Blood Components (RBCs-Platelets)

Question 1

Component rich in Hemoglobin and RBC to increase the mass of the circulating red cell in situations where tissue oxygenation may be impaired

Answer 1

Packed Red Blood Cells

Question 2

Indication of Packed RBC (1)

Answer 2

Restore oxygen carrying capacity (anemia)

Question 3

Patients that commonly require RBC transfusion: (5)

Answer 3

1. Oncology patients (Undergoes chemotherapy)
2. End-stage renal disease patients
3. Dialysis patients
4. Chronic kidney disease
5. Infants and neonates

Question 4

Content/QC of Packed RBC:

Answer 4

Hematocrit must be 80% or less

Question 5

Storage temp of Packed RBC:

Answer 5

1-6°C

Question 6

Immediate effect of one unit packed RBC:

Answer 6

Increase in 3% Hct. Increase of 1 g/dL in Hgb

Question 7

Red blood cell component in which the white blood cells have been removed/reduced

Answer 7

LEUKODEPLETED/ LEUKOREDUCED RED BLOOD CELLS

Question 8

How much RBCs are left in Leukoreduced RBCs

Answer 8

85%

Question 9

Indication of Leukoreduced RBCs: (2)

Answer 9

1. Anemia with history of febrile reactions
2. decrease alloimmunization to WBC or HLA antigens or CMV transmission

Question 10

Shelf life of Packed RBCs:

Open System:
Closed System:

Answer 10

Open System: 24 hours

Closed System: Depends on the anticoagulant used

Question 11

Means of Leukocyte removal: (3)

Answer 11

1. Means of centrifugation
2. Washing procedures (using saline or glycerol)
3. Mechanical separation (use of leukoreduction
   filters)

Question 12

Filter sized of Leukoreduction Filters:

1st generation filter:
2nd generation filter:
3rd generation filter:

Answer 12

1st generation filter – 170 µm
2nd generation filter – 20-40 µm
3rd generation filter – 3-log filter

Question 13

Preparation of Leukoreduced RBCs: (2)

Answer 13

1. Pre-storage - can be separated during or
   immediately after collection
2. Post-storage - can be separated at the time of
   transfusion

Question 14

Blood component with the addition of Rejuvenation solution.

Answer 14

Rejuvenated RBCs

Question 15

Components revived in rejuvenating RBCs: (2)

Answer 15

ATP and 2,3 Diphosphoglyceric acid

Question 16

Components used in RBC rejuvenation: (5)

Answer 16

1. Phosphate
2. Inosine
3. Pyruvate
4. Adenosine
5. Glucose – also used for rejuvenating RBCs but is now removed

Question 17

FDA Approved Rejuvenating Solution

Answer 17

Rejuvesol

Question 18

Shelf life of Rejuvenated RBCs

Answer 18

Can be prepared 3 days after expiration of blood. The addition of rejuvenating solution alters the shelf life of the blood component. Only valid 24 hours prior to transfusion.

Question 19

RBCs washed with sterile saline for the removal of plasma proteins, platelets, leukocytes and cellular debris.

Answer 19

Washed RBCs

Question 20

Shelf life of Washed RBCs

Answer 20

Open System: 24 hours at 1-6°C

Question 21

Indications of Washed RBCs: (3)

Answer 21

1. Anemia with history of febrile reactions
2. Paroxysmal nocturnal hemoglobinuria
3. For patients with plasma proteins antibodies to reduced allergic reactions (for IgA-deficient patients). For patients at risk of developing anti-IgA antibody

Question 22

Quality control requirement for washed RBCs

Answer 22

Plasma must be removed

Question 23

prepared for those with rare units such as AB (-) individuals, Bombay phenotype, Rh phenotype and patients that undergoes autologous donation

Answer 23

Frozen RBCs

Question 24

Cryoprotective agent used in Frozen RBCs

Answer 24

Glycerol

Question 25

What is the use of glycerol in Frozen RBCs

Answer 25

Keeps the RBC components from being destroyed when stored in low temperatures

Question 26

Give the three concentrations of Glycerol and its temperature requirement: (3)

Answer 26

1. High Concentration: 40% glycerol. Freezer requirement: Mechanical freezer (- 65°C) (Preferred) 2. Low Concentration: 20% glycerol. Requirement: Liquid Nitrogen (- 100°C) 3. 79 % Glycerol + Dextrose, Fructose and EDTA: -65°C

Question 27

Why is high concentration of glycerol is preferred than the low concentration?

Answer 27

Low concentration glycerol uses liquid nitrogen that is prone to formation of ice crystals. These ice crystals lead to cell lysis.

Question 28

Shelf life of Frozen RBCs

Answer 28

Frozen – 10 years provided that cryoprotective agent is added Deglycerolized – 24 hours (thawed)

Question 29

What is the temperature requirement in thawing frozen RBCs?

Answer 29

1-6°C

Question 30

Important requirement in deglycerolization process:

Answer 30

Use decreasing concentration of saline or NaCl (Hypertonic to Isotonic Sol'n)

Question 31

Explain deglycerolization washing process

Answer 31

1st washing process – wash thawed RBC to 12% NaCl (Hypertonic sol’n) – 2nd washing process – wash RC at 1.6% NaCl 3rd wash – 0.9 or 0.85% NaCl (isotonic sol’n)

Question 32

given to patient with impaired normal platelet function and impaired number of circulating platelet

Answer 32

Platelet components

Question 33

Purpose of giving platelet component

Answer 33

Control/prevent bleeding associated with critically decreased or functionally abnormal platelet

Question 34

Platelet Concentrates are done via: (2)

Answer 34

1. Random Donor Platelets 2. Single Donor Platelets

Question 35

Indications of Random Donor Platelets: (4)

Answer 35

1. Thrombocytopenia 2. DIC 3. Platelet disorders 4. Bleeding

Question 36

Shelf life of RDP:

Answer 36

5 days with the need of constant agitation

Question 37

What is the purpose of constant agitation of platelets?

Answer 37

Agitation facilitate oxygen transfer and oxygen consumption by the platelets. Also to prevent clumping of platelets. Oxygen consumption of platelets is associated with maintaining the pH of platelets (key parameter in maintaining platelet viability in vitro)

Question 38

Storage temp: Random Donor Platelet: Single Donor Platelet

Answer 38

Both are stored in 20-24°C

Question 39

Contraindications of RDP:

Answer 39

1. Triggers Immune Thrombocytopenia 2. Heparin induced thrombocytopenia

Question 40

Quality Control of RDP:

Answer 40

5.5 x 1010 and 50-65mL of plasma sample

Question 41

Immediate effect of RDP:

Answer 41

Increase platelet count by 5,000 – 10,000 per unit

Question 42

How is Single Donor Platelet prepared?

Answer 42

Prepared from apheresis procedure

Question 43

Indications of SDP: (2)

Answer 43

1. Thrombocytopenia 2. For patients refractory to RDP due to platelet antibodies

Question 44

Considerations of SDP: (2)

Answer 44

1. If platelets are necessary to transfuse 2. Indication for the use of RDP are given to those actively bleeding patients

Question 45

Shelf life of SDP: Closed system: Open system:

Answer 45

1. Closed system – 5 days 2. Open system – 24 hours

Question 46

Contents of SDP:

Answer 46

3.0 x 1011 platelets in approx. 300 mL plasma

Question 47

Other platelet components: (4)

Answer 47

1. Pooled Aliquot 2. Irradiated Platelets 3. Leukoreduced Platelets 4. Pooled Platelets

Question 48

for platelet transfusion for neonates (< 50,000 mL per unit)

Answer 48

Pooled Aliquot

Question 49

Platelet component that is used to prevent development of TA-GVHD

Answer 49

Irradiated Platelets

Question 50

Platelet component that must be < 8.3 x 105 of residual WBCs for platelet derived from whole blood

Answer 50

Leukoreduced Platelets

Question 51

6 pooled RDPs is combined into 1 bag

Answer 51

Pooled Platelets

Question 52

Pooled platelets must be transfused within _____ of pooling?

Answer 52

4 hours