Faculty of Allied Medical Science

1. Faculty of Allied Medical Science Blood Banking (MLBB 201)

2. HAEMOSTATIC COMPONENTS Prof.Dr. Nadia Aly Sadek Director of Blood Bank Centre – MRI University of Alexandria

3. ILOs • By the end of this lecture, the students will be able to recognize; • What is Fresh frozen plasma and cryoprecipitate.

4. Content

5. Fresh Frozen Plasma (FFP) 1 • Prepared from whole blood donation and frozen within 6 – 8 hours . • It is stored at – 18o c or colder for up to 12 months. • It contains: 91% water – 7% protein – 2% carbohydrate.

6. Fresh Frozen Plasma (FFP) 1 Indications • To treat prolonged PT or PTT • Vitamin K deficiency and liver disease • Dilutional coagulopathy • Protein S, Protein C or Antithronbin deficiency.

7. Fresh Frozen Plasma (FFP) 1 Thawing • It should be thawed at temperature 30-37oc in a water bath. • The unit should be wrapped in a plastic bag. • Thawed FFP should be transfused immediately or within 12 hrs or stored between 1-6oc for no more than 12 hours. • It should not be refrozen.

8. Fresh Frozen Plasma (FFP) 1 Administration • The same ABO as the protein. • Given via a filter over 1 – 1.5 hours.

9. CRYOPRECIPITATE 2 • Obtained from FFP and concentrated to 10 -20 ml. • It contains F VIII, (80 – 120 Units), v WF, 250 mg fibrinogen, 20 – 30% of factor XIII &fibronectin.

10. CRYOPRECIPITATE 2 Indications • Factor VIII deficiency (Haemophilia A). • Type II VW disease. • Type I VW disease not responding to DDAVP. • Factor XIII deficiency. • Congenital fibrinogen abnormality.

11. CRYOPRECIPITATE 2 Indications • When fibrinogen is ≤ 100 mg. • Control of bleeding in uremic or hepatic patients. • For preparation of fibrin glue: Topical use in orphopedic, ENT, dental, cardiac or neurological procedures. • Reversal of warfarin overdose.

12. CRYOPRECIPITATE 2 Thawing • It should be thawed at 37 0 c immediately before use and the pack should NOT be refrozen. • Fibrinogen dose: 8 – 10 bags supply 2 g fibrinogen. Infusion • Filter at rate of 1 – 2 ml/min.

13. CRYOPRECIPITATE 2 • Cryoprecipirate represents the cryoglobulin fraction of the plasma. • It contains F VIII, VWF, fibrinogen, fibronectin and F XIII. • It is used primarily for the treatment of Haemophilia A patients.

14. Platelet Concentrates 3 • Volume: 50 – 70 ml/unit provide about 5000 platelets. Kept at 20 – 22 0 c in a shaker for a maximum of 5 days. • Should be infused within 4 hours, administered with filter

15. Prothrombin Complex 4 • This component contains prothrombin (F II), factor VII, F IX and factor X. • It is lyophylized and virus-inactivated to reduce the risk of transmitting infections. Indications • Haemophilia B (F IX deficiency). • Serious coumarin overdosage together with Vitamin K1 • Coagulation defects due to fulminant hepatitis or liver insufficiency.

16. FEIBA AND AUTOPLEX 5 • These are some activated prothrombin complex preparations used for treatment of Haemophilia A patients with inhibitors. • These should be given with caution, as overuse may cause thrombosis and DIC. • Currently, there are factors IX and F VII concentrates for TR of Haemophilia B.

17. Fibrin Glue 6 • It is formed by the reaction of cryo (fibrinogen) + thrombin as they are applied topically. Advantage • Good hemostasis in different solid organ bleeding. • Prevents post-operative bleeding. • Efficient in the presence of coagulation defect and bacterial contamination.

18. Study Question • Mention the indication of cryopercipitate.

19. Assignments • Complication of blood transfusion محمد مصطفى محمد

20. THANK YOU