ABO Group
Four blood groups: A, B, O, or AB
Almost all serum contains antibodies to ABO antigens it lacks
Antibodies are crucial to safe transfusion
type A
type B type O
type AB
Red blood cell antigens
A antigen A and B antigen
B antigen H antigen
(no A or B antigen)
ABO type
Pt Cells Pt Serum
vs vs
anti-A anti-B Acells Bcells
A + 0 0 + 40%
B 0 + + 0 11%
AB + + 0 0 4%
0 0 0 + + 45%
Patient ABO Type
Antibody (Serum)
RBCs or Granulocyt
es
Plasma- Containing Componen
ts*
Whole Blood
O (45%)
Anti-A
andAnti-B O A, B, AB, O O
A
(40%) Anti-B A, O A, AB A
B
(11%) Anti-A B, O B, AB B
AB
(4%) None A, B, AB, O AB AB
ABO Selection of Blood Components
RBC Agglutination
BLOOD COMPONENT THERAPY
It is the transfusion of specific blood components required by the patient.
Principles
Use blood products only when it is essential.
Replace only the deficient component, if possible.
Identify the cause and nature of the deficiency
and if possible, treat it.
Components
Whole blood
Platelets rich plasma
1stcentrifugation
Platelets concentrate
Whole blood
Whole blood
2nd centrifugation
Fresh plasma
FFP for clinical use
FFP for fractionation
Optimal additive solution
Red cells in OAS
Cryoprecipitate
Red Cell concentrate
Blood COMPONENTS AVAILABLE FROM THE BLOOD BANK
Whole blood Packed RBCs Platelets
Single donor platelets (Apheresis) Fresh Frozen Plasma (FFP)
Cryoprecipitate
Indication for Red Blood Cells Transfusion:
Red blood cells
are component of choice to maintain an adequate
supply of oxygen to meet tissue
demands.One unit increase the
haemoglobin level
by 1g/dL in a 70kg
recipient.
Indication for Transfusion of Whole Blood
Fresh whole blood<5 days old is often used for exchange transfusion in newborns.
Stored whole blood can be used in actively
bleeding patients who have lost > 30-40% of
their blood volume.
Indication for red blood cells Transfusion
Symptomatic anaemia
Acute blood loss>30-40% of blood volume.
Pre-operative Hb< 8g/dl and operative
procedure associated with major blood loss.
Evidence of inadequate oxygen delivery.
Administration and Dose
Red blood cells transfusion has to be grouped specific & Rh specific, if not one of alternative compatible group.
This component must be administered through a suitable transfusion set (170 mM filter).
Dose of 4ml/kg raises venous Hb by about 1g/dl.
Specifications
Whole blood volume 450mls+63mls of CPD-A1 anticoagulant.
Packed RBCs volume 250mls±50mls.
Hct=0.55-0.75.
Anticoagulant CPD-A1 store at 4c°±2c° for 35 days.
SAG-M for 42 days.
Indication for Platelet Transfusion
Decrease platelet production (Bone marrow failure)
Therapeutic:for patient who are bleeding associated with BMF caused by either disease, therapy or
irradiation.
Prophylactic: >10x 109/L to decrease morbidity in patients with thrombocytopenia due to B.M.F.
Cont, Platelet Transfusion
In acute D.I.C (Disseminated intravasculr coagulation).
In neonatal alloimmune thrombocytopenia (NAIT) from donor known to be negative for the appropriate HPA or mother platelet.
Platelet function disorders or thrombocytopenia <50x 109/L going for invasive procedure, for operation in critical sites such as the brain or eyes the platelet count should be raised to 100x109/L.
In massive blood transfusion, the platelet count to be maintained above 50x109 /L.
Administration of Platelet Concentrate:
ABO compatible platelet are preferred but not necessary.
Platelet concentrate should be transfused as soon as possible after reaching the ward with standard blood transfusion sets with 170 mm filters.
The transfusion should normally be completed within 30 minutes.
Observation during platelet transfusion should include pulse& temperature before& after transfusion.
Indications For The Use Of FFP
Definite indication:
Replacement of single factor deficiencies Immediate reversal of warfarin effect
Vitamin K deficiency
Acute disseminated intravascular coagulation Thrombotic thrombocytopenic purpura
Inherited deficiencies of inhibitors of coagulation:at, protein S, protein C.
CI esterase inhibitor deficiency
Conditional uses of FFP
FFP is only indicated in the presence of bleeding and disturbed coagulation in:
Massive transfusion Liver disease
Cardiopulmonary bypass surgery Special Paediatric indications:
sever sepsis, DIC.
Administration of FFP
1unit of FFP= APPROXIMATELY 200 ML Dose = 12-15 ml/kg
Should be administered within 2 hours of thawing.
PT & PTT used for monitoring in addition to the clinical assessment.
ABO compatible FFP should be used. Compatibility testing is not required.
Group O should only be given to group O recipient.
Group AB FFP should be reserved for group AB recipients and for emergencies.
Indications for The Use Of Cryoprecipitate
1-congenital or Acquired Fibrinogen Deficiency.
2-Haemophilia A, vonWillebrand ’ s Disease.
3-factor X111 Deficiency
4-disseminated intravascular coagulopathy(DIC).
Administration of Cryoprecipitate
1 unit of cryo= approximately 10-20ml Adult dose equivalent to 10 units of cryo
For factor replacement the dose can be calculated according to the volume of the factor in the concentrate.
Fibrinogen 150-300mg/pack
Von Willebrand factor 80-120u/pack Factor V111c 80-120u/pack
Factor X111 20-30% of factor X111 present in the FFP.
Should be administered within 4 hours of thawing.
Platelet, Apheresis
An adult dose of Platelets prepared from
anticoagulated blood which is separated into
components by apheresis machine with retention of the platelets and a portion of the plasma. The
remaining elements may be returned to the donor.
Specification
Volume 200 – 800 mls
Platelet count > 240 x 10
9/ unit Leucocyte count < 5 x 10
8/ unit
PH at end of shelf life 6.4-7.4 Availability
:On request
.Shelf life storage: 5 days at 22 ± 2°c
gently agitated
