Blood Components Defined

Blood corI.i", of blood cell • .00 plasm>., Blood cell. i""lude red blood cell.

(i,e . . . I')'.hn><y',,), ... hi", blood cell. (i.~ .. leukoc)'t .. ) . • nd pl>tole" (i,e ..

thrnmboc)",,), 1I ... opoios .. i. defined •• the generation of "" .. ' blond «II., All blood «Il •• re derived from pluripo«nt .I<m cell. th>t. in tum. differenti.1<

into ge"""'tiOlU of moce clearly diff .. <nti.rod cell. under ,he stim"l>1ioo of

coIOlly_stimul>tin~ facton,"

n.e

^{rompl ... blood «Iun' (CDC)} i. the I.bocatory test that .n.l)'Ze.

concentrations of blood cell. in • sample of blood, Norm.1 vol"". from lUI adult CDC .re di.pl.yed in Table 9_1. E,),throc),"', ore the mo>1 .bund"", blood cell.,

n.e

>olume of erythrocyte. in 0 •• mple of blood i. referred to .. the hem •• oedt.

n.e

norm.1 hematoerit for an adult m.le i. het ... n 39.nd 48 pe«ent .nd for ,n adult f.m,l. i. be' ... ",n J.6 ""d 4~ peroent, The hemoglobin molecul. compri",.

most of the .. 'eight of .""h erythrocyte. It i. the mol""ule th>t , .. n.porI> o'y~.n,

n.e

n"",,"1 co"""ntr.,ion of hemoglobin in a .. mpl. of blond fOf on .dult mal.

nn~e. be' ... ""n 13 and 16 gldL .nd for an adult female range> bet ... n 12 ""d I ~ gldL. Thu. the nu"",ric .. Iu" of 'he hematocrit i. "I'pro'imotcly thr"" time.

the numeric ".Iue of the hemoglobin, Erythrocyte. Ii"" for "I'pro,im>toly 1lO-1l0d.y.,"

leukoc),te .... ,he blood cell. =poo.ible fo.- mountin~ ond modul>tin~ host immune.nd infl.mm.tory re.ponse. to p>.thog.n •• nd injurious .gent>, A. weh.

CHAPTER 9 Blood Component Th erapy m

~'" _ ... _ ... C ... "Iood('.-(CBC)

,

-.. ^••

-

--

^~

'k - - •

^"'

^,J-" ,1-,,;'" ^...

.... - _ ^... -

^'.l-5.h ,0' ...

-

^{l,W.'. '0'}

.- ^,

--_ ^{... -}

^{0-11.0.,0'«11}

^,

-

^,~.,o'«'"

,

.... i, 1n,,1. can clw>llI" _ .... II~ ... tIm die """' bc>;"'OU Injul'ft! 0< Inf...-..d.

While blood ""I"

,,,,,Iud<

lItIIII'opIIiI .. _ • • ,1 .. baM>pIoilo. 1rIOCIOC}-' :and lynop/oo<y1el. Tho ~fc 'f'OII '" ."'" of , _

«lI.

^COIl '"01)' con...!<nobly from day>

I<>~""',"

1hromboc-y"" or< _ true

""n.

ⁱⁿ

u....

,hey or< die "",10"" f,""""nlS of mepUryocy"'" 110""""",,)'1<' .,. die inili01Ofl1 of ,he d .. lln! 00",,011< ... >D<h.

they "'"

".c,,,..,. on

""",,,,lIin, hemorrhlF :and In ;n;'io';nB ",poi, of injul'ft!

'iMo><. Thrombocyte> hve f.,.. "",y 'W"'.inwoly 9 day •. "

Ph ... i. ,he """ lIul ... <:omponen' "r bloOO. 11 """'''''y <:ompri ... 'W"'xinwol y 52-64 ",,!cr.' of ,he ",lull>< of •• p«I ... of

0<1""

^{blood. (h.."} 90

""=.,

^of

pi .. "", i. romp<>O«l of .... '.r. IIt''' .... n 6.5 and g.O ",,"'cn' of pl."mo ;. """'prised of various proIei.,. c.lkJ ,II<

pl."'"

p ... , .... '" Tho mo.I i"""",on' of

m. ..

pi .. "", proIein. i""lud< .Ibumln.

m.

Imn'"""I!lobuhn •. ond fibrinog<n .... , .... min i.

m.

^pi ... ".-in ,hal i. _ im"""..,' in """n!>.iniog in ....

'"HC"'.,

^colloidal

oo.mo<ic

P"''"''"''

^(COP). I, i • • b" i"""",1111 in P""'"",nS """nd ... Iin,. Tho imm"_lobulin ... i_ito ,l1li .,. p"'f<>rn>e<l b)' , ... ,.. pIaoou «11>.

"'hleh .... dm.'Od from 8.ly~ .. ,odofond

m.

h<lOI from f"",i,n ~

collrd onli.n •. • ibri""fl<n i. o<:kllt,,,! ("""" 'hM is importOlll '" """"'l2Iin, die

commDI>

fCh ....

y in

m.

coqulal"", oaxOll<."

In ooIdibon 1<>"-'-ond

m.

^pIumo

1'fOIC''',

plauno ..,...". ... y of ...

... b>wo<n. iD<ludilo, ""',,"" ....

poes.

ond ol«ln>lylt .. Cok,um i .... clrctrolylt fuoond in pi ... ItIoI .100 fun<."licw ... cI ... "", ("""" (i .•.• """"

IV).-m I.V. Therapy Demystified

It is """ibl. to repl"". deficiencies in .inually any of lIle"" previou.ly identified blood rompo'"'." through ;o,,, .... oou. 'ran.fu.;on.

n.e ..

blood compo""." ""'Y be taken from human dot\Of. (i.e .. allos",,,ic) or from ,h.

origin,l boo, to

"Of

^{0 .}00 ,ran.fuse back to tbe ... , in I."",. of ""..J (i ....

"u,olog""')' The ""'" common of the .. blood compo"""" .... ilabl. for ,ran.fu,ion will be discu.sed in the follo,,'ing >e<tions.

S,.n> BUM,

[Jo"",6i blood co"'fJ'JM"u or< "fr,,,d 10 a. blood """'_"".

".","", blood compon'IIl' M'iIMro ... nfrom ,'" hill,

"'i'"

^,II<

i""",

to tramji'"

bad '0 Ih. "'''' in Ii"",.

of

.ud ",. "f""d 10 a. blood compoti<OI'.

In genenl. iodie .. i""" [Of tramfu,ioo of any bloOO rom""""." are more re>tric1i,'e than <hey "''ere n yea!1l 'go.

n.e.e

",.trict;oo, have been g .... ratod in p:ut by ~"t J>Iwm:orologic <!e>'.lopm<n" thai. use roccmbinarn go"",i.

,ngiDeCfing. Fo< i .. tanc<. it i. novq,oMible toadmini".r. ">rie'y of recombinantly manufac1ured coiony_"imul",ng facrors to "",ien" with chronic di>e.>e> that result in low erythrocyte """n" (i,e .. aDemi.) or low leukocyte counts (i .•..

l<okopHIia). The .. p/larmacologic prodocts include """""binant .r:r.hropoiriin (i,e ... poetin [Epogon. f>rocritlJ to treat """mi." IUld recombinant gntnolocyl<

roIony ... irnolating ractor (G·CSF) (i.e .. pegfilgn>tim [Neula .... 1) to treat teulropeni:L Clinic.1 re..,,,,,,h i ... imed ot d..''Cloping • ~. IUld effecti".

recombin""t thrombopoietin. a <oiony."imulating f"",or that ioo"' .... the prodoctioo of plot.le" to ".,.t low pl.tolet """nlS. or thrombocltop<nia,

I n addition to tb.", p/I:trmaoologic ad "'000'. there i. now • b. It., unders .. nd ing thot ,,,,,,.fu.ioo. h .. 'e ad"er ... offeet. 00 !>os, immunity. whieh .Iso h •• had the effec' of re,"icting tb.ir indications, Fo< in".""e. hum.n immunodeficieocy virus (HIV) .nd hep.ti'i. B and C viru",. w.re tr'ruIru",d to numerous un,u'peeling !WienlS along with tb.ir blood oomponen" in the 1980..

Sophisticated "''''''"ing "" .. thwaned ,b. tran,mission of the . . . iru ... in I .. .,

}UB. but wi'hin the pa" f ... · y .... , We" Nile "iru., c)',omeg.loviru. (CMV).

IUld 'he Creutzfold,·Jal;oo prion .... r. tran,mitred to patients ",,,,,i.ing blood

""".fu,ions," In addi,ion to tron.mining "iruses IUld "'b.r !WOOgcns, i, i. "" ...

helie>ed th .. ,,,,,,,fusioo of allogeneic blood oomponen" has both .bon· .nd IonS·tOnD ><Iv"" •• ffect> on ho>t immunocompetcoce, ll,M P>tionts "'ho rocei, ..

blood components ""'Y be.t incre ... d ri,k ror.inl infection., bacteri.1 infection •.

acute lung injut')', recUIre"". of e""""" that were in remi .. ion. ""d d ... lopment of ,u'oimmune di""de .. I .... in life,"

CHAPTER 9 Blood Component Therapy m

Types of Blood Components •

h _ _ «I ... pn<:e<linl...:lion thai;' io """,,bit to lBIUf ... iruWly OIl)'

blood rornpon«>1 to pol ... Whole III" io poooobit ...

n..u ... ""-...

,"'ith Ir2mf .. i"l!..,.... o f . -

""">pOIo:ou

mil)' 0\I1"'~&h

....

pol<1IIw

_fi ...

^Few

i~. _ .... ~ f ... thai

ouppon ...r ... ,

^{,.-hl .. blood ~Ih..}

Tobie 9·1 ~ ... """" ~Iy lnW.fuoed blood ccm_ ...

oppro<imal< in _ _ _ _ IbM ;. iIIf...! "'dh .odI ""f'<CI"" .... ~ thai i.

tr-r1lOed. and Ihow rapoctI~ ,,.,.,.._.

Co,","«, _ Ik_ ....

KU'''r._,

_VU,_""_al

I.V. Therapy Dem ystified

I, was ooted in the I""""di ng """ioo om, InfISfu.i ng .llog"""ic blood compone""

c.me •• ignific.n, h . . l,h risk,. 11>< lik.lihcod of e.<periencing a '""",fu.;oo_rel>lOO

>,1> ... '" ""ent iocre .... if. blood romp"""'" i. stored imp<operly C4" i. used 1'''' its expi .. 'ion date. For inst.nce. > "ni, of "'hoi. blood C4" I""ked red blood cell.

may be stored ooly for up to 42 day •. ge .... lly speaking." It i. hoped that ,,,,,,III from clinic.1 ", .. arch "'ill one day yi.k! .. fe and effec,ive blood component

","'titulO. >0 ,h .. the .. dual problems of hosl_i<15ul1oo immuni'y and prodoc' stonge may be thw>rted. Thu, far ,hi. q"'" 1= "'" re.n ... Ii,ed,