Download MBBS (Bachelor of Medicine, Bachelor of Surgery) 1st Year, 2nd Year, 3rd Year and Final year Transfusion Medicine and Blood Bank 7 Blood Transfusion PPT-Powerpoint Presentations and lecture notes
PRINCIPLES OF BLOOD
TRANSFUSION
HISTORY
1900- Landsteiner -Blood Groups
A, B, and O
1902- Sturli and DeCastello - AB
1940- Landsteiner and Wiener-
Rh typing
Over 250 different antigens categorized
More than 25 major discrete systems are
now known
Progression
Blood groups
Anticoagulants
? ABO
Plastic bags
? Rh
? Many other!!!
Transfusion
Apheresis
Medicine
World Health Organization data for Southeast Asia
Requirement ?
16 mil ion units per year
Gap ?
6
mil ion
units
Col ection - about 9.4
mil ion units annual y
Aggarwal S, Sharma V. Attitudes and problems related to voluntary blood donation in India: A short
communication. Ann Trop Med Public Health 2012;5:50-2
Every three seconds someone needs blood!
One out of every 10 people entering a hospital
needs blood !
A country needs- 20?25 donors per
1000 inhabitants.
In developed countries
50 per 1,000 people
donate blood
In India eight per 1,000
do so
? About 112.5 million blood donations are collected
yearly worldwide.
? More than half of these are collected in high-income
countries, home to 19% of the world's population.
Blood donation rate (per 1000 people)
? High-income countries- 33.1
? Middle-income countries- 11.7
? Low-income countries-4.6
? Data reported to WHO shows significant
increases of voluntary unpaid blood donations
in low- and middle-income countries
Blood cannot be manufactured
It can only come from generous donors.
Facts about donors
? Common reasons cited by people who don't
give blood
"Never thought
"I don't like
about it"
needles."
What is the solution??
Retention donors
Donor satisfaction
Donating blood is a safe process
Sterile disposable blood bags are
used.
The entire process, from the time
you arrive to the time you leave,
takes about an hour.
Donated blood is tested for HIV,
hepatitis B and C, syphilis and
malaria.
Blood cannot be manufactured in
factories, and someone has to donate.
Action needed
v Conduct more blood donation camps.
v Enlist dedicated donors.
v Conduct donor education / awareness programs.
Social media plays a role too!!
They donate regularly too !!
Right blood
to the right patient
at the right time!
Rational Use of Blood
? Right product
? Right dose
? Right time
? Right reasons
Criteria for donor
selection
Conditions for donation of Blood
(1)General ?
(3)Weight > 45 kg
once in three months
(4)Normal
good health
Temperature
(2)Age group
Pulse
18 to 65 years
Blood pressure
e) Hemoglobin more than 12.5 g/dl
f) The donor should be free from
acute respiratory diseases
skin diseases at the site of phlebotomy
disease transmissible by blood transfusion
i) The arms and forearms of the donor should be free from
skin punctures or scars indicative of professional blood
donors or addiction of self injected narcotics.
Additional criteria- (Deferral)
Conditions
Period of Deferment
1) Abortion
6 Months
2) Accident ? major
6 Months
3) Accident ? minor
4 Weeks
4) Acupuncture
6 Months
5) Alcoholism
24 hours after intake
6) Al ergy
Til symptom free
7) Anemia
Til treated
8) Aspirin
3 days
9) Asthma
Til acute attack subsides
10)Blood Donation (previous)
3 months
11)Blood Transfusion
6 months
Conditions
Period of Deferment
l2) Common Cold
Til symptom free
13) Contraceptive
No deferral
14) Child Birth
6 months
15) Ear Piercing
6 months
16) Fracture
6 months
17) Hepatitis
12 months
18) Immunization
15 days
19) Immunoglobulin
12 months
20) Infectious Mononucleosis
24 months
21) Hepatitis Vaccination
6 months after the
last dose
Conditions
Period of Deferment
21)Lactation
12 months after delivery
22)Malaria
3 months after treatment
23)Menstruation
Temporary
24)Pregnancy
12 months
25)Rabies vaccination
1 year after vaccination
26)Surgery ? major
12 months
27)Surgery ? minor
3 months
28)Tattooing
6 months
29)Toxoplasmosis
12 months
30)Tuberculosis
Til completely treated
31)Typhoid
12 months after recovery
32)Vaccination ? Kil ed Vaccine
48 hours
33)Vaccination ? Live Vaccine
3 weeks
No person shal donate blood suffering from any of the
disease mentioned below,
a) Cancer
b) Heart disease
c) Abnormal bleeding tendencies
d) Unexplained weight loss
e) Diabetes ? control ed on Insulin
f) Hepatitis infection
g) Chronic nephritis
h) Signs and symptoms, suggestive of AIDS
i) Liver disease
j) Tuberculosis
k) Polycythemia vera
l) Asthma
m) Epilepsy
n) Leprosy
o) Schizophrenia
p) Endocrine disorders
QUESTIONNAIRE FOR MEDICAL HISTORY
? (Ask fol owing question from the donor in
? Do you get up every night to urinate ?
privacy)
? Have you had sugar in the urine ?
? HAVE YOU HAD ANY OF THE FOLLOWING
ILLNESS?
? Have you had /suspected you had a
venereal disease ?
? Hepatitis
? Did you ever have painful, swol en
? Malaria
joints/rheumatism ?
? Asthma
? Have you ever been told you have
? Al ergic to Medication/Chemicals ?
anemia ?
? Significant infections or diseases of the skin
? Subjects to diziness, fainting, twitching,
?
spel s/fits ?
? Do you bruise easily ?
? Do you have neuralgia or neuritis ?
? Do you perspire excessively ?
? Do you have numbness/tingling in your
? Do you faint easily ?
fingers/toes ?
? Have you ever been knocked unconscious ?
? Does cold/hot weather bother you
? Do you have light headedness/dizziness ?
excessively ?
? Have you been jaundiced (Yel ow eyes and
? Do you have a chronic cough ?
skin) ?
? Have you ever coughed up blood ?
? Have you lost weight ?
? Do your gums bleed frequently ?
Types of blood bags &
anticoagulants used in
Blood Bank
Blood Storage
? Acid Citrate Dextrose (ACD)
? Citrate Phosphate Dextrose (CPD)
? Citrate-phosphate-double dextrose (CP2D)
? Citrate-phosphate-dextrose-adenine (CPDA1)
SINGLE BAG-WHOLE BLOOD
DOUBLE BAG-PRBC & PLASMA
TRIPLE BAG-PRBC & FFP & PLATELETS
Quadruple bag- +Cryoprecipitate
What are Components?
1. Cellular components: RBCs,
platelets, granulocytes
2. Non cellular components: FFP,
Cryoprecipitate, Cryo poor plasma
Why Components?
? Better shelf life
? Whole blood has shelf life of 35days
? Shelf life of components: PRBC 42days
FFP 1year
RDP 5days
Why Components?(Contd..)
? Whole blood can be used only for one patient.
? Components:
? PRBC can be used for anemia and thalassemia.
? FFP for coagulopathy
? Platelet concentrate for thrombocytopenia.
Principle of component preparation:
? Principle: different components of whole blood have
different specific gravities and require different centrifugal
force to separate from one another.
Specific gravities of Components:
1.030
1.035
1.090
1.093
Different components that can be
prepared:
1. Packed RBC(PRBC)
2. RBC with Additive solution(ADSOL)
3. Leucoreduced RBC
4. Platelet concentrates: random donor platelets(RDP)
5. Granulocyte concentrates
6. Fresh frozen plasma(FFP)
7. Cryoprecipitate
8. Single donor plasma(SDP)
9. Cryo poor plasma(CPP)
Preparation of Packed RBC:
Whole blood bags are kept at room
temperature after donation
Bags are put in centrifuge cups and
balanced by soft weights
Balanced centrifuge cups are to placed
diagonal y in refrigerated centrifuge
Centrifuge should be run at speed of
1800rpm with 9 acceleration and 6
deceleration for 10mins
Using plasma expresser, platelet rich
plasma(4/5th Plasma) is separated into
another satel ite bag to retain RBC in
mother bag.
RBC Components:
1. PRBC: RBCs are separated from plasma by plasma
expresser and kept at 2-40C. Shelf life is 35days.
2. RBC with Additive: SAGM
? Requires quadruple or penta bags.
? Shelf life is 42days when stored at 2-40C.
? It contains Saline, Adenine, Glucose and Mannitol
Clinical indications of PRBC
transfusion: BCSH
? Surgery/Critical care: <7g/dl
? Cardiovascular disease: <8g/dl
? Chronic anemia: Hb maintained >8g/dl to prevent
symptoms
Clinical response of PRBC
transfusion:
? Each unit of PRBC,
i. In a 70kg adult will cause increase of 1g/dl of Hb and 3%
HCT
ii. In a child, 3g/dl of Hb and 6% HCT
Long term storage
? Cryopreservation of red blood cells is done
to store rare units for up to 10 years.
? The cells are incubated in a glycerol solution
which acts as a cryoprotectant
Platelet Concentrate:
? Random donor platelets(RDP) are prepared from whole
blood unit by centrifugation.
? Ideally from 450ml unit of whole blood kept at room
temperature and within 6 to 8 hours of collection.
Storage of Platelet Concentrate:
Temperature:20-24 degrees
Agitation
? Exchange of gases
? Maintenance of pH
? Decreased formation of aggregates
Clinical response of Platelet
concentrate:
? 1 unit of RDP causes an increment of 5000 to
10000/mm3 in a 70kg adult.
Fresh frozen plasma:
? Prepared from a single unit of whole blood and frozen
rapidly within 6-8hrs
? Contain all coagulation factors
? Rapidly frozen within 1 hour of separation
? Used as FFP until 1year if stored below -300C.
FFP Transfusion:
? Dosage of FFP: 15ml/kg body weight
? Compatibility testing is not necessary before transfusion.
? Donor plasma should not contain ABO antibodies that
interact with recipient's red cells.
Cryoprecipitate:
? Precipitated proteins of plasma rich in Factor VIII,
Fibrinogen and Fibronectin.
? Stored at -300C for 1year.
Component Storage
Expiration
Whole Blood 2-6 0 C
35-42 days
PRBC
2-6 0 C
35-42 days
Platelets
20-24 0 C
5 days
FFP
<-18 0 C
12 months
PRETRANFUSION TESTING
? BLOOD GROUPING
? CROSS- MATCHING
Q. What determines a blood
group?
A. The antigens on the red cell
surface.
What are the antigens?
Group A
Group B
Group AB
Group O
We have antibodies to the antigens we don't have!
Group A
Group B
Group AB
Group O
Cell grouping Serum grouping
Group A
Group B
Group AB
Group O
This is very important during
blood transfusion
Anti-A antibodies lyse type A red cel s
Anti-B antibodies lyse type B red cel s
CROSSMATCH
patient
donor
AHG
serum
red cells
Cross-matching
? Major Cross-match: Recipient serum is tested
against donor packed cells
? Minor Cross-match: Recipient red cells are
tested against donor serum
This post was last modified on 08 April 2022