Basics of Transfusion Therapy

Laura Cooling MD, MS

Associate Medical Director

Transfusion Medicine

Blood Transfusion Policiesand Standard Practices

www.pathology.med.umich.edu

Select: Clinical Resource

“Blood Bank and Transfusion Services”

Link on UMHS Clinical Homepage

Practical Guide to Transfusion Medicine

By Marian Petrides, Gary Stack

AABB Press

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FOR BLOOD BANKSPECIMENS ONLY

Blood Collection• Most components results of single whole

blood donations

• 500 mL blood + anticoagulant

• 20-30 min

• Blood processed into components– packed RBC, FFP, platelets, cryo – Manufactured Components: IVIgG, albumin,

factor concentrates, etc….

Anticoagulants-Preservative• Anticoagulant: Sodium citrate

– prevent coagulation through chelation Ca++

• Carbohydrate: Dextrose– RBC utilize glycolytic pathway

• Buffer: Na Phosphate – Counter lactic acid acumulation

• Adenine: Support ATP production

• Mannitol: Stabilize RBC membrane

CPD CPDA AdsolNa Citrate 1.66 gm 1.66 gmCitric Acid 3.27 3.27Dextrose 1.6 gm 2.0 gm 2.2 gmNaHPO4 140 mg 140 mg 276 mgAdenine 17.3 mg 27 mgMannitol 750 mgFinal Hct 70-80% 70-80% 55-60%Shelf-life 21 days 35 days 42 days

ABO TYPES

Fucose 1-2Galactose-RH-Antigen

GalNAc1-3Gal-R

Fuc12

A-Antigen

Gal1-3Gal-R

Fuc1

2

B-Antigen

ABOType

%Donors

RBCAntigens

PlasmaAntibodies

CompatibleRBC Plasma

A 40 A Anti-B A, O A,AB

B 12 B Anti-A B,O B,AB

O 44 O Anti-A,B O all

AB 4 A&B None All AB

DISTRIBUTION AND COMPATIBILITY OF ABO TYPES AND BLOOD COMPONENTS

(holds true for solid organ transplant as well)

%Donors

WholeBlood

PackedRBC

FFP

A 40 40 84 44

B 12 12 56 16

O 44 44 44 100

AB 4 4 100 4

Volume (mL) 525 250-300 200-250

% Donors Compatible/Component