RBC and Platelet Preservation

Question 1

What are the naturally occurring antibodies?

Answer 1

anti-a and anti-b

Question 2

Name the 4 metabolic pathways.

Answer 2

EMP
Pentose Phosphate Pathway (Hexose Monophosphate Shunt)
Methemoglobin Reductase Pathway
Luebering-Rapaport Shunt Pathway

Question 3

Which metabolic pathway produces 90-95% of a cell’s energy?

Answer 3

EMP

Question 4

What does the Hexose Monophosphate Shunt do?

Answer 4

Protects the cell from oxidative damage

Question 5

G6PD deficiency affects which metabolic pathway?

Answer 5

Pentose Phosphate pathway

Hexose Monophosphate shunt

Question 6

Which metabolic pathway is responsible for maintaining iron in the ferrous state?

Answer 6

Methemoglobin Reductase Pathway

Question 7

The Leubering-Rapaport Shunt Pathway regulates

Answer 7

2,3-DPG (which in turn regulates oxygen transport)

Question 8

What is the function of hemoglobin?

Answer 8

carry oxygen to the tissues and carry CO2 back to be expelled

Question 9

What molecules on the RBC surface help maintain the cell’s shape?

Answer 9

Antigens

Question 10

After collection, what needs to be maintained for RBC viability?

Answer 10

ion pumps, hemoglobin, and RBC integrity and deformability

Question 11

How many pints of blood does a normal adult have?

Answer 11

10-12 pints

Question 12

A standard unit of blood contains what volume of blood?

Answer 12

450 mL (1 pint)

Question 13

Low volume units can only be used for

Answer 13

Packed RBCs

Question 14

How many mL of anticoagulant is needed per 1 unit of blood?

Answer 14

63 mL

Question 15

After processing, what is the shelf life for a normal unit of blood?

Answer 15

21-24 days

Question 16

How is RBC viability measured?

Answer 16

via the amount of hemolysis that has occured

Question 17

What percentage of cell survival is needed in order for a unit of blood to be considered viable?

Answer 17

75% survival after 24 hours

Question 18

At what temperature is collected blood stored at?

Answer 18

1-6 degrees C

Question 19

Which factors are decreased during storage lesion (biochemical changes)?

Answer 19

pH
glucose consumption
ATP
Na

Question 20

Which factors are increased during storage lesion (biochemical changes)?

Answer 20

lactic acid
Hemoglobin-oxygen affinity
K and ammonia

Question 21

What increases hgb-oxygen affinity during storage lesion?

Answer 21

decrease in 2,3-DPG

Question 22

Which RBC enhancement additive supports ATP generation by glycolytic pathways?

Answer 22

Dextrose

Question 23

Which RBC enhancement additive provides substrate from which ATP can be synthesized?

Answer 23

Adenine

Question 24

Which RBC enhancement additive prevents coagulation by chelating calcium?

Answer 24

citrate

Question 25

Name additives that enhance RBC survival and function

Answer 25

Dextrose, adenine, citrate, phosphate, mannitol

Question 26

Which RBC enhancement additive prevents pH from falling excessively?

Answer 26

phosphate

Question 27

Which RBC enhancement additive is a carbohydrate that reduces hemolysis by acting as an osmotic diuretic?

Answer 27

Mannitol

Question 28

Name 4 whole blood anticoagulants and preservatives

Answer 28

ACD (Acid-citrate-dextrose) CPD (citrate-phosphate-dextrose) CP2D (citrate-phosphate-dextrose x2) CPDA-1 (citrate-phosphate-dextrose-adenine)

Question 29

How long can whole blood be stored when ACD, CPD, or CP2D are used? What about CPDA-1?

Answer 29

ACD, CPD, CP2D 21 days CPDA-1 35 days

Question 30

What are the additives for Packed RBCs?

Answer 30

AS-1 (Adsol): glucose-adenine-mannitol-sodium chloride AS-3 (Nutricel): glucose-adenine-phosphate-sodium chloride AS-5 (Optisol): glucose-adenine-mannitol-sodium chloride

Question 31

What is the storage life of PRBCs when AS-1 (Adsol), AS-3 (Nutricel), or AS-5 (Optisol) are used as additives?

Answer 31

42 days

Question 32

What is an autologous donor?

Answer 32

An individual who donates blood for themselves before a procedure

Question 33

PIPA solution contains what and is used in which process?

Answer 33

Pyruvate, Inosine, Phosphate, Adenine Used during rejuvenation of RBCs

Question 34

Adding PIPA during the rejuvenation process of RBCs restores...

Answer 34

2,3-DPG and ATP

Question 35

RBCs preserved in which solutions can be rejuvenated within 3 days of outdating?

Answer 35

CPD, CPDA-1, or AS-1

Question 36

How is RBC rejuvenation performed?

Answer 36

Incubate the cells with PIPA solution and then wash the cells before administration.

Question 37

How long after rejuvenation can the RBCs be used?

Answer 37

Must be administered within 24 hours

Question 38

How long can RBCs be stored when frozen?

Answer 38

10 years

Question 39

Freezing RBCs lowers WBCs/platelets and removes most plasma proteins. Why is this advantageous?

Answer 39

Lower WBCs and platelets decreases HLAs Antibodies are plasma proteins and when removed, won't cause a transfusion reaction.

Question 40

How old can RBCs be in order to be frozen?

Answer 40

less than 6 days

Question 41

Which cryoprotective agent is used when freezing RBCs?

Answer 41

glycerol

Question 42

What is the initial temp and storage temp when a high concentration (40% w/v) is used in the freezing procedure?

Answer 42

Initial temp: -80 degrees C | Storage temp: -65 degrees C

Question 43

What is the initial temp and storage temp when a low concentration (20% w/v) is used in the freezing procedure?

Answer 43

Initial temp: -196 degrees C | Storage temp: -120 degrees C

Question 44

What is an advantage and disadvantage to using a low concentration of glycerol when freezing RBCs?

Answer 44

Advantage: thaws more rapidly Disadvantage: more expensive

Question 45

How do you deglycerolize frozen RBCs?

Answer 45

Replace the glycerol with decreasing concentrations of saline. Initial wash: 12% NaCl 2nd wash: 1.6% NaCl 3rd wash: 0.2% dextrose in normal NaCl