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Blood Bank Exam 3 Lecture 16 & 17
Blood Components / Transfusion Therapy I & II
140
Biology
Undergraduate 3
02/21/2015

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Term
What does Whole Blood contain?
Definition
RBCs, Plasma, Platelets, White Cells
Term
The Hematocrit of Whole Blood is between what values?
Definition
36% - 40%
Term
What is the volume of Whole Blood?
Definition
500 mL
Term
What is the storage temperature range of Whole Blood?
Definition
1 - 6 degrees Celsius
Term
What is the dating period for Whole Blood?
Definition
35 Days
Term
What 2 things does Whole Blood simultaneous replace?
Definition
blood volume
O2 carrying capacity
Term
When would Whole Blood be used?
Definition
Massive transfusion or trauma
Term
Is Whole Blood commonly used?
Definition
No; almost never used anymore
Term
What are the limitations on Whole Blood?
Definition
No viable platelets, clotting factor V & VIII or granulocytes
Large volume of fluid
Term
What can Whole Blood cause in the elderly?
Definition
Fluid Overload
Term
What is the volume of RBCs when CPDA-1 is used and have is the HCT?
Definition
250 mL
75%
Term
What is the volume of RBCs when ADSOL is used and have is the HCT?
Definition
330 mL
55%
Term
True or False:
RBC Dating Period - Once entered, only good for 24 hours
Definition
True
Term
One uses RBCs to increase what?
Definition
O2 carrying capacity in symptomatic anemia
Term
One transfuses RBCs when Hemoglobin and Hematocrit are at what values?
Definition
8 gm
24%
Term
When supplied with RBCs, how much should hematocrit rise?
Definition
3% / unit
Term
What are the limitations of RBCs?
Definition
No viable platelets, granulocytes, or coagulation factors
Term
What is the advantages of RBCs?
Definition
No ABYs to react with recipient AGNs because plasma is removed
Term
All RBCs for transfusion (regardless of additional processing) must be what?
Definition
ABO & D compatibility
IAT & Cross match
Infectious Diseases
Term
How many/much WBCs have been removed from Leukocyte-Reduced RBCs?
Definition
99.99%
Term
What is the method of preparation for Leukocyte-Reduced RBCs?
Definition
Filtration
Term
What is the volume for RBCs?
Definition
300 mL
Term
What % of Leukocyte-Reduced RBCs must remain after filtration?
Definition
85%
Term
What is the storage temperature for Leukocyte-Reduced RBCs?
Definition
1 - 6 degrees Celsius
Term
What does Leukocyte-Reduced RBCs prevent?
Definition
Febrile Reactions due to HLA ABYs
Term
You use Leukocyte-Reduced RBCs after the patient has had how many febrile reactions?
Definition
2+
Term
What does Leukocyte-Reduced RBCs decrease the likelihood of?
Definition
CMV infection in susceptible patients
Term
Leukocyte-Reduced RBCs decrease alloimmunization to what?
Definition
HLA antigens in those who will need large number of transfusions
Term
True or False:
Leukocyte-Reduced RBCs are more expensive than RBCs
Definition
True
Term
What will Leukocyte-Reduced RBCs not prevent and why?
Definition
TA-GVHD
Lymphs are too small
Term
What are the advantages of using Leukocyte-Reduced RBCs?
Definition
Reduce immune modulation of transfusions by getting rid of WBCs before they release cytokines
Term
When would you use Washed RBCs?
Definition
When you want to remove ALL the plasma
Term
What type of patients do you use Washed RBCs for?
Definition
IgA deficient patients who develop an ABY to IgA and have a severe allergic reaction to past transfusions
Term
True or False:
You also use Washed RBCs for people with PNH to remove plasma and its complement
Definition
True
Term
How long are RBCs good for after they have been washed?
Definition
24 Hours
Term
You use irradiated blood to prevent what?
Definition
GVHD
Term
Radiation prevents what from proliferating?
Definition
Donor Lymphs
Term
Whom should the transfusions come from for patients who need Irradiated RBCs?
Definition
First Degree Blood Relatives
Term
What type of patients need irradiated RBCs?
Definition
Intrauterine
Preemies
Severe Immunocompromised
Term
RBC that have been irradiated has their expiration date changed to how many days?
Definition
28 days
Term
True or False:
Irradiated RBC expiration date changes to original date if it is closer due to RBC membrane destruction and increased potassium
Definition
True
Term
CMV Negative Blood is needed for what type of patients?
Definition
Seronegative preemies, intrauterine, BMT, HIV, solid organ transplant and other severely immunosuppressed
Term
What % of the population is seronegative?
Definition
20-40%
Term
What are frozen RBCs reconstituted with after thawing?
Definition
Sterile Saline
Term
What is added to RBCs prior to being frozen?
Definition
Glycerol
Term
What does Glycerol do to RBCs?
Definition
Removes Water to prevent lysis
Term
What is the volume of Frozen RBCs post-deglycerolization?
Definition
180 cc
Term
What is the storage temperature for Frozen RBCs?
Definition
-70 degrees Celsius
Term
What is the dating period of Frozen RBCs?
Definition
Up to 10 years
Term
Once Frozen RBCs are prepared what is the dating period and at what temperature must they be stored?
Definition
24 hours
1 - 6 degrees Celsius
Term
True or False:
Freezing RBCs provides extended storage for rare RBCs or autologous blood
Definition
True
Term
True or False:
Since plasma is removed by washing, Frozen RBCs can be used for the same indications as washed RBCs
Definition
True
Term
What are the limitations of Frozen RBCs?
Definition
No platelets, leukocytes, or plasma
Term
What can be a problem if washing to remove glycerol is incomplete?
Definition
Intravascular hemolysis
Term
One unit of RBCs will raise Hemoglobin by what amount?
Definition
1 g/dL
Term
What do you need to check before, during, and after RBC transfusion?
Definition
BP
Pulse
Temperature
Respiration
Term
Transfused RBCs over _____ hours with an 18 g needle if cardiovascular system is stable
Definition
1-2
Term
You should transfuse for no more than how many hours because you don't want bacteria to be able to grow?
Definition
4 hours
Term
If a transfusion reaction is to occur, when is it most likely to occur?
Definition
Early
Term
All clerical information must be checked when?
Definition
The unit is released & Before start of transfusion
Term
What procedure should you perform for the preparation of platelets, random and within how many hours of collection?
Definition
Double Spin within 6 hours of collection
Term
Volume for Platelets, random?
Definition
50 mL/unit
Term
How many platelets,random should there be for each unit?
Definition
5.5 x 10^10
Term
What is the storage temperature for platelets, random?
Definition
20-24 degrees Celsius with Agitation
Term
How often should the temperature be checked on the platelets, random storage?
Definition
Constantly or every 4 hours
Term
What is the dating period for platelets, random?
Definition
5 days
Term
What is the dating period for platelets, random after pooling?
Definition
4 hours
Term
A pool of how many units of platelets, random are given for adults?
Definition
6-10
Term
Each unit of platelets, random should increase the patient's count by how much?
Definition
5-10,000 / microliter
Term
What are the limitations of platelets, random?
Definition
Platelet consumption or disease states may compromise patient's response to platelet transfusion
Term
Is it absolutely necessary to have platelets ABO compatible with plasma and why?
Definition
No, because there is not much plasma present
Term
When should you transfuse platelets?
Definition
When count is 10-20,000 / microliter
Term
What is the usual dosage of platelets, random and how much should the count go up by?
Definition
6 units
30-60,000 / microliter (up to 80,000/uL)
Term
What makes platelets, apheresis different from platelets, random?
Definition
Apheresis is collected from a single donor during apheresis procedure
Term
What is the volume for Platelets, Apheresis?
Definition
~ 300 mL
Term
What is the minimum amount of platelets for each unit of Platelets, Apheresis?
Definition
2 x 10^11
Term
What is the storage temperature with agitation for Platelets, Apheresis?
Definition
20-24 degrees Celsius
Term
What is the dating period for Platelets, Apheresis?
Definition
5 days
Term
What do Apheresis Platelets decrease?
Definition
Allogeneic donor exposure for patient that are needing multiple transfusions
Term
True or False:
Platelets Apheresis will be used if patient is refractory to random platelets
Definition
True
Term
Explain what is meant when a patient is refractory to random platelets
Definition
Plt count does not go up after platelet transfusion
Term
What is the volume of Granulocytes, Apheresis?
Definition
~220 mL
Term
How many granulocytes, apheresis are in each unit?
Definition
1 x 10^10
Term
What is the storage temperature for granulocytes, apheresis?
Definition
20-24 degrees Celsius
Term
What is the dating period for granulocytes, apheresis?
Definition
24 hours
Term
What 3-4 types of patients use Apheresis Granulocytes?
Definition
Severe infections and severe neutropenia
Severe infections and unresponsive to antibiotics
Mostly for neonates
Term
What are the limitations of Apheresis Granulocytes?
Definition
Dose may not be sufficient to be therapeutic
Potential for pulmonary reactions
Term
When is FFP separated from platelet-rich plasma?
Definition
Second spin
Term
FFP is frozen within how many hours of collection from donor?
Definition
6 hours
Term
What is the volume of FFP?
Definition
220-250 mL
Term
Storage Temperature of FFP Frozen?
Definition
-18 degrees Celsius
Term
Storage Temperature of FFP Thawed?
Definition
1-6 degrees Celsius
Term
What is the dating period for Frozen FFP?
Definition
1 year
Term
What is the dating period for Thawed FFP?
Definition
24 hours
Term
What is FFP used for?
Definition
*Treatment of some coagulation disorders
*Bleeding disorders when cryo or platelets not indicated
Term
What do you monitor FFP with?
Definition
PT
PTT
Term
How many units of FFP are typically given to one individual?
Definition
4-6 units
Term
Limitations of FFP?
Definition
*Not a concentrate
*Need a large volume to replace sufficient quantity of specific coagulation factor
Term
Does FFP need to be ABO compatible?
Definition
Yes
Term
Preparation of Cryoprecipitated AHF?
Definition
FFP thawed at 4 degrees Celsius
Spun in refrigerated centrifuge
Term
True or False:
The Fraction of FFP precipitating out of solution in cold is collected and refrozen
Definition
True
Term
Volume of Cryoprecipitated?
Definition
15-20 mL / unit
Term
Storage temperature Frozen Cryo?
Definition
-18 degrees Celsius
Term
Storage Temperature Thawed Cryo if used for Factor VIII?
Definition
RT
Term
Storage Temperature Thawed Cryo if used for fibrinogen?
Definition
1-6 degrees Celsius
Term
Once Cryo has been pooled how soon must you use it?
Definition
Within 4 hours
Term
Dating period for Cryo?
Definition
1 year
Term
Limitations of Cryo?
Definition
Infectious diseases
Many units may be needed for treatment of factor deficiencies
Term
Uses for Cryo?
Definition
Deficiency of Factor VIII
Factor XIII
Fibrinogen
vonWillebrand's factor
Term
With a Deficiency of Factor VIII what tends to be used the most?
Definition
AHF Concentrate
Term
# Factor VIII = what?
Definition
(Plasma volume x (desired level % - initial level %))/ 80 u / bag
Term
Hemophilia A is missing which factor?
Definition
VIII
Term
How are Factors separated?
Definition
Cold fractionation
Purified
Pasteurized
Term
How are viruses killed for Factor VIII or IX Concentrate?
Definition
Pasterurization
Solvent Detergent
Term
Advantages of Factor VIII or IX Concentrate over Cryo?
Definition
Can be given at home
No infectious disease
Term
How are viruses killed for Alubumin and plasma protein fraction?
Definition
Fractionated and heat treated
Term
What is Albumin and plasma protein fraction used for?
Definition
Volume expansion
Plasma replacement in plasma exchange
Burns
Term
What is immune serum globulins used to treat?
Definition
Decreased immunoglobulins, IgG, and disease exposure
Children following meningitis outbreak or immunocompromised patients
Term
Growth factors
Definition
EPO
G-CSF
GM-CSF
Anemia, after bone marrow transplant
Term
Each full dosage of Rh immune Globulin will protect against what?
Definition
30 mL bleed or 15mL of D+ cells
Term
When is Rh immune Globulin given during pregnancy to Rh negative women or after aminocentesis?
Definition
28 weeks
Term
True or False:
Rh immune Globulin is given to mother prior to birth because Within 72 hours of delivery of an Rh+ baby the mother already has produced anti-D
Definition
True
Term
True or False:
Screen for fetal maternal bleed and adjust dosage if using Kleihauer-Betke
Definition
True
Term
The following are two types of what?
Dextran
HES
Definition
Synthetic volume expanders
Term
What can Synthetic volume expanders cause?
Definition
Rouleaux in patient's blood
Term
What is Synthetic volume expanders used for?
Definition
Hemorrhagic shock or burns
Term
What else do you use along with Synthetic volume expanders?
Definition
Crystalloids saline or Ringers Lactate
Term
Composition of crystalloids saline?
Definition
Sodium and Chloride
Term
Composition of Ringers Lactate?
Definition
Sodium, Chloride, Potassium, Calcium, and Lactate
Term
ATIII is fractionated from what?
Definition
Human Plasma
Term
You give ATIII to ATIII deficient patients in anticipation of surgery or delivery to prevent what?
Definition
Thrombosis
Term
Match what the following is used for:
Whole
Definition
Cells and volume
Term
Match what the following is used for:
Packed
Definition
Anemia
Term
Match what the following is used for:
Washed
Definition
Allergy to plasma proteins in IgA deficiencies
Term
Match what the following is used for:
Leuko-Depleted
Definition
Febrile from HLA or CMV risk
Term
Match what the following is used for:
Irradiated
Definition
GVHD
Term
Match what the following is used for:
Frozen, deglycerolized
Definition
Rare or autologous
Term
To give the unit what must be compatible?
Definition
ABO
Rh
Screening
Term
True or False:
Plts and WBCs are always given at RT
Definition
True
Term
Factor VIII or IX Concentrate:
Pasteurized to inactivate virus and _____
Definition
lyophilized
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