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Blood Bank

Blood Components

This section covers the components derived from whole blood or apheresis

Core Components

  • Red Blood Cells (RBCs)
    • What: Concentrated red cells (carry oxygen via hemoglobin) suspended in plasma/additive solution
    • Use: Treat symptomatic anemia, acute blood loss
    • Key: Stored at 1-6°C; expiry 21-42 days depending on solution
  • Platelets
    • What: Cell fragments essential for forming blood clots (primary hemostasis). Collected via apheresis (SDP) or from whole blood (WBD, requires pooling)
    • Use: Prevent/treat bleeding due to low platelet count (thrombocytopenia) or dysfunction
    • Key: Stored at 20-24°C with agitation; short expiry (5-7 days) due to bacterial risk
  • Plasma
    • What: Liquid portion of blood containing water, proteins, and coagulation factors. Prepared as FFP (frozen <8hrs), PF24 (frozen <24hrs), etc
    • Use: Replace multiple coagulation factors (e.g., liver disease, DIC, massive transfusion, warfarin reversal)
    • Key: Stored frozen (≤ -18°C) for 1 year; must be ABO compatible
  • Cryoprecipitated AHF (Cryo)
    • What: Concentrate precipitated from thawed FFP, rich in Fibrinogen, Factor VIII, vWF, Factor XIII
    • Use: Primarily to replace fibrinogen; secondary for Factors VIII, XIII, vWD if concentrates unavailable
    • Key: Stored frozen (≤ -18°C); thawed units stored at room temp, expire in 4-6 hours. Requires pooling for adult dose
  • Granulocytes
    • What: Concentrate of neutrophils collected by apheresis (donor requires stimulation)
    • Use: Rare indication for severe neutropenia with documented infection unresponsive to antimicrobials
    • Key: Stored at 20-24°C without agitation; 24-hr expiry; MUST be irradiated and crossmatched. High reaction rate
  • Whole Blood
    • What: Unseparated blood containing RBCs, plasma, platelets, WBCs
    • Use: Largely replaced by component therapy; niche use in massive hemorrhage (trauma/military) or resource-limited settings
    • Key: Stored at 1-6°C; platelets/labile factors degrade quickly. Requires ABO identical transfusion

Modifications & Specialized Components

  • Leukocyte-Reduced Components
    • What: RBCs or Platelets processed (usually by filtration) to remove most WBCs
    • Purpose: Reduce febrile reactions (FNHTRs), HLA alloimmunization, and CMV transmission. Standard practice in many regions (Universal Leukoreduction)
    • Key: Does not change expiry if done via closed system
  • Irradiated Components
    • What: Cellular components (RBCs, Platelets, Granulocytes) exposed to radiation
    • Purpose: Inactivate donor T-lymphocytes to prevent Transfusion-Associated Graft-vs-Host Disease (TA-GVHD) in at-risk recipients
    • Key: Mandatory for granulocytes, directed donations from relatives, immunocompromised pts. Shortens RBC expiry (original OR 28 days post-irradiation, whichever is first); does not change platelet expiry
  • Washed Red Blood Cells / Platelets
    • What: Cellular components washed with saline to remove plasma proteins
    • Purpose: Prevent severe allergic reactions (esp. in IgA deficiency w/ anti-IgA); reduce supernatant potassium in RBCs for neonates/renal patients
    • Key: Open system process shortens expiry to 24 hrs (RBCs) or 4 hrs (Platelets)
  • Frozen/Deglycerolized Red Blood Cells
    • What: RBCs treated with glycerol (cryoprotectant), frozen (≤ -65°C) for long-term storage (10 yrs), then thawed and washed (deglycerolized) before use
    • Purpose: Store rare units, autologous units, strategic reserves
    • Key: Deglycerolization (washing) is required to prevent hemolysis; post-wash expiry is 24 hrs (open system) or longer (closed system)
  • Rejuvenated Red Blood Cells
    • What: Stored RBCs treated in vitro with solutions (PIPA) to restore ATP and 2,3-DPG levels
    • Purpose: Salvage near-expiry units; potentially improve O₂ delivery (debated); enhance quality for freezing
    • Key: Requires extensive washing after rejuvenation; 24-hr post-wash expiry (open system). Not routine
  • Apheresis Products
    • What: Components collected using an apheresis machine (Platelets, Plasma, Double RBCs, Granulocytes, Stem Cells)
    • Purpose: Obtain larger dose of specific component from single donor, reducing recipient exposure
    • Key: Donor may experience citrate reaction. Enables more frequent donation of certain components (e.g., platelets)
  • Hematopoietic Progenitors (HPCs / Stem Cells)
    • What: Stem cells capable of generating all blood cells; collected from bone marrow (HPC-M), peripheral blood after mobilization (PBSC / HPC-A), or umbilical cord blood (HPC-C)
    • Purpose: Used for transplantation to restore hematopoietic function after high-dose chemo/radiation or in marrow failure states
    • Key: Requires HLA matching for allogeneic transplant; often cryopreserved using DMSO; specialized processing and infusion protocols apply
  • Fractionation Products
    • What: Highly purified plasma proteins derived from large pools of plasma via industrial manufacturing (e.g., Albumin, IVIG, Factor VIII/IX concentrates, PCCs, Fibrinogen concentrate)
    • Purpose: Provide specific protein replacement therapy with enhanced viral safety and standardized dosing
    • Key: Regulated as pharmaceuticals, often stored at room temp/refrigerated with long shelf lives. Distinct from blood bank components