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Transfusion Medicine. Blood Bank. Red Blood Cells. Red color from hemoglobin, an iron -containing protein that binds oxygen. Red Blood Cells (RBC’s). Biconcave shape Helps RBC’s squeeze through tiny capillaries Larger surface area for oxygen pickup / dropoff by hemoglobin in the RBC’s

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red blood cells
Red Blood Cells

Red color from hemoglobin,

an iron -containing protein

that binds oxygen

red blood cells rbc s
Red Blood Cells(RBC’s)
  • Biconcave shape
    • Helps RBC’s squeeze through tiny capillaries
    • Larger surface area for oxygen pickup / dropoff by hemoglobin in the RBC’s
      • Hemoglobin
        • Picks up oxygen (O2) from lungs
        • Releases it to cells in tissues
        • Picks up carbon dioxide (Co2)
        • Exchanges CO2 for O2 in lungs
antigens and antibodies
Antigens and Antibodies
  • Antigens: On RBC’s, protrusions on the surface of the cell that could cause an antibody to form against it
  • Antibodies: Proteins in the plasma

that form in

response to a

foreign antigen

blood groups
Blood Groups
  • RBC’s have antigens on their surface
    • The most important antigens are the ABO antigens
    • People usually have antibodies against those ABO antigens that they lack.
blood groups1
Blood Groups

(rbc’s)

rh type
Rh Type
  • Another antigen on RBC surfaces is called Rh, also known as D.
    • If a person that is Rh negative is transfused with Rh positive blood, it is very likely that they will make an antibody to the Rh, called anti-D
    • In U.S., 85% are Rh positive, 15% Rh negative
  • When a person gets a blood type, both the ABO and the RH are tested
    • Group O Rh positive is usually abbreviated as O Pos
    • Group A Rh negative is called A Neg
transfusion
Transfusion
  • Red blood cells for anemia, surgery, emergency blood loss
  • Plasma for clotting disorders due to disease, medication,

surgery, or emergency

blood loss

  • Platelets to stop

bleeding, aid clotting

donating blood
Donating blood
  • Volunteer: not paid (True Heroes!)
  • Must be age 17 or older
  • May donate 1 unit blood every 8 weeks
  • Blood is spun
    • Plasma removed and frozen
  • Platelets are collected

by pheresis

May donate 2 units of rbc’s

by pheresis, every 16 weeks

component prep
Component Prep
  • Blood is spun and plasma removed
    • Packed Red Blood Cells good for 3 weeks
      • Additive solution extends life to six weeks
      • Must be stored in monitored, alarmed refrigerator
    • Plasma frozen within 24 hours
      • Shelf life one year in monitored, alarmed freezer
      • Thaw in 37C (98F) water bath
      • Store in refrigerator up to 5 days
pheresis donation
Pheresis Donation
  • Pheresis is a process where blood is drawn from the donor, spun in a machine, and certain components returned to the donor, usually with the same needle / tubing.
  • Platelets, plasma, and two-unit red blood cells may each be collected by pheresis
platelets
Platelets
  • Platelets are small plate-shaped cellular bits that circulate in the blood.
  • When bleeding occurs, the platelets activate and become sticky and help block the blood flow and help form a clot.
plateletpheresis
Plateletpheresis
  • A unit of platelets drawn by pheresis is equivalent to the number of platelets in 6-8 units of whole blood.
  • Platelets must be stored at room temperature and be agitated to keep viable.
    • If they are refrigerated, they transform from plates to spheres, and lose their function.
    • Because they are stored at room temperature, the shelf life of platelets is only 5 days.
    • Because of short shelf life, platelets may be transfused without regard to blood type.
testing donor blood
Testing Donor Blood
  • All Donor blood is tested for many diseases before being released, including HIV, Hepatitis B, Hepatitis C, and West Nile Virus
  • Blood is labeled with ABO/RH type of component, supplier, and expiration date.
  • When blood arrives at the hospital transfusion service, the blood type of rbc’s is rechecked.
blood transfusion
Blood Transfusion
  • If a patient needs a blood transfusion, a tube of blood is drawn for crossmatching.
  • Many hospitals attach an extra armband with a unique identifier number onto the patient when the crossmatch tube is drawn to ensure that the blood is transfused to the correct patient.
  • The tube is brought to the hospital transfusion service for testing
crossmatching
Crossmatching
  • When there is an order for a crossmatch:
    • The lab computer system is checked to see if there is blood bank history on the patient.
    • A blood type is performed on the sample, even if we have the patient’s blood type many times previously
    • An antibody screen is

performed with the patient’s

plasma against a screen of

3 reagent red cells to check

for antibodies.

crossmatching cont
Crossmatching, cont.
  • If the antibody screen is negative, a crossmatch is performed with patient plasma and a segment from the unit of rbc’s.
  • If the antibody screen is positive, a panel of cells is tested with the patient plasma to determine the antibodies present.
    • Compatible blood is chosen based on the antibodies found.