Читать книгу Transfusion Medicine - Jeffrey McCullough - Страница 125
5.1 Whole blood preparation and storage
ОглавлениеWB can be collected in 450‐ and 500‐mL bags that contain citrate–phosphate–dextrose (CPD), citrate–phosphate–double dextrose (CP2D), or citrate–phosphate–dextrose adenin‐1 (CPDA‐1). WB collected in CPD and CP2D is stored for 21 days, and blood collected in CPDA‐1 is stored for 35 days at 1–6°C. No additional manufacturing step is required prior to issuing of WB. WB can be leukoreduced. There is one platelet‐sparing leukoreduction filter available in the United States (Imuflex WB‐SP, Terumo BCT). In the military, warm fresh WB is used. It is collected and stored at 22°C up to 24 hours. It can be stored at 1–6°C up to 48 hours (cold fresh WB). It is not approved by the US Food and Drug Administration (FDA) in the civilian setting because the results of infectious disease testing are not available at the time of transfusion. To mitigate risks of transfusion‐transmitted infectious diseases, military personal is tested prior to deployment and every 90 days during their deployment.
Table 5.2 Components produced by blood banks and the medical use of these components.
| Component | Medical use |
|---|---|
| Red blood cells | Oxygenation of tissues |
| Platelets | Prevention or cessation of bleeding |
| Fresh frozen plasma | Prevention and cessation of bleeding, plasma exchange, reversal of vitamin K antagonist if prothrombin complex concentrate is not available |
| Cryoprecipitate | Cessation of bleeding |
| Cryoprecipitate‐poor plasma | Plasma exchange |
| Granulocytes | Treatment of infection |
| Frozen red blood cells | Storage of rare blood |
| Leukocyte‐depleted red cells | Prevention of febrile non‐hemolytic transfusion reactions, prevention of certain diseases (e.g., CMV) and decrease in HLA alloimmunization |
CMV, cytomegalovirus; HLA, human leukocyte antigen.
Table 5.3 Some of the products manufactured from whole blood subject to licensure by the US Food and Drug Administration.
| Red cell components | Red blood cells |
| Red blood cells irradiated | |
| Red blood cells leukocytes removed | |
| Red blood cells leukocytes removed irradiated | |
| Red blood cells deglycerolized | |
| Red blood cells deglycerolized irradiated | |
| Red blood cells frozen | |
| Red blood cells frozen irradiated | |
| Red blood cells frozen rejuvenated | |
| Red blood cells frozen rejuvenated irradiated | |
| Red blood cells washed | |
| Whole blood CPD irradiated | |
| Whole blood cryoprecipitate removed | |
| Whole blood leukocytes removed | |
| Whole blood modified—platelets removed | |
| Whole blood platelets removed irradiated | |
| Cryoprecipitate AHF | |
| Plasma components | Cryoprecipitate AHF irradiated |
| Cryoprecipitate AHF pooled | |
| Fresh frozen plasma | |
| Fresh frozen plasma irradiated | |
| Liquid plasma | |
| Plasma | |
| Plasma irradiated | |
| Plasma cryoprecipitate reduced | |
| Plasma pathogen reduced | |
| Thawed fresh frozen plasma | |
| Thawed fresh frozen plasma irradiated | |
| Platelet‐rich plasma | |
| Platelets | Platelets |
| Platelets irradiated | |
| Platelets washed | |
| Pooled platelets | |
| Pooled platelets leukocyte reduced | |
| Pooled platelets leukocyte reduced irradiated | |
| Platelets pathogen reduced |
AHF, antihemophilic factor; CPD, citrate–phosphate–dextrose.
