TOPIC 1 - P2 Flashcards by Sharmaine Madjid

Q

added to the RBCs after removal of the plasma with or without platelets

A

ADDITIVE SOLUTION

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Q

In Additive solutions, Removal of the _______ during the preparation of RBC concentrates removed much of the ______ needed to maintain RBCs during storage

A

plasma component ; nutrients

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Q

In Additive solutions, RBC concentrates can be relatively void of plasma with _______, which causes the units to be ______ and _______ , especially in emergency situations

A

high hematocrits ; more viscous and difficult to infuse

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Q

In Additive solutions, _____ to the RBC concentrate prepared from a _____ blood collection

A

100 mL ; 450-mL

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Q

In Additive solutions, contained in a _____ and is added to the RBCs after most of the plasma has been expressed

A

satellite bag

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Q

(AS) All three additives contain ______, ______ and ______.

A

saline, adenine, and glucose.

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Q

____ and _____ also contain mannitol, which protects against storage-related hemolysis

A

AS-1 and AS-5

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Q

AS-1 and AS-5 also contain _______, which protects against storage-related hemolysis

A

mannitol

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Q

____ contains citrate and phosphate for the same purpose

A

AS-3

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Q

(AS) As with RBCs stored only with primary anticoagulant preservatives, _____ is depleted by the ______ week of storage

A

2,3-DPG ; second

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Q

3 ADDITIVE SOLUTIONS IN USE IN NORTH AMERICA

A

Adsol (Baxter Healthcare) = AS-1 with 42 days storage time
Nutricel (Pall Corporation) = AS-3 with 42 days storage time
Optisol = AS-5 with 42 days storage time

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Q

autologous units and the storage of rare blood types

A

(RBC FREEZING)

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Q

(RBC FREEZING) allows individuals to donate blood for their own use in meeting their needs for blood transfusion

A

Autologous transfusion

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Q

(RBC FREEZING) RBCs that are less than _____

A

6 days old

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Q

(RBC FREEZING) cryoprotective agent used most commonly

A

Glycerol

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Q

(RBC FREEZING) added to the RBCs slowly with _____ then rapidly frozen and stored in a freezer.

A

vigorous shaking

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Q

(RBC FREEZING) usual storage temperature is _____; __ years from the date of freezing

A

below –65°C ; 10

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Q

2 concentrations of glycerol

A

high concentration glycerol = 40% weight in volume [w/v]
low-concentration glycerol 20% weight in volume [w/v]

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Q

ADVANTAGES OF HIGH CONCENTRATION GLYCEROL TECHNIQUE USED BY MOST BLOOD BANKS OVER LOW CONCENTRATION GLYCEROL TECHNIQUE

Initial Freezing Temperature

A

High Glycerol: -80°C
Low Glycerol: -196°C

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Q

ADVANTAGES OF HIGH CONCENTRATION GLYCEROL TECHNIQUE USED BY MOST BLOOD BANKS OVER LOW CONCENTRATION GLYCEROL TECHNIQUE

Need to control freezing rate

A

High Glycerol: NO
Low Glycerol: YES

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Q

ADVANTAGES OF HIGH CONCENTRATION GLYCEROL TECHNIQUE USED BY MOST BLOOD BANKS OVER LOW CONCENTRATION GLYCEROL TECHNIQUE

Type of Freezer

A

High Glycerol: Mechanical
Low Glycerol: Liquid Nitrogen

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Q

ADVANTAGES OF HIGH CONCENTRATION GLYCEROL TECHNIQUE USED BY MOST BLOOD BANKS OVER LOW CONCENTRATION GLYCEROL TECHNIQUE

Maximum storage temperature

A

High Glycerol: -65°C
Low Glycerol: -120°C

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Q

ADVANTAGES OF HIGH CONCENTRATION GLYCEROL TECHNIQUE USED BY MOST BLOOD BANKS OVER LOW CONCENTRATION GLYCEROL TECHNIQUE

Shipping Requirements

A

High Glycerol: Dry Ice
Low Glycerol: Liquid Nitrogen

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Q

ADVANTAGES OF HIGH CONCENTRATION GLYCEROL TECHNIQUE USED BY MOST BLOOD BANKS OVER LOW CONCENTRATION GLYCEROL TECHNIQUE

Effect of changes in storage temperature

A

High Glycerol: Can be thawed and refrozen
Low Glycerol: Critical

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Replacing glycerol with decreasing concentrations of saline

Deglycerolization process

In Deglycerolization process, the saline are: ____ saline, followed by ____ saline, with a final wash of _______________

12% saline ; 1.6% saline; 0.2% dextrose in normal saline

In Deglycerolization process, ____ of the unit should also be monitored to ensure adequate deglycerolization

Osmolality

In Deglycerolization process, thawed RBCs: stored at _____ for ___ hours (open system)

1°C to 6°C ; 24

ADVANTAGES OF RBC FREEZING

Long Term Storage (10 years) Maintenance of RBC viability and function Low residual leukocytes and platelets Removal of significant amounts of plasma proteins

DISADVANTAGES OF RBC FREEZING

A time consuming process Higher cost of equipment and materials Storage requirements (-65°C) Higher cost of products

ATP and 2,3-DPG levels are restored or enhanced by metabolic alterations

RBC Rejuvenation

only FDA-approved rejuvenation solution

Rejuvesol

Rejuvesol contains ____, _____, ____ and _____

contains phosphate, inosine, pyruvate, and adenine

In RBC rejuvenation, RBCs (liquid state) can be rejuvenated at outdate or up to _____ after outdate

3 days

incubating the RBC unit with _____ of the rejuvenating solution for ____ at ____ then washed to remove the rejuvenation solution and transfused within _____

50 mL ; 1 hour ; 37°C ; 24 hours

Current Trends in RBC Preservation Research

1. Improved Additive Solutions 2. Procedures to Reduce and Inactivate Pathogens 3. Formation of O-Type RBCs 4. Blood Pharming 5. RBC substitutes

procedures that would reduce the level of or inactivate residual viruses, bacteria, and parasites in RBC units

Procedures to Reduce and Inactivate Pathogens

inadequate supply of O-type RBC units

Formation of O-Type RBCs

In Formation of O-Type RBCs, O-type RBCs manufactured from B-type RBCs were effective when transfused to ____ and ____ type patients in need of RBCs.

O- and A-

Creating RBCs in the laboratory(O-negative RBCs)

Blood Pharming

In Blood Pharming, bioengineering company (______) uses proprietary technology (____) to turn hematopoietic stem cells (HSC) from umbilical cord

Arteriocyte ; NANEX

_______ is a search for a safe and effective oxygen carrier that could eliminate many of the problems associated with blood transfusion, such as the need for refrigeration, limited shelf-life, compatibility, immunogenicity, transmission of infectious agents, and shortages.

RBC substitutes

Hemoglobin-Based Oxygen Carriers

Bovine hemoglobin

Bovine hemoglobin advantage

Lower oxygen affinity and better oxygen uploading in ischemic tissues

Bovine hemoglobin disadvantage

potential immunogenicity and transmission of prions

synthetic hydrocarbon structures in which all the hydrogen atoms have been replaced with fluorine, chemically inert, excellent gas solvents, and carry O2 and CO2 by dissolving them

Perfluorocarbons

Perfluorocarbons, Bcoz of small size (about 0.2 microns in diameter), they are able to pass through areas of _____ and deliver ____ to tissues that are inaccessible to RBCs

vasoconstriction ; oxygen

Normal platelet function in vivo requires more than _____

100,000 platelets per microliter

Spontaneous hemorrhage may occur when the platelet count falls below ______

10,000 platelets per microliter

loss of platelet quality during storage

Platelet Storage Lesion

In Platelet Storage Lesion, varying degree of platelet activation occurs that results in release of some _____ and a decline in ____ and ____

intracellular granules ; ATP and ADP

In Platelet Storage Lesion, Also results in temporary aggregation of platelets into large sheets that must be allowed to rest for the aggregation to be reversed, especially when the platelet concentrates (PCs) are prepared with the _______ method.

platelet-rich-plasma (PRP) method

In Platelet Storage Lesion, ___ days and ____ temperature associated with bacterial contamination

5 days and 22 degree celsius

In Platelet Storage Lesion, the storage of PCs in plasma, the principal buffer is _____

bicarbonate

In Platelet Storage Lesion, the normal platelet concentrates pH is

6.2

In Platelet Storage Lesion, when the PC pH is below 6.2 it is associated with a _____; platelets ____ and there is a ____ transformation in morphology that is associated with a loss of ______

loss of platelet viability ; swell ; disk-to-sphere ; membrane integrity

In Platelet Storage Lesion, loss of membrane integrity using _____ (binding of _____ with anionic phospholipids)

flow cytometry ; annexin V

flow cytometry can also be used to measure the platelet ______

degranulation process

Immediately before distribution to hospitals, a visual inspection is made that often includes an assessment of ______

platelet swirl

absence of platelet swirl is associated with the _____ during storage, resulting in the loss of _________

loss of membrane integrity ; discoid shape with irreversible sphering

Since the 1970s, platelets have been prepared from whole blood as concentrates in which the volume per unit is near ____ in contrast to the ______ volume of platelet-rich plasma units

50 mL ; 250- to 300-mL

Today, platelets are prepared as concentrates from _____ and increasingly by ______

whole blood ; apheresis

In platelet preservation, the platelets are stored at _____, with continuous agitation for up to __ days and the expiration time is the midnight of day __

20°C to 24°C ; 5 ; 5

(History of Platelet Storage) _____ has been shown to facilitate oxygen transfer into the platelet bag and oxygen consumption by the platelets; maintenance of platelet component pH

agitation

(History of Platelet Storage) The gas transport properties of a container are known to reflect _______, ________, ________, and ________.

the container material, the gas permeability of the wall of the plastic container, the surface area of the container available for gas exchange, and the thickness of the container.

Storage in Second-Generation Containers was developed in

1982

Containers with increased gas transport properties (allowing increased oxygen transport and carbon dioxide escape)

Second-Generation Containers

In Storage in Second-Generation Containers, polyvinyl chloride (PVC) plastic containing a _______; other cases with _____ plastic.

phthalate plasticizer ; polyolefin

Storage in Second-Generation Containers is ___ days

5

In Storage in Second-Generation Containers, the nominal volumes of the containers are _____ and _____for WBD platelet concentrates and apheresis components, respectively

300 to 400 mL ; 1 to 1.5 L

Measurement of Viability and Functional Properties of Stored Platelets... _____ indicates the capacity of platelets to circulate after infusion without premature removal or destruction

Viability

Measurement of Viability and Functional Properties of Stored Platelets... observation of the _____ when placed in front of a light source: used to obtain a semiqualitative evaluation of the retention of platelet viability properties in stored units

swirling phenomenon

Measurement of Viability and Functional Properties of Stored Platelets... _______: ability of viable platelets to respond to vascular damage in promoting hemostasis.

Function

Measurement of Viability and Functional Properties of Stored Platelets... _______: have reflected an undesirable activation of platelet processes at a temperature range of 1°C to 6°C.

cold-stored platelets

Platelet Storage and Bacterial Contamination... major concern storage of platelets at 20°C to 24°C is the potential for ______

bacterial growth

Platelet Storage and Bacterial Contamination ______ due to contaminated platelets is the most common infectious complication

Sepsis

Platelet Storage and Bacterial Contamination three commercial systems approved by the FDA for screening platelets for bacterial contamination:

BacT/ALERT (bioMérieux) eBDS (Pall Corp.), and Scansystem (Hemosystem).

Platelet Storage and Bacterial Contamination 1st rapid test

Pan Genera Detection (PGD) test (Verax Biomedical)

Platelet Storage and Bacterial Contamination Eighty percent of the septic reactions were due to _____ (2004 to 2006 culture neg products)

Staphylococcus spp.

Platelet Storage and Bacterial Contamination - recent precaution is the _____ of the first aliquot (about _____) of collected blood into a separate but connected diversion pouch - minimizes the placement of ____, the most common source of bacterial contamination, into the ______

diversion ; 20 to 30 mL skin plugs ; platelet products

Current Trends in Platelet Preservation Research

1 Storage for 7 Days at 20°C to 24°C 2. Storage with Additive Solutions 3 Procedures to Reduce and Inactivate Pathogens 4 Development of Platelet Substitutes 5 New Approaches for Storage of Platelets at 1°C to 6°C 6 Frozen Platelets

first platelet additive solution

(PAS-C)

_____: Reports of septic transfusion reactions increased following this change (___ to ____ days)

1984 ; 5 to 7