Download MBBS Transfusion Medicine and Blood Bank Presentations 7 Blood Transfusion Lecture Notes

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