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blood bank sem 2 > components and prep > Flashcards

components and prep Flashcards

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1
Q

when is whole blood transfusion used

A

need both volume and Hgb replacement

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2
Q

whole blood donation standard ratio

A

14 mL additive solution for every 100 mL of whole blood collected

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3
Q

what is reconstituted blood

A

group O cells with AB plasma (universally compatible)

24 hrs til expiration

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4
Q

soft spin yields

A

platelet-rich plasma

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5
Q

cryoprecipitate is rich in what coag components

A

factor 8
fibrinogen

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6
Q

RBC storage requirements

A

temp: 1-6
shelf life: 42 days w AS-1
(35 with CDPA-1)

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7
Q

fresh frozen plasma storage requirements

A

temp: <-18
shelf life: 1 year

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8
Q

“thawed plasma” storage requirements

A

temp: 1-6
shelf life: 5 days

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9
Q

thawed fresh frozen plasma storage requirements

A

temp: 1-6
shelf life: 24 hrs (up to 5 days)

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10
Q

platelets storage requirements

A

temp: 20-24
shelf life: 5 days from collection

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11
Q

frozen cryo storage requirements

A

temp: <-18
shelf life: 1 year

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12
Q

thawed cryo storage requirements

A

temp: 20-24
shelf life: 4 hours

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13
Q

packed red cell prepared by

A

removing as much plasma as possible

AS-1 must be added within 3 days of collection or CDPA

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14
Q

what is used to collect double red cells

A

apheresis

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15
Q

final RBC product needs hematocrit of

A

55-65%

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16
Q

how does RBC aliquot work

A

bag gets zeroed on a scale and requested amount is expressed into aliquot bag

-closed system doesn’t compromise sterility so expiration is unchanged

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17
Q

RBC aliquot syringe

A

syringe can be used to draw blood out of unit

expiration is changed to 24 hrs because sterility is broken

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18
Q

preparing long term storage RBC by

A

frozen, glycerolized RBC

stable at -65 for 10 years

when time to use: thawed, washed, deglycerolized cells

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19
Q

when are RBC used for long term storage settings

A

-rare blood types
-autologous donation
-military use in remote areas

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20
Q

high glycerol

A

40% weight per volume
-more cryoprotection to the cells so they can be frozen “slowly” in a normal -65 freezer

wash carefully when thawing to avoid contamination

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21
Q

low glycerol

A

20% weight per volume
-must be rapidly frozen with LN2 and stored in much more expensive -120 degrees freezer

-more sensitive to lysis from overhandling and temperature fluctuations

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22
Q

reduced change of GVHD

A

irradiated cells

FDA requires every irradiated unit to receive at least 25 Gy to center of the unit and no less than 15 Gy to any single part

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23
Q

new expiration date for irradiation

A

28 days from time of irradiation OR original outdate
-whichever comes first (only really applies to RBC unit)

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24
Q

for each RBC transfusion what bump should you get in Hgb

A

1 g/dL per unit
-depends on final Hct of unit and pt size

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25
indication for RBC transfusion
general- anemia HGB <7.0 active bleed hemoglobinopathies
26
platelets must be prepared within
8 hrs of collection if made from whole blood
27
platelet units are screened for
presence of NSAIDs which damage the platelets -done by removing platelet-rich plasma and pelleting the platelets with hard spin
28
platelet units must have
a device to detect bacterial contamination OR pathogen reduced units -continuously agitated while stored
29
random donor platelets from whole blood should have
5.5 x 10^10 platelets
30
single donor platelets from apheresis should have at least
3.3 x 10^11 platelets -more concentrated
31
single donor units can be matched how
HLA -RDP tend to be pooled to get required amount -SDP more expensive
32
indications for platelet transfusions
thrombocytopenia or less than 50,000 during an active bleed/ pre- or intraoperative -or trauma setting
33
how much bump of platelets is received when transfused
10-40,000 plt -depends on product type, actual plt count of unit and pt size small increase of plt difficult to see refractoriness
34
platelet- poor plasma that is frozen within 8 hrs is labeled
FFP
35
if plasma is frozen within 24 hrs it is labeled as
PF 24 -good for 1 year
36
plasma can be kept liquid up to
5 days but only good for volume replacement like thawed plasma
37
thawed FFP has all the stable and labile clotting factors present but
factor V and factor 8 degrade within 24 hours at 2-8 degrees -PF24 lacks these factors
38
after 24 hrs the plasma unit is
"thawed plasma" -anything beside coag needs
39
convalescent plasma
apheresis plasma collected from a donor that has recovered from particular illness and it will be given as a form of passive immunity -MERS, SARS,Ebola, Flu, Measles, etc
40
indications for plasma transfusion
INR>1.5 or PT> 1.5x normal limit -DIC -liver failure -nonspecific coagulopathy -correct warfarin overdose -massive trauma -therapeutic plasmapheresis
41
plasma retains most of
coag factors for several days -now we use thawed plasma up to 5 days even to correct coagulopathy
42
how is cryo prepared
slow-thawing FFP -the clotting factors (factor 8 and fibrinogen) sediment and can be separated and frozen
43
units of cryo can be made from pools of
up to 10 donors to get a good dose -became a big problem during HIV -doctors prefer to given recombinant coag factors
44
who is cryo used for
hemophiliac patients when having a bleeding episode -volume is not needed
45
indications for use of cryo
fibrinogen < 100 mg/dL massive trauma hemophilia in emergency setting when factor 8 not available
46
what is either purified from FFP or recombinant and pathogen inactivated
factor 8, 9, 7a, protein S and C -factor 8 includes vWF
47
what is purified from pooled plasma
IV immunoglobulin -mainly IgG
48
RhIg can be used to treat
ITP in D + pts -D+ RBC's distract RES from killing platelets until problem gone
49
what is apheresis
removing a specific component from whole blood and returning the remainder to donor -Edwin Cohn
50
therapeutic apheresis
pathological substance removed from circulation
51
apheresis procedure
single or double phlebotomy -takes 45-120 min -may also have co-infusion of saline to prevent hypovolemia
52
blood from the send tube us immediately mixed with
citrate to anticoag it
53
after mixing with citrate it enters the system either through
intermittent flow centrifugation (IFC) or continuous flow centrifugation (CFC) -CFC requires second venipuncture
54
for erythrocytapheresis must have a way to measure total
RBC loss (not just donation volume ) so don't exceed max amount of loss
55
intermittent flow centrifugation
blood drawn in batches or cycles -citrate mixed with blood as it is pumped into bowl, spun, and desired component pumped into collection bag -remainder pumped into reinfusion bag and returned to donor
56
IFC may take how many cycles
6 -8 to remove sufficient component
57
continuous flow centrifugation
blood is withdrawn, processed, and reinfused in a continuous manner -requires 2 venipuncture sites OR PICC line with double lumen -reduces amount of blood processed which needs to stay below 10.5 mL/kg
58
changes in blood volume can cause reactions in
younger patients -donor must be monitored for total volume of lost RBC's
59
double RBC apheresis freq
once every 112 days
60
plasma frequent apheresis freq
every 2 days (not more than twice a week)
61
plasma infrequent apheresis freq
every 4 weeks (not more than 13 times/year)
62
platelets single unit apheresis freq
every 2 days (no more twice a week and 24 times a year)
63
platelets 2x/ 3x apheresis freq
every 7 days
64
specific testing ordered by doctor for apheresis
CMP, PT/aPTT, CBC for freq plasma/platelet donors
65
why not just prepare plasma from whole blood?
donor benefits: fewer rxn product benefits: larger volume collected
66
why larger plasma volume better?
-allows collection of specific ABO types -allows collection of greater amount of specific products -collection of sufficient product to make cryo, IVIG, hepatits IG
67
platelets removed by apheresis can replace a unit of
6-8 pooled units harvested from whole blood
68
for platelet donation donor must have plt count of
150 x 10^9/L -except for initial donation or if 4 or more weeks have elapsed since last apheresis ???
69
most platelet units are produced with a
leukocyte filter
70
granulocyte units can be used to
treat infections that are unresponsive to drugs (sepsis in neonates)
71
what is the only efficient way to capture enough granulocytes
apheresis
72
leukocyte donor will be given
corticosteroids or G-CSF to increase number of circulating cells -hydroxyethyl starch will be added to removed blood to help sediment RBC (better separation from buffy coat)
73
RBC exchange
erythrocytapheresis
74
rather than collecting bone marrow
hematopoietic progenitor cells

blood bank sem 2 (6 decks)

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