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Transfusion Medicine

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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Transfusion Medicine

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  1. Transfusion Medicine Blood Bank

  2. Red Blood Cells Red color from hemoglobin, an iron -containing protein that binds oxygen

  3. 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

  4. 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

  5. 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.

  6. Blood Groups (rbc’s)

  7. 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

  8. U.S. Blood Type Distribution

  9. Compatible types: RBC’sO NEG is Universal RBC Donor

  10. Compatible Plasma types(Rh doesn’t matter)AB is Universal Plasma Donor

  11. 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

  12. 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

  13. 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

  14. 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

  15. 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.

  16. 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.

  17. 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.

  18. 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

  19. 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.

  20. 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.

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