blood components preparation and storage pdf

Blood components preparation and storage pdf

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Processing and storage of blood components: strategies to improve patient safety

Clinical Guide to Transfusion

Step by Step Technical Manual of Blood Components Preparation

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Processing and storage of blood components: strategies to improve patient safety

Jump to navigation. Whole blood donations are separated into specific cellular red blood cells and platelets and plasma components. Transfusing the appropriate blood component to effectively provide for the clinical needs of patients optimizes use of donated blood.

This chapter describes the manufacturing process for the most commonly prepared blood components:. Brief descriptions of the indications, contraindications, storage and transportation requirements, dose, administration and available alternatives are included in the sections below. Further information may be found in other chapters of this Guide as indicated within the different sections.

Canadian Blood Services also publishes a Circular of Information to provide an extension of the component label and information regarding component composition, packaging, storage and handling, indications, warnings and precautions, adverse events, dose, and administration. At Canadian Blood Services, whole blood is collected from donors into a collection pack in which multiple bags are connected, allowing blood and components to be transferred between bags aseptically closed system during manufacturing.

The collection packs include two different configurations:. Figure 1 highlights the main steps of both manufacturing processes. Both collection sets contain a citrate-phosphate-dextrose CPD anticoagulant in the collection bag.

Apheresis technology instead of whole blood collection may also be used for collection of some blood components, including plasma and platelets. This collection procedure utilizes an automated in-line process in which whole blood from the donor enters a collection chamber where centrifugation separates the plasma from cellular blood constituents such as red blood cells and white blood cells.

Information about the anticoagulants used can be found in the Circular of Information for each component type and in Table 1. Depending on the process, either plasma or platelets suspended in plasma are collected into a bag while the remaining constituents of the blood are returned to the donor. Figure 1. The manufacturing processes used at Canadian Blood Services to produce blood components from whole blood. In the B1 method, whole blood is centrifuged to separate the red blood cells from the platelets and plasma.

The red blood cells are then leukoreduced LR by filtration. In the B2 method, the whole blood is first filtered to remove platelets and leukocytes LR , then centrifuged to separate the red blood cells from the plasma.

For both B1 and B2 methods, the red blood cells are then mixed with an additive solution, saline-adenine-glucose-mannitol SAGM and labelled as a red blood cell unit. These parameters are also described and updated in the Circular of Information.

Further modifications of red blood cell components such as washing, deglycerolizing and irradiation are covered in Chapter 15 of this Guide. Each donation is tested for various antigens and for a number of infectious diseases outlined in Chapter 6. Kell typing is performed on every donor twice and, when negative, this result is printed on the label.

A proportion of donors are also phenotyped for additional red cell antigens corresponding to common clinically significant antibodies C,c,E,e,Jka, Jkb, Fya, Fyb, S,s. Negative results for any of these antigens appear on the label.

The complete set of results, including positive and negative antigen tests, appears in the bar code label. Figure 2 : Canadian Blood Services label for a red blood cell unit. Available on blood. The primary purpose for a red blood cell transfusion is to increase the oxygen-carrying capacity of the blood. Therefore, red blood cell transfusion is indicated in patients with anemia who have evidence of impaired oxygen delivery.

For example, symptomatic acute blood loss, chronic anemia and cardiopulmonary compromise, or disease or medication effects associated with bone marrow suppression may be triggers for red blood cell transfusion. In patients with acute blood loss, volume replacement is often required and, depending on clinical circumstances, plasma and platelets may also be transfused.

See Chapter 11 of this Guide for details on massive hemorrhage and emergency transfusion. Effective oxygen delivery depends not only on the hemoglobin level, but also on the cardiovascular condition of the individual, and the associated ability to compensate for decreased hemoglobin concentration. Patients without cardiopulmonary compromise, therefore, will typically tolerate lower hemoglobin levels than patients with limited cardiopulmonary reserve.

Similarly, the normal hemoglobin levels of infants and children vary from those seen in adults and transfusion triggers as well as usual blood component dose will also vary according to age. See Chapter 13 of this Guide for details on neonatal and pediatric transfusion. Finally, patients who develop anemia slowly develop compensatory mechanisms to allow them to tolerate lower hemoglobin values than patients who become acutely anemic. The decision to transfuse anemic patients should be based on an individual case assessment.

There is no uniformly accepted hemoglobin value below which transfusion should occur for every patient, in every scenario. However, many studies and guidelines support the use of a restrictive transfusion strategy, including in the intensive-care unit ICU setting and with postoperative anemia.

Red blood cells are not given for volume replacement or for any reason other than correction of acute or chronic anemia and should be given only after non-transfusion alternatives have been either assessed and excluded or do not adequately manage anemia. The decision to transfuse should not be based on a single hemoglobin or hematocrit value as a trigger without considering all relevant physiologic and surgical factors affecting oxygenation and clinical status in that patient.

Cardiovascular status along with other co-morbid conditions, the acuity and severity of the anemia, and the presence or risk for ongoing blood loss are also considered in determining the need for correction of anemia with transfusion.

See the Choosing Wisely Canada website for more information about transfusion guidelines. Chapter 8 and Chapter 9 of this Guide provide detailed information on pre-transfusion testing and administration, respectively.

Chapter 13 of this Guide is also recommended for guidelines on neonatal and pediatric transfusion. An unused RBC unit may be returned only if the bag is intact, passes a visual inspection and has either been maintained at an acceptable temperature see Storage and transportation , or has not been out of a temperature controlled environment for more than 60 minutes See CSTM Standard 5.

Proper storage and transportation of blood components are critical for safe transfusion. As a biological product, blood carries risk of bacterial contamination if stored improperly.

Improper storage may also affect blood component efficacy. The shelf life of a red blood cell unit issued by Canadian Blood Services is 42 days from collection. Manipulation of the unit, including washing or irradiation, shortens the shelf life. The expiry date is documented on the label of each unit. Units selected for irradiation at Canadian Blood Services must be less than or equal to 14 days old after collection and following irradiation, irradiated cells must be transfused as soon as possible, but not later than 14 days after irradiation.

Records must be kept during storage and transportation that maintain the chain of traceability of blood components from their source to final disposition, and to ensure that appropriate conditions were present throughout this time frame.

Chapter 15 provides additional information on washing and irradiation. Maintaining proper storage temperature during transportation is essential. Visual inspection of each blood component to be shipped must be performed and documented at the time of shipping and receiving. Some hospitals and regions use temperature-monitoring devices in one or more shipping containers with each shipment of blood and blood components to ensure the correct temperature during transportation.

When red blood cell units accompany a patient who is transferred from one facility to another, traceability of the RBC must be maintained. Accordingly, the issuing hospital transfusion service is responsible for notifying the receiving hospital transfusion service, which is then responsible for the final disposition documentation including whether the RBC was transfused to a patient or was discarded.

Monitoring the patient while treating the underlying condition s contributing to anemia may be an alternative to transfusion for some patients.

At Canadian Blood Services, there are two types of platelet preparations: pooled platelets and apheresis platelets. Pooled platelets are prepared from whole blood collected into a buffy coat collection set B1 method with CPD anticoagulant Figure 1. The whole blood donations are cooled to room temperature after collection. After transportation to the production site, the blood components are separated by centrifugation.

The top layer, containing the plasma, and the bottom layer, containing the red blood cells, are extracted. The buffy coat layer between the red blood cells and plasma contains platelets and white blood cells.

The buffy coat layers from four donations of the same ABO blood group, along with plasma from one of the same four donations a male donor , are pooled together and processed further, including LR by filtration, in order to produce one pooled platelet unit or dose Figure 2.

The pool is labeled as Rh negative only when all the donor units within the pooled component are Rh negative. Pooled platelet units are produced within 28 hours of collection and have a unique pool number identifier. The shelf life is seven days from the time of collection. The typical unit of pooled platelets has an average residual leukocyte count of 0.

The transfusion of platelets is indicated in the treatment of patients with bleeding due to severely decreased or dysfunctional platelets. Platelet transfusion may also be useful if given prophylactically to patients with rapidly falling or low platelet counts secondary to bone marrow disorders or chemotherapy. Platelet transfusions are not recommended for patients with rapid platelet destruction e.

Indications are similar for both pooled platelets and apheresis platelets. Apheresis platelets may be selected based on similar human leukocyte antigen HLA typing to the recipient's when a recipient fails to respond to platelet transfusion because of demonstrated anti-HLA antibodies alloimmune refractoriness. See Chapter 18 of this Guide for details of treatment and testing for platelet-refractory patients. While ABO-identical platelets may be preferred for transfusion of some patients, ABO compatible platelets are often used.

See Chapter 9 and Chapter 18 of this Guide for information on ABO compatibility, dose and administration of platelet components. Transfusion of apheresis platelets should result in increments similar to those achieved by transfusion of pooled platelets.

In practice, the post-transfusion platelet count often does not rise to the expected level. Sepsis, alloimmunization, fever, ITP, or disseminated intravascular coagulation DIC may contribute to a suboptimal response. See Chapter 18 of this Guide for more information. If the agitator is not a closed platelet incubator, the ambient temperature must be recorded manually using a calibrated thermometer every four hours or through use of a constant room temperature monitoring device.

Both pooled platelets and apheresis platelets have a shelf life of seven days from the date of collection. Once opened, the unit expiry time is four hours from the time of opening unless aliquots are prepared using a sterile connection device. Aliquots obtained using such a device retain the original seven-day expiry date and must contain a minimum residual volume that is dependent on the collection pack.

Canadian Blood Services collects apheresis platelets using Terumo Trima collection packs, which have a minimum volume of ml. The collection and expiry dates indicated on the platelet unit must be copied to the label of each aliquot pack made from the original unit. Canadian Blood Services manufactures and distributes the following main types of plasma components:.

Blood donors are screened for the presence of antibodies to red cell antigens. If a clinically significant antibody is identified, the plasma is discarded. FP produced by the B1 method is both leukoreduced and platelet-reduced by centrifugation but not leukoreduced by filtration. FP produced by the B2 method is both platelet-reduced and leukoreduced by filtration Figure 1.

Clinical Guide to Transfusion

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component preparation, processing, and storage and also for safe distribution. In our country today, the use of blood components remains an essential-step in.

Step by Step Technical Manual of Blood Components Preparation

A blood bank is a center where blood gathered as a result of blood donation is stored and preserved for later use in blood transfusion. The term "blood bank" typically refers to a division of a hospital where the storage of blood product occurs and where proper testing is performed to reduce the risk of transfusion related adverse events. However, it sometimes refers to a collection center, and some hospitals also perform collection. Blood banking includes tasks related to blood collection, processing, testing, separation, and storage.

Processing and storage of blood components: strategies to improve patient safety

A single whole blood donation can be separated into different components to provide treatment to more than one patient.


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    The whole blood which is a mixture of cells, colloids and crystalloids can be separated into different blood components namely packed red.


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