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Haematology Physiology http://www.manual.transfusion.com.au/Home.aspx ADDITIVES & ANTICOAGULANTS Anticoagulants used for whole blood collections (61- 69mL used for the collection of 450mL + 10% of whole blood) Constituents in 63mL CPD CPDA-1 (Citrate Phosphate Dextrose) (Citrate Phosphate Dextrose Adenine) Manufacturer Terumo Corporation Pall Corporation Fresenius MacoPharma Sodium citrate dihydrate 1660mg 1656mg 1657mg 1660mg Citric acid monohydrate 210mg 206mg 206mg 210mg Dextrose monohydrate 1610mg 1610mg 1610mg 2010mg Sodium phosphate dihydrate 160mg 140mg 158mg 160mg Adenine 0mg 0mg 0mg 17.3mg Red cell additive solution (100mL used with red cells from 450mL + 10% of whole blood) Constituents in 100mL AS-1 (Adsol®) AS-5 (Optisol®) SAGM SAGM-2 Manufacturer Baxter Healthcare Terumo Corporation Baxter Healthcare Terumo Corporation Fresenius MacoPharma Pall Corporation Dextrose monohydrate 2200mg 900mg 900mg 0mg Dextrose anhydrous 0mg 0mg 0mg 818mg Sodium chloride 900mg 877mg 877mg - 880mg (a) 877mg Mannitol 750mg 525mg 525mg - 530mg (b) 525mg Adenine 27mg 30mg 17mg 30mg (a) Baxter Healthcare 877mg; Fresenius 877mg; MacoPharma 880mg; Pall Corporation 880mg. (b) Baxter Healthcare 525mg; Fresenius 525mg; MacoPharma 530mg; Pall Corporation 525mg Platelet additive solution (300mL used in each platelet pool) Constituents T-Sol® Manufacturer Baxter Healthcare Sodium chloride 2025mg Sodium acetate trihydrate 1224mg Sodium citrate dihydrate 882mg Apheresis plasma and platelet collection packs Pack Type Anticoagulant Formulation Haemonetics Corporation, product 420J Sodium citrate 4% solution: AustL 57561, contains 250 mL 40g/L Sodium citrate dihydrate Used for plasma apheresis 138mmol/L Sodium Citrate This is mixed ~1:16 with whole blood. Baxter Healthcare, product AHB 7898 ACDA solution: AustL 31522, contains 500 mL 22.0g/L sodium citrate Used for platelet apheresis 8.0g/L citric acid monohydrate 24.5g/L glucose This is mixed ~1:12-16 with whole blood. Gambro BCT, product 7779 7000 ACDA solution: AustL 51681, contains 700 mL 22.0g/L sodium citrate Used for platelet apheresis 8.0g/L citric acid monohydrate 24.5g/L glucose This is mixed ~1:6 initially, then ~1:11 subsequently, with whole blood. TYPE & SCREEN A request for a ‘type and screen’ (also commonly referred to as a ‘group and hold’) involves the following: Determining the ABO and Rh(D) group of the person, and Performing a red cell antibody screen on the person o For patients who have a negative red cell antibody screen, a rapid serological crossmatch (such as the immediate spin crossmatch) or electronic crossmatch is performed to ensure ABO compatibility prior to the issue of the donor red cells. o Patients who have a positive red cell antibody screen require antibody identification and full serological crossmatching, using the indirect antoglobulin test (IAT). Specially selected donor red cell units should be made available prior to surgery (see 4 below). Checking for previous or duplicate records, and then comparing current results with historical findings o If the patient has a history of having a clinically significant red cell antibody then a serological crossmatch (by IAT) may be necessary o Selecting appropriate donor red cells When the patient has a clinically significant red cell antibody, red cells that do not have the corresponding antigen must be selected for crossmatching. CROSSMATCH The crossmatch is a final validation of compatibility between the recipient and the selected donor red cells. This may be performed by either serological or electronic means. Serological Crossmatch Serological crossmatching techniques have been simplified in recent years, and only the 37°C IAT crossmatch and immediate room temperature spin crossmatch remain in common use. The IAT crossmatch is performed when the patient’s serum/plasma contains clinically significant red blood cell antibodies. The room temperature immediate spin crossmatch has been retained primarily to detect ABO incompatibility. Electronic Crossmatch An electronic crossmatch uses the hospital blood bank computer to perform a compatibility check on the compatibility between the recipient and the red cells selected for transfusion. Electronic crossmatch and issue must only be used to confirm ABO and Rh(D) compatibility between the donor units and a current patient sample which has completed pretransfusion testing and has a negative antibody screen.
