Transfusion products
need to do last 2 components of blood comp drop down
blood.gov.au
transfusion.com.au
Whole blood collection into anticoagulant (citrate) and preservative
Centrifuge > Plasma (55%), Buffy(colour) coat (<1% WCC,plt), RBC (45%)
Cells then leukodepleted (WCs filtered) i.e. RBC and Plt but not plasma
4 ABO matched buffy coats pooled for plts
Apheresis: collects FFP +/- Plt
FFP thawed to 2C and precipitate collected, both products refrozen as Cryp/cryodepleted plasma
FFP can be fractionated:
Recombinant factors (i.e. genetically engineered)
individual product split into 4 paed bags (not available for cryo/cryodep)
RBC 250/60ml (last 1m at 2C)
Platlets (apher180/50ml or pool320ml) (5d at 25C if agitated)
FFP 280/70ml (12m at -25C)
Cryodepleted plasma (250/600ml) = FFP minus Cryo
(all require blood grouping)
Massive transfusion = 40ml/kg PRBC
Includes RPBC + FFP +/- Plt +/- Tranexamic acid +/- cryoprecipitate (if fibrinogen < ?1g/L)
FFP aim INR <1.5, Plt aim >50 (or 100 in head injury)
How much do products elevate count/level
RBCs can be Washed to remove protein (inc antibodies) and electrolytes
RBCs and both plts can be:
O, A, B, AB an Rh+/-
Phenotyped
CMV neg (for immunocompromised)
Irradiated: to prevent transfusion related GVHD (leukodepletion not enough)
FFP: IgA def, low anti-T, secretor
Platelets most likely component to cause sepsis as kept at room temp
ABO (type II hypersensitivity)
Antithymocyte
Immunoglobulin
http://blood.gov.au/Ig-governance
Need consent for blood product, retention of data
Order form and pt info from same website
?? why does IVIG not cause alloimmune haemolysis
allogeneic hematopoietic stem cell transplantation (HSCT)
Graft verses host disease caused by immunocompetent donor T-Cells
Prevention
blood.gov.au
transfusion.com.au
Whole blood collection into anticoagulant (citrate) and preservative
Centrifuge > Plasma (55%), Buffy(colour) coat (<1% WCC,plt), RBC (45%)
Cells then leukodepleted (WCs filtered) i.e. RBC and Plt but not plasma
4 ABO matched buffy coats pooled for plts
Apheresis: collects FFP +/- Plt
FFP thawed to 2C and precipitate collected, both products refrozen as Cryp/cryodepleted plasma
FFP can be fractionated:
- Albumin (human 40g/L) for shock and alb <25g/L, therapeutic plasmapheresis
- Albumin (human 200g/L) for burns, ascitic paracentesis, haemodialysis
- Prothrombinex = II, VII, IX, X for warfarin overdose to be given with VitK
- Biostate: vWF and FVIII
- Thrombotrol: antithrombin III, to treat deficiency
- IgG: PEProphylaxis for CMV, HepB, RhD, Tetanu, VZV, Normal IgG (hep A, measles, polio, rubella)
- SCIG: hypogammaglobulinaemia (Primary immunodef, second to malign, acquired iatrog)
- IVIG:
Recombinant factors (i.e. genetically engineered)
- VIII
- IX (christmas disease)
individual product split into 4 paed bags (not available for cryo/cryodep)
RBC 250/60ml (last 1m at 2C)
Platlets (apher180/50ml or pool320ml) (5d at 25C if agitated)
FFP 280/70ml (12m at -25C)
- contains all coagulation factors
- Extended life plasma to (can keep for 5 days) to reduce wastage (NOT for <1mo OR FV def OR FVIII deficiency ie use FFP)
Cryodepleted plasma (250/600ml) = FFP minus Cryo
(all require blood grouping)
Massive transfusion = 40ml/kg PRBC
Includes RPBC + FFP +/- Plt +/- Tranexamic acid +/- cryoprecipitate (if fibrinogen < ?1g/L)
FFP aim INR <1.5, Plt aim >50 (or 100 in head injury)
How much do products elevate count/level
RBCs can be Washed to remove protein (inc antibodies) and electrolytes
RBCs and both plts can be:
O, A, B, AB an Rh+/-
Phenotyped
CMV neg (for immunocompromised)
Irradiated: to prevent transfusion related GVHD (leukodepletion not enough)
- immunocomprimised host fails to destroy donor t-cells which establish themselves and prolipherate
FFP: IgA def, low anti-T, secretor
Platelets most likely component to cause sepsis as kept at room temp
ABO (type II hypersensitivity)
Antithymocyte
Immunoglobulin
http://blood.gov.au/Ig-governance
Need consent for blood product, retention of data
Order form and pt info from same website
?? why does IVIG not cause alloimmune haemolysis
allogeneic hematopoietic stem cell transplantation (HSCT)
Graft verses host disease caused by immunocompetent donor T-Cells
Prevention
- give T-cell depleted
- Immunosuppression