(F) Preparation of Blood Component, Storage, Transport, Indication for transfusion

Question 1

Familiarize the goals in blood collection

Answer 1

1. Maintain viability and function
2. Prevent physical changes
3. Minimize bacterial contamination
4. Practice good manufacturing practice (GMP)

Question 2

Matching type

a. Maintain viability and function
b. Prevent physical changes
c. Minimize bacterial contamination
d. Practice good manufacturing practice (GMP)

1. The storage of blood unit should be considered
2. This is done especially during collection and component preparation
3. Prevention of bacterial contamination starts from the collection of blood
4. The blood unit should be viable until the time it is transfused to the patient

Answer 2

1. b
2. d
3. c
4. a

Question 3

Considerations in blood collection

1. Blood units should be collected based on the time
   allotted. The ideal time of collection is ____minutes or
   maximum of____ only.
2. ____ should be minimized as much as possible
   during collection, especially to the tissues that would probably alter and render blood products not fit for transfusion.
   * If a collection is past 15 minutes, it would affect the coagulation factors and it can’t be processed anymore to ____*
3. Blood should be collected by a ____ only. Gentle mixing and the choice of anticoagulant should be monitored.

Answer 3

1. Blood units should be collected based on the time
   allotted. The ideal time of collection is** 4-10** minutes or maximum of 15 minutes only.
2. Trauma should be minimized as much as possible during collection, especially to the tissues that would probably alter and render blood products not fit for transfusion.
   * * If a collection is past 15 minutes, it would affect the
   coagulation factors and it can’t be processed anymore
   to fresh frozen plasma (FFP).
3. Blood should be collected by a single venipuncture only. Gentle mixing and the choice of anticoagulant should be monitored.

Question 4

Changes that occur during storage

1. Shelf life is synonymous with ____
2. An accepted criterion for maintenance of viability and function during storage (RBC) is that at the end of the expiration, at least ____ of the original red cells should be in the recipient’s circulation 24 hours after transfusion.

Answer 4

1. Shelf life is synonymous with expiration date.
2. 2. An accepted criterion for maintenance of viability and function during storage (RBC) is that at the end of the expiration, at least 75% of the original red cells should be in the recipient’s circulation 24 hours after transfusion.

Question 5

storage lesions or biochemical changes

1. Biochemical changes occuring during storage at ____, called as ____
2. 2. It can affect the oxygen dissociation curve, causing an (increased / decreased) affinity for oxygen

Answer 5

1. Biochemical changes occuring during storage at 1-6C, called as storage lesion
2. It can affect the oxygen dissociation curve, causing an increased affinity of hemoglobin for oxygen

Question 6

storage lesions or biochemical changes

• (high / low) 2,3-DPG, (increased / decreased) O2 affinity => less O2 released to the red cells
• pH (increases / decreases) due to lactic acid production causing 2,3-DPG levels to fall
• Once transfused, RBCs (regenerate / destroy) ATP and 2,3-DPG

Answer 6

1. low 2,3-DPG, increased O2 affinity => less O2 released to the red cells
2. pH decreases due to lactic acid production causing, 2,3=DPG levels to fall
3. Once transfused, RBCs regenerate ATP and 2,3-DPG

Question 7

Storage lesions or biochemical changes

1. There will be few functional platelets present. Note that the storage platelets should be at ____, thus, if they are stored at 1-6C, there will be no more viable platelets
2. Viable or living RBCs ______

Answer 7

1. There will be few functional platelets present. Note that the storage platelets should be at room temperature, thus, if they are stored at 1-6C, there will be no more viable platelets.
2. Viable or living RBCs decrease

Question 8

Storage lesions or biochemical changes

Increase or decrease?

1. Plasma Na+
2. Plasma K+
3. Plasma Hgb

Answer 8

1. decrease
2. increase
3. increase

Question 9

storage lesions or biochemical changes

1. pH
2. 2,3-DPG levels
3. ATP level
4. Ammonia

Answer 9

1. decrease
2. decrease
3. decrease
4. increase

Question 10

Identify:

prevents blood clotting and provides nutrients for the cells

Answer 10

Anticoagulants

Question 11

Match the anticoagulant to the action

a. citrate
b. dextrose
c. phosphate
d. adenine
e. mannitol

1. Membrane stabilizing agent
2. Protection against events storage-related hemolysis
3. Acts as a buffer

Answer 11

1. e
2. e
3. c

Question 12

Match the anticoagulant to the action

a. citrate
b. dextrose
c. phosphate
d. adenine
e. mannitol

1. a.k.a. Glucose, provides energy to red cell
2. Substrate for random blood sugar (RBS) synthesis of ATP
3. Binds Ca2+, prevents coagulation

Answer 12

1. b
2. d
3. a

Question 13

In adding the ADSOL, you first have to centrifuge the whole blood and remove ____ within ____ hours

Answer 13

remove platelet rich plasma (PRP)
within 72 hours

Question 14

Additive solution

Once PRP is separated from the red cells, you can add additive solution or ADSOL to ____ only, extending the storage up to ____ days

Answer 14

you can add ADSOL to RBCs only, extending the storage up to 42 days

Question 15

ADSOL is composed of?

Answer 15

1. Adenine
2. Dextrose (or glucose)
3. Sodium Chloride / saline
4. Mannitol

Question 16

Additive Solution

There will be a change in the hematocrit since additional
solutions have been incorporated which has a volume of
around ____. Final hematocrit of the unit would
decrease approximately ____.

But with a normal packed RBC (without additive
solutions), hematocrit would be ____.

Answer 16

There will be a change in the hematocrit since additional
solutions have been incorporated which has a volume of
around 100 mL. Final hematocrit of the unit would
decrease approximately **50 – 60%. **

• But with a normal packed RBC (without additive
  solutions), hematocrit would be 70 to 80%.

Question 17

Preparation of blood components

Blood from a donor is collected into a ____
and ____ to be processed into different
components.

Answer 17

Blood from a donor is collected into a system of tubings
and satellite containers to be processed into different
components.

Question 18

Preparation of blood components

Collect within ____ minutes to prevent the activation of the coagulation system

If more than this amount , the collected unit cannot be processed to ____ or ____

Answer 18

Collect within 15 minutes, the collected unit cannot be processed to fresh frozen plasma (FFP) or Cryoprecipitate

Question 19

Preparation of blood components

Draw the blood into the mother bag using a ____ primary bag with satellite bags, making sure that the hermetic seal is intact

Answer 19

closed system primary bag

Question 20

Preparation of blood components

If hermetic seal is broken, it is now considered as an ____ and the blood should be transfused within ____ hours if stored at 1-4C

If stored at 20C to 24C, transfuse within ____ hours

Answer 20

If hermetic seal is broken, it is now considered as an open system and the blood should be transfused within 24 hours hours if stored at 1-4C

If stored at 20C to 24C, transfuse within 4 hours

Question 21

One unit of whole blood can produce

Answer 21

1. Packed RBCs
2. FFP
3. Cryoprecipitate
4. Single donor plasma
5. Platelets

Question 22

FFP can be processed to which components?

Answer 22

1. cryoprecipitate
2. single donor plasma

Question 23

What are the three critical variables in preparation of blood components through centrifugation?

Answer 23

1. rotor size
2. speed
3. duration

Question 24

What is the principle involved in separating blood components

Answer 24

centrifugation

Question 25

What are the two equipments needed for blood component separation through centrifugation?

Answer 25

1. refrigerated centrifuge 2. sterile docking device (joins tubing)

Question 26

# Identify the equipment being described This is used by placing the segment of the mother bag on one end and the segment of the satellite bag to the other end and locking the system before pressing start on the machine. The tubes will then be welded into one, thereby, imitating a closed system.

Answer 26

sterile docking device

Question 27

What does the greek word "hermes" mean

Answer 27

the exit or entry of air

Question 28

this is synonymous to a closed system and is prevented from being broken to maintain the closed system

Answer 28

hermetic seal

Question 29

# T or F 1. Centrifuge the blood using a heavy spin to keep the platelets suspended in the plasma 2. REmove the platelets suspended in plasma or platelet rich plasma (PRP) from the red cells -> packed RBCs 3. If citrate phosphate dextrose (CPD) is used, packed RBCs can be stored up to 21 days 4. if ADSOL is used, packed RBCs can be stored up to 42 days at room temperature 5. PRP is further processed through centrifugation using a heavy spin to separately produce a platelet concentrate and a platelet poor plasma.

Answer 29

1. F (light spin) 2. T 3. T 4. F (1-6C or ref temp) 5. T

Question 30

# T or F 1. If PPP is to be processed as FFP, freeze the plasma solid within 24 hours 2. If PPP is to be processed as cryoprecipitate, remove the FFP from the freezer and thaw the plasma at room temperature to form the precipitate 3. Once the plasma is slushy, it is placed back to the centrifuge at 4C thus resulting to a cryoprecipitate 4. The cryoprecipitate settles at the bottom of the bag 5. Excess plasma / cryo-poor plasma is stored at 1-6C

Answer 30

1. F (within 8 hours) 2. F (at 1-6C or ref temp) 3. T 4. T 5. F (-18C)

Question 31

# Whole blood Identify the following: 1. Storage 2. Volume 3. HCT 4. Selection of unit

Answer 31

1. 1-6C or ref temp 2. 450-500mL 3. 40% 4. ABO identical / type specific

Question 32

What are the two benefits of whole blood

Answer 32

1. has O2 carrying capacity --> improved oxygenation 2. Volume expander (unit has plasma)

Question 33

What are the uses of whole blood?

Answer 33

* limited, rarely has uses * autologous transfusion * massive transfusion / correct hypovolemia

Question 34

What is the increased increment after 48-72 hours since transfusion

Answer 34

3% Hct 1 g/dL Hgb

Question 35

whole blood contains which components if less than 8 hours or after 24 hours, stored at 22C

Answer 35

1. red cells 2. platelets 3. buffy coat 4. fresh frozen plasma

Question 36

What does whole blood contain after storage at 4C for 24 to 72 hours

Answer 36

only red cells remain kasi within 8 hours lang yung FFP and PLT

Question 37

# pREPARATION OF WHOLE BLOOD COMPONENT 1. optimum setting of the cryofuge 2. Centrifuge must be spin unloaded until it reaches ____ 3. Once equal weight is achieved, the whole blood is loaded into onto the ____ 4. Whole blood is placed toward the (inside / outside) of the circular centrifuge bucket 5. Ensure that the attached bags and segments are ____ into the bucket next to the unit.

Answer 37

1. 18-22C (room tem) 2. optimum temperature 3. centrifuge bucket 4. outside 5. securely folded

Question 38

1. ____ the segments and bags properly will prevent them from becoming loose and attaching to other buckets, or being cut during centrifugation 2. Check if the buckets are ____ freely on their axis, sometimes, ____ is applied to the buckets 3. What happens is the buckets are not swinging? 4. what temp is needed to prevent PLT aggregation?

Answer 38

1. folding 2. swinging , grease 3. RBCs will not settle properly 4. 20-24C

Question 39

a. light spin b. heavy spin 1. used to keep the platelets suspended in the plasma 2. platelets will settle into the buffy coat 3. there will be no platelet concentrate available for harvesting

Answer 39

1. a 2. b 3. b

Question 40

1. after centrifugation, carefully examine the unit to confirm that the plasma is ____ 2. The buckets are carefully removed from the centrifuge and placed in a ____

Answer 40

1. clear 2. plasma expressor

Question 41

approximately ____ of donor plasma is expressed through a filter into the first satellite bag to produce platelet-rich plasma (PRP)

Answer 41

200-250 mL

Question 43

The RBC unit and additive pack are separated from the ____ and sent for preparation of AS-3 RBC LR. (AS= additive solution)

Answer 43

Platelet rich plasma (PRP)

Question 44

If a blood collection set up doesn't have an additive, where do you cut?

Answer 44

after the mother bag

Question 45

What are the two seals that may be used after processing packed RBC

Answer 45

1. electric sealer 2. aluminum clip / buhol-buhol system resulting to a white knot

Question 46

# Separation of PRP 1. Serparation of PRP will be further processed into what products? 2. PRP is centrifuged at what temperature? 3. PRP is centrifuged using (light / hard) spin 4. Platelet concentrate will be found at the (top / bottom) of the satellite bag

Answer 46

1. platelet concentrate and plasma 2. room temperature 3. hard spin 4. bottom of the satellite bag

Question 47

# Separation of PRP T or F 1. what would remain in the primary satellite bag would be RBCs suspended in 50-70mL of plasma 2. PPP will now be stored as fresh frozen plasma (FFP)

Answer 47

1. F (PLT concentrate will be suspended in plasma) 2. T

Question 48

# RBCs 1. storage for RBCs? 2. When is it prepared? 3. Hematocrit? 4. Final red cell volume? 5. Selection of unit?

Answer 48

1. 1-6C 2. shortly after collection or anytime during storage 3. 70-80% (CPDA-1) or 55-65% (with AS) 4. 160 to 275 ml or 50 to 80 g of hemoglobin 5. ABO identical or type specific