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Blood products.
Preparation of blood
components
Whole blood
plasma
90% water
10% plasma material
Fresh frozen plasma
Platelet concentrate
Cryoprecipitate – VIII = AHF
albumin
Fibrinogen
Immunoglobulin
Others
Backed Red Cells
RBC
Blood bags
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Single blood bag:
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Whole blood
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Double bags:
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Backed red cells
plasma
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Triple bags:
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Backed cells
Plasma
platelets
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Quarterly bags:
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Backed cells
Plasma
Platelets
Plasma factors
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Special bags:
 Frozen blood upto 2 years and store under
(– 70- 90 c)
 The bags should be sterile = no
contamination.
Patient information's:
 No of patients.
 Name.
 Others.
Centrifugation
This is the first step of blood preparation
 Depend on 2 factors:
 Relative centrifugation factor (RCF).
 Duration of centrifugation.
1. Heavy spin
 5000 /g / 7min = leukocyte-poor RBC, or cell free plasma.
 5000/g / 5min = backed cell and platelet concentrate.
 4170/ g / 10min = cryoprecipitate
2. Light spin
 4170 /g/2min = platelet rich plasma.
Centrifugation temp.
 Platelet = at 22c
 Others = 1-6c
1- Whole Blood:

Contents
RBC’s
 WBC’s
 Platelets
 Plasma
 Clotting factors


Indications

Acute loss of whole blood
2- Packed Red Cells

Contents
RBC’s
 20% Plasma


Indications
Replace O2 carrying capacity with less
volume
 Severe anemia, slow blood loss, CHF

2- Packed Red Cells
- Preparation:
 Blood should be drawn in double bags.
 Usually 225 ml of plasma is removed.
 The Hct is about 70-80%.
 The blood should be used within the
expiration date of the bags.
 Packed RBCs are ordinarily the
component of choice with which to
increase Hb.

2- Packed red cells
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

Indications depend on the patient. O2-carrying
capacity may be adequate with Hb levels as low
as 7 g/L in healthy patients, but transfusion may
be indicated with higher Hb levels in patients
with decreased cardiopulmonary reserve or
ongoing bleeding.
One unit of RBCs increases an average adult's
Hb by about 1 g/dL and his Hct by about 3% of
the pretransfusion Hct value.
When only volume expansion is required, other
fluids can be used concurrently or separately.
3- Washed red cells
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
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It’s convenient but expensive.
Washed RBCs are free of almost all traces of
plasma, most WBCs, and platelets.
They are generally given to patients who have
severe reactions to plasma (eg, severe
allergies, paroxysmal nocturnal
hemoglobinuria, or IgA immunization).
In IgA-immunized patients, blood collected
from IgA-deficient donors may be preferable
for transfusion.
4- Leukocyte-poor red cells or
WBC-depleted RBCs:
Are prepared with special filters that remove ≥
99.99% of WBCs.
 The majority of febrile non-hemolytic reactions
(FNH), can be alienate by transfusion leukocytepoor red cells, so they are indicated for patients
who have experienced nonhemolytic febrile
transfusion reactions, and possibly for the
prevention of platelet alloimmunization.

3- Leukocyte-poor red cells or
WBC-depleted RBCs:

Can be prepared by several techniques:
Double centrifuge
 Heavy spin.
 Filtration: passing the blood through a nylon
filter which is an efficient method for removal
of granulocytes. Heparin is the anticoagulant
used for this procedure. In Europe the used
the cotton for removal lymphocytes and
granulocytes.

3- Leukocyte-poor red cells or
WBC-depleted RBCs:



Sedimentation: this method provides 90% of
red blood cells and 10% of original no of
platelet and leukocyte.
Washing: is provides a good recovery of
erythrocyte with low no of WBC and platelet.
Frozen deglycerolized red cells: when
maximally leukocyte poor red blood cells
needed.
5- Fresh frozen plasma (FFP)

Contents
 Clotting factors
 Fibrinogen
 Prothrombin
 Albumin
 Globulins
5- Fresh frozen plasma (FFP)

Indications
 Volume expansion : FFP can supplement RBCs
when whole blood is unavailable for exchange
transfusion, but FFP should not be used simply for
volume expansion.
 Fresh frozen plasma (FFP) is an unconcentrated
source of all clotting factors deficiency, so
indications also include correction of bleeding
secondary to factor deficiencies for which specific
factor replacements are unavailable, multifactor
deficiency states (eg, massive transfusion,
disseminated intravascular coagulation [DIC], liver
failure)
5- Fresh frozen plasma (FFP)
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Preparation:
Can be prepared by:
 Single heavy spin.
 Double centrifugation to prepare platelet conce. At
the same time.
Each unit contains about 225 ml of plasma.
Can protect bags within 6h. After collection by placing it
in a dry ice-alcohol path or in freezer at -30c or below.
FFP bags should be frozen in a horizontal position and
store at vertical position.
Shelf life is 12 months when store at -18c or less.
When required FFP can be thawed with agitation in 37c
in water path and used within 2h.
6- Platelet concentrate
Contents
 Platelets
 WBC’s
 Plasma
Indications
Low platelet counts (bleeding) . Platelet concentrates are
used to prevent bleeding in:
 asymptomatic severe thrombocytopenia (platelet count
< 10,000/μL)
 For bleeding patients with less severe
thrombocytopenia (platelet count < 50,000/μL)
 For bleeding patients with platelet dysfunction due to
antiplatelet drugs but with normal platelet count
 For patients receiving massive transfusion that causes
dilutional thrombocytopenia
 And sometimes before invasive surgery.
6- Platelet concentrate

Preparation:
 Platelet-rich
plasma is separated by light
spin from erythrocyte.
 Platelet conc. is then obtained by a
heavy spin of platelet rich plasma.
 Centrifugation should be done at 22c.
 Separation should be done within 4h.
After the blood is drawn.
 Plasma portion can be frozen as FFP.
6- Platelet concentrate
Plasma should be frozen within 2h of
separation at -30c or less.
 When needed, Frozen plasma should then be
thawed between 1-6c over night in a
refrigerator or more quickly in a water path at
4c.
 One platelet concentrate increases the
platelet count by about 10,000/μL, and
adequate hemostasis is achieved with a
platelet count of about 10,000/μL in a patient
without complicating conditions and about
50,000/μL for those undergoing surgery.
Therefore, 4 to 6 random donor platelet

6- Platelet concentrate
Platelet concentrates are increasingly being
prepared by automated devices that harvest the
platelets (or other cells) and return unneeded
components (eg, RBCs, plasma) to the donor.
This procedure, called cytapheresis, provides
enough platelets from a single donation
(equivalent to 6 random platelet units) for
transfusion to an adult, which, because it
minimizes infectious and immunogenic risks, is
preferred to multiple donor transfusions in
certain conditions.
6- Platelet concentrate
 Certain
patients may not respond to platelet
transfusions, possibly because of splenic
sequestration or platelet consumption due to HLA or
platelet-specific antigen alloimmunization. These
patients may respond to multiple random donor
platelets (because of greater likelihood that some
units are HLA compatible), platelets from family
members, or ABO- or HLA-matched platelets.
 Alloimmunization may be mitigated by transfusing
WBC-depleted RBCs and WBC-depleted platelet
concentrates.
7- Cryoprecipitated anti hemophilic
factor ( AHF )
Contents

Factors VIII and XIII, Fibrinogen and von Willebrand
factor (vWF)v. It also contains fibronectin
Indications
Hemophilia A
 Fibrinogen deficiency
 Factor XIII deficiency

Disseminated intravascular coagulation
 Rare factor XIII deficiency.

7- Cryo-precipitated anti hemophilic
factor ( AHF )
Preparation:
 Cryoprecipitate is a concentrate prepared from
FFP, it should be frozen within 4h and stored at
-18c or less.
 A bag of cryoprecipitate should be contain on
the average about 80-100 units of AHF/unit.
 The shelf life is 12 month, when store at -18c
or low.
 When requested, cryo precipitate may be
thawed in a 37c water path and then should be
maintained at room temp. And used as soon as
possible or within 6h after thawing.
6- Cryo precipitated anti hemophilic
factor ( AHF )
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In general, it should not be used for other
indications.
A bag of cryo precipitate should be contain on
the average about 80-100 units of AHF/unit.
The shelf life is 12 month, when store at -18c or
lower.
When requested, cryo precipitate may be
thawed in a 37c water path and then should be
maintained at room temp. And used as soon as
possible or within 6h after thawing.
8- WBCs:
Granulocytes:
 Contents
 WBC’s
 20% Plasma
 Indications
 Life-threatening decreases in WBC count
 Granulocytes may be transfused when sepsis
occurs in a patient with profound persistent
neutropenia (WBCs < 500/μL) who is
unresponsive to antibiotics.
8- WBCs:
Important Notes:
 Granulocytes must be given within 24 h of
harvest; however, testing for HIV, hepatitis,
human T-cell lymphotropic virus, and
syphilis may not be completed before
infusion.
 Because of improved antibiotic therapy and
drugs that stimulate granulocyte production
during chemotherapy, granulocytes are
seldom used.
9- Immune globulins:
Rh immune globulin (RhIg), given IM or IV,
prevents development of maternal Rh antibodies
that can result from fetomaternal hemorrhage.
 Other immune globulins are available for
postexposure prophylaxis for patients exposed to a
number of infectious diseases, including
cytomegalovirus, hepatitis A and B, measles,
rabies, respiratory syncytial virus, rubella, tetanus,
smallpox, and varicella.

10- Plasma Protein Fraction:

Contents


5% Albumin/Globin in saline
Indications
Expand volume in burns
 Hemorrhage
 Hypoproteinemia

11- Albumin:

Contents


5% or 25% albumin
Indications
Replace volume in shock
 Burns


Hypoproteinemia