RBC PRESERVATION

Question 1

What is the main goal of RBC preservation?

Answer 1

Maintain RBC viability during storage

Question 2

_____% of transfused RBCs should remain viable in the bloodstream for 24 hours

Answer 2

> 75%

Question 3

Free hemoglobin should be ________% of total hemoglobin

Answer 3

less than 1%

Question 4

Temperature requirement for storage of liquid whole blood/RBC units:

Answer 4

1-6 degrees Celsius

Question 5

Temperature requirement for shipping/transporting of liquid whole blood/RBC units:

Answer 5

1-10 degrees Celsius

Question 6

Blood Units without RBCs:

Answer 6

• Platelet concentrate
• Granulocyte concentrate
• Fresh Frozen Plasma (FFP)
• PF 24
• Cryoprecipitate

Question 7

RBC units:

Answer 7

• Packed RBC
• Washed RBC
• Leukocyte reduced RBC
• RBC aliquots
• Deglycerolized RBC

Question 8

Temperature requirement for storage of Platelet concentrate and Granulocyte concentrate:

Answer 8

20-24 degrees Celsius (room temperature)

Question 9

Temperature requirement for storage of FFP and PF 24:

Answer 9

-18 degrees Celsius (Frozen)

Question 10

Consequence of incorrect temperature storage:

Answer 10

Bacterial contamination
Discoloration of blood unit

Question 11

RBC storage lesion (loss of viability)
Increased:

Answer 11

RBC storage lesion
Increased:
- Plasma potassium (K+) (due to hemolysis)
- Plasma hemoglobin (due to hemolysis)
- Lactic acid (due to extensive glycolysis)

Question 12

RBC storage lesion (loss of viability)
Decreased:

Answer 12

RBC storage lesion (loss of viability)
Decreased:
- ATP & glucose levels
- 2, 3 DPG (decreased oxygen delivery to tissues)
- pH

Question 13

Approved preservative solutions:

Answer 13

1. Acid-Citrate-Dextrose Formula A (ACD-A)
2. Citrate-Phosphate-Dextrose (CPD)
3. Citrate-Phosphate-Dextrose-Adenine (CPDA-1)
4. Citrate-Phosphate-Double Dextrose (CP2D)

Question 14

Shelf life of:

1. Acid-Citrate-Dextrose Formula A (ACD-A)
2. Citrate-Phosphate-Dextrose (CPD)
3. Citrate-Phosphate-Dextrose-Adenine (CPDA-1)
4. Citrate-Phosphate-Double Dextrose (CP2D)

Answer 14

1. ACD-A = 21 days
2. CPD = 21 days
3. CPDA-1 = 35 days
4. CP2D = 21 days

Question 15

Remarks of:

1. Acid-Citrate-Dextrose Formula A (ACD-A)
2. Citrate-Phosphate-Dextrose (CPD)
3. Citrate-Phosphate-Dextrose-Adenine (CPDA-1)
4. Citrate-Phosphate-Double Dextrose (CP2D)

Answer 15

1. ACD-A = has lower pH; loss of 2, 3-DPG @ 1st week
2. CPD = Phosphate preserves 2, 3-DPG
3. CPDA-1 = Adenine maintains ATP levels
4. CP2D = 100% more glucose than CPD

Question 16

Common preservative in the Philippines:

Answer 16

CPDA-1

Question 17

Added to RBCs within the first 72 hours of storage:

Answer 17

Additive solution

Question 18

The additive solution can extend the shelf life of a blood unit for up to:

Answer 18

42 days

Question 19

Contents of an additive solution:t

Answer 19

Mannitol - prevents storage related hemolysis
Adenine - maintains ATP levels
Glucose - Source of energy
Saline - isotonic

“MAGS”

Question 20

Can be used up to 3 days after expiration of red cells:

Answer 20

Rejuvenation solution

Question 21

Rejuvenation solution can extend an expired RBC unit for:

Answer 21

24 hours/ 1day

Question 22

Rejuvenation solution content:

Answer 22

Phosphate - buffer
Inosine - maintains 2, 3-DPG levels
Pyruvate - maintains 2, 3-DPG levels
Adenine - maintain ATP levels

Question 23

Includes addition of a cryoprotective agent to RBCs that are <6 days old; primarily used for autologous units and storage of rare blood type:

Answer 23

Red cell Freezing

Question 24

Red cell freezing can extend the shelf life of an RBC unit for:

Answer 24

10 years @ -65 degrees Celsius

Question 25

Most common cryoprotective agent:

Answer 25

Glycerol: (40% w/v or 20% w/v)

Question 26

The FDA-approved rejuvenation solution in US

Answer 26

Rejuvesol

Question 27

It is done prior of the transfusion of a glycerolized RBC unit

Answer 27

Deglycerolization

Question 28

Deglycerolization process:

Answer 28

Washing: 1st = 12% NaCl 2nd = 1.6% NaCl 3rd = 0.9% NaCl (NSS) with 0.2% dextrose

Question 29

Carry and transfer oxygen in the absence of intact RBCs:

Answer 29

RBC substitutes

Question 30

Advantage of RBC subtitutes:

Answer 30

Abundant supply Long shelf life (1-3 years) No blood typing/crossmatching required

Question 31

Platelet preservation storage:

Answer 31

Stored at 20-24C (room temperature) with continuous gentle agitation tp to 5 days

Question 32

What happens when platelets are stored in the refrigerator?

Answer 32

Causes cold-induced platelet activation

Question 33

What is the purpose of the continuous gentle agitation in storing platelet units?

Answer 33

Facilitates oxygen transfer to maintain pH

Question 34

Platelet unit pH must be maintained at:

Answer 34

6.2 or more (>/= 6.2 pH)

Question 35

Why is the platelet unit the most common blood unit that is contaminated?

Answer 35

Because platelet blood units are stored in room temperature, that is why it's shelf life is only 5 days

Question 36

Visual inspection of platelet units includes assessment of "_____________" (no visible aggregation)

Answer 36

"platelet swirl" (no visible aggregation)

Question 37

The normal shape of platelets:

Answer 37

Discoid

Question 38

Shape of platelets when expired:

Answer 38

Spherical (loss of swirling effect)

Question 39

Platelet storage lesion Increased:

Answer 39

Platelet storage lesion Increased: - Lactate - Degranulation - Platelet activation markers

Question 40

Platelet storage lesion Decreased:

Answer 40

Platelet storage lesion Decreased: - pH - ATP - Platelet aggregation agonists