Blood Components

Prepared by:

John Gabriel B. Abcede, RN, RMT, MLS(ASCPi)CM

Assistant Professor III
Calayan Educational Foundation Incorporated
 Whole Blood
• Contains RBC and plasma with a
hematocrit level of approximately 38%

• Provides both oxygen-carrying capacity

and volume expansion

• Obsolete – same benefit can be

obtained with concentrated RBC plus a
plasma expander like saline or frozen
plasma that would contain viable
clotting factors (labile clotting factors
do not survive in stored whole blood)

• Storage temperature: 1-6 C

• Shelf-life: depends on the anticoagulant

used
 Packed RBC
• Prepared from whole blood by
centrifugation or sedimentation

• May also be obtained directly by apheresis

• Prepared within 8 hours of collection to

allow the manufacture of other components
(frozen plasma, platelets and
cryoprecipitate)

• Amount of plasma depends on the

anticoagulant used
▫ CPDA-1 = 200-250mL can be removed, final
hematocrit of 65-80%
▫ If with additive solutions = additional 50mL can be
removed, final hematocrit of 55-65%

• Use: increase in RBC mass and oxygen

carrying capacity

• Advantage: lesser risk for circulatory

overload due to lower volume
 RBC Aliquot
• Packed RBC divided into several
aliquots using multiple pack system,
each pack retaining the original outdate
of the primary bag within a closed
system. Several aliquots may be
prepared from a single-donor unit

• Most often transfused during the

neonatal period or in infants to prevent
circulatory overload and minimize
wastage due to the limited opened
stability of RBCs.

• Storage temperature: 1-6 C

• Shelf-life: depends on the anticoagulant

used
 RBC Aliquot
• If multiple pack is not available,
aliquot can be aspirated through a
large bore needle attached to a
syringe. The syringe must contain
the original label of the parent bag
and aseptic technique observed
when transferring blood and
handling the aliquot.

• Open system = carries a 24-hour

expiration time within 2-6 C
 RBC Irradiated
• RBC that have undergone irradiation of
25 Gy to the central portion and 15 Gy
to any part to render the donor unit’s T
lymphocytes incapable of attacking the
host’s tissue

• Uses
▫ Immunocompromised individuals – host’s
immune system is not capable of defending
against the foreign lymphocytes
▫ Fetuses undergoing intrauterine transfusion
▫ Prevention of TA-GVHD
▫ Recipients of blood coming from relatives

• Storage temperature: 1-6 C

• Shelf-life:
▫ 28 days from the time of irradiation

• Shelf life of the anticoagulant

(whichever is sooner)
 RBC Leukoreduced
• Absolute WBC count in the unit is
reduced to less than 5 x 106 and
contains at least 85% of the
original RBC mass

• Uses:
▫ Prevention of BRM (biological
response modifiers) released from
leukocytes during storage of the
component that may cause febrile
transfusion reaction
 BRM includes proinflammatory
cytokines (IL-1, IL-6, TNF, C5a and C3a)

▫ Prevention of
 Febrile transfusion reaction
 TRALI (transfusion-related acute lung
injury) due to anti-leukocyte antibodies
 Transmission of EBV, CMV and HTLV
viruses
 RBC Leukoreduced
Types of leukoreduction
• Prestorage
▫ Removes at least 99.9% removal of
leukocytes by multiple layers of polyester
or cellulose acetate fibers that trap
leukocytes and platelets but allows RBC
to flow through
▫ Prevents release of BRM
▫ Random donor platelets cannot be
harvested because it will be trapped in
the leukoreduction filter

• Poststorage
▫ Leukocytes are removed prior to issuing
blood or at the bedside before
transfusion using leukoreduction filter
which lowers the leukocyte levels to 5 x
106 or lower
▫ Prevents reactions caused by leukocyte
antibodies
▫ Will not prevent reactions caused by
BRM’s that originate from the leukocytes
present in the component during storage
 Washed RBC
• RBCs washed with 1 liter of saline to
remove plasma proteins

• Use: prevention of allergic, febrile or

anaphylactic reactions (especially in
patients who are IgA deficient) due to
donor’s plasma proteins

• Storage temperature: 1-6 C

• Shelf-life: 24 hours after washing

 Frozen, Deglycerolized RBC
• Glycerol acts as cryoprotective agent,
allowing the RBC to be frozen and
stored for up to 10 years

• Used for autologous units with rare

phenotypes

• Requires thawing at 37 C and

deglycerolization prior to use which
subsequently removes leukocytes,
platelets and plasma due to the
washing process

• Storage temperature: depends on the

cryoprotective agent used

• Shelf-life:
▫ 10 years storage
▫ 24 hours after deglycerolization
 Frozen, Deglycerolized RBC
Cryoprotective agents

• Penetrating
▫ Small molecules that cross the cell membrane into cytoplasm
▫ Osmotic force of the agent prevents water from migrating outward as
extracellular ice is formed, preventing intracellular dehydration
▫ Ex: glycerol

• Nonpenetrating
▫ Large molecules that do not enter the cell but instead form a shell
around the RBC and prevents loss of water and subsequent dehydration
 Frozen, Deglycerolized RBC
Methods

• High Glycerol
▫ Frozen at:-80°C
▫ Stored at:-65°C – mechanical freezer
▫ Deglycerolization:
 12% NaCl> 1.6% NaCl> 0.9% NaCl

• Low Glycerol
▫ Frozen at:-196°C
▫ Stored at:-120°C - liquid nitrogen
▫ Deglycerolization:
 45% NaCl> 15% Mannitol> 0.9%
NaCl
 Granulocyte Concentrate
• Contains leukocytes and platelets as well as 20-
50 mL of RBC

• Collected by apheresis techniques

• Indications:
▫ WBC count of <500/uL
▫ Bacterial infection unresponsive to
antibiotics
▫ Bone marrow hypoplasia

• Storage temperature: 20-24°C without

agitation

• Shelf-life: 24 hours

• Crossmatch is important before transfusion

because of red cell contamination

• Use: Irradiation is important to prevent GVHD

 Platelet Concentrate
• Indications:

▫ Thrombocytopenia

 Actively bleeding, preoperative with

platelet of <50,000/uL

 Radiation and chemotherapy induced

<20,000/uL

 Not indicated for ITP (idiopathic

thrombocytopenic purpura) or DIC
(disseminated intravascular
coagulation)

• Shelf-life: 5 days
 Platelet Concentrate
Random-Donor

• Prepared from whole blood

▫ Must be drawn from a single,
nontraumatic phlebotomy and
prepared within 4 hours of
collection

• Contains at least 5x105

platelets suspended in 40-
70mL of plasma to yield a pH of
greater than or equal to 6.2

• Storage temperature: 20-24°C

with continuous agitation
 Platelet Concentrate
Single-Donor

• Produced by apheresis

• Given to patients who are

unresponsive to random platelets
due to HLA alloimmunization or to
limit the platelet exposure from
multiple donors

• Contains at least 3x1011 platelets

suspended in 300 mL of plasma to
yield a pH of greater than or equal
to 6.2

• Storage temperature: 22-24°C

with continuous agitation
 Plasma
• Obtained from whole blood
components by centrifugation and
frozen to preserve the clotting
factors.

• Storage requirement and shelf-life

▫ -18°C or colder = 1 year
▫ -65°C = 7 years

• Thawed at 30-37°C water bath or

in an FDA-approved thawing
device

• Once thawed, may be stored at 1-

6°C for 24 hours
 Plasma-Derived Products
FFP / PF24

• Plasma frozen within 6 hours (ACD) to 8

hours (CPD, CP2D, CPDA-1) of collection

• Contains all the coagulation factors,

including the labile factors V and VIII
▫ Approximately 400 mg of fibrinogen

• Volume:
▫ 150-250 mL – single donor
▫ 400-600 mL – apheresis

• Indications
▫ Multiple factor deficiency
▫ Specific factor deficiency when individual
concentrates are not available
▫ Thrombotic Thrombocytopenic Purpura
▫ Hemolytic Uremic Syndrome
▫ DIC with fibrinogen levels <100 mg/dL
▫ Rare specific plasma protein deficiencies
 Plasma-Derived Products
Thawed Plasma

• Thawed plasma (>24 hours – 5 days)

stored at 1-6°C

• Contains stable coagulation factors

(fibrinogen and prothrombin)

• Reduced amount of labile factors (V, VII,

VIII, X)

• May be indicated in all of the same

situations as FFP that does not require
the missing factors
 Plasma-Derived Products
Cryoprecipitate

• Cold-precipitated concentration of
factor VIII suspended in
approximately 15 mL of plasma

• Contains most of the factor VIII

and part of the fibrinogen from
the original plasma
▫ At least 80 units of AHF
▫ At least 150 mg of fibrinogen

• Preparation
▫ Requirements:
 Non-traumatic venipuncture
 At least 200 mL of plasma
 Frozen within 8 hours of collection and
within 1 hour from the time freezing
was initiated
 Plasma-Derived Products
Preparation
• Plasma is allowed to thaw slowly in the refrigerator at 1-6°C
▫ 14-16 hours at blood bank refrigerator, 4 hours at circulating
cryoprecipitate thaw bath

• The endpoint is when the plasma becomes “slushy”

• Plasma is centrifuged (hard spin) at 4°C

• Supernatant plasma is expressed ( cryoprecipitate-poor plasma),

leaving only 10-20 mL of plasma in the precipitate

• Cryoprecipitate is the small white mass in the original plasma bag.

 Plasma-Derived Products
• Handling and use
▫ Thawed quickly at 37°C
▫ Shelf-life: 12 months (frozen), 6 hours (post-thawing)

• Indications
▫ Hypofibrinogenemia
▫ Classic haemophilia
▫ von Willebrand disease
▫ Factor XIII deficiency
▫ Fibrin glue
 Cryoprecipitate + topical thrombin
 Used to stop bleeding
 Plasma-Derived Products
Plasma, Cryoprecipitate-Reduced

• Plasma leftover after the removal of cryprecipitate from FFP

that is refrozen within 24 hours of thawing

• Contents:
▫ ADAMTS13 (protein reduced in TTP)
▫ Albumin
▫ Coagulation factors II, V, VII, IX, X, XI

• Shelf life: 1 year at 1-6°C

• May be indicated in all of the same situations as FFP that

does not require the missing factors