
• FNHTR caused by alloantibodies directed against HLA
antigens
• Need to evaluate for AHTR and infection
 WHAT TO DO?
IF AN FNHTR OCCURS

• STOP TRANSFUSION
• Use of Antipyretics
• Use of Corticosteroids for severe reactions
• Future considerations
– May prevent reaction with leukocyte filter
– Use single donor platelets
– Use fresh platelets
– Washed RBC’s or platelets
TRANSFUSION
ASSOCIATED
INFECTIONS

• HEPATITIS C
• HEPATITIS B
• HIV
 SUMMARY
• Blood
• Its Parts
• Blood Groups
• Blood Transfusion / Types
• Criteria Donor / Deferral
• Blood Components / Uses
• Reactions (What to do) / TTI
 SAFE BLOOD FOR
SAVE MOTHER
• PREGNANCY
- Anemia
- Bleeding in Early and Late
Pregnancy
- Miscarriage
- Caesarean
CREATIVE ART

Things we wish to change

① Remove ‘+’ or ’-’ symbol

② Instead of ‘being a hero is in your
blood’ Put ‘Every blood donor is a
hero’

Posters don’t
recruit donors…
people do