Blood Component Preparation

Upon expiration, a unit of thawed Plasma Frozen Within 24 Hours (PF24) is converted to thawed Plasma. This thawed Plasma can be stored for an additional: A) 1 day B) 4 days C) 14 days D) 28 days

B) 4 days Thawed Plasma has an expiration date of five days from the date the product was thawed. This product was already thawed for 24 hours, leaving four days before expiration. [AABB BB/TS Standards 2018, p 59]

What is Irradiation?

-Exposing blood components to gamma or x-ray radiation inactivates T lymphocytes -No adverse effect on platelet or red blood cell function -Increased potassium leakage into the storage fluid

What is Leukoreduction?

-Removes WBCs from whole blood or blood components -Reduces risk of adverse reactions in transfused patients -Leukoreduction filter may be used -Acceptable number of remaining leukocytes = 5 x 106 per component

According to AABB Standards, what is the minimum pH required for Apheresis Platelets at the end of the storage period? A) 6.0 B) 6.2 C) 6.8 D) 7.0

B) 6.2 Per AABB Standards, at least 90% of Apheresis Platelet units sampled must have a pH of at least 6.2 at the end of the allowable storage. [AABB T/S Standards 2018, p 30]

What is the minimum amount of fibrinogen required in one unit of cryoprecipitated AHF? A) 150 mg B) 250 mg C) 80 IU D) 1000 mg

A

Red Blood Cells, Leukocytes Reduced must be stored at: A) 1-6°C B) 1-10°C C) 1-20°C D) 20-24°C

A) 1-6°C Red Blood Cells, Leukocytes reduced are stored at 1-6°C. [AABB BB/TS Standards 2018, Reference Standard 5.1.8 A, p 53]

Quality control of Apheresis Granulocytes must demonstrate which of the following granulocytes counts in 75% of units tested? A) 1.0×10^10 B) 2.0 X 10^10 C) 3.0×10^10 D) 4.0×10^10

A) 1.0×10^10 Apheresis Granulocytes must yield a minimum of 1.0×10^10 granulocytes in at least 75% of units tested. [AABB BB/TS Standards 2018, p 31]

According to AABB standards, Fresh Frozen Plasma must be infused within what period of time following thawing? A) 24 hours B) 36 hours C) 48 hours D) 72 hours

A) 24 hours Per AABB Standards, thawed FFP should be stored at 1 to 6°C for no more than 24 hours. [AABB BB/TS Standards 2018]

Cryoprecipitated AHF must be transfused within what period of time following thawing and pooling? A) 4 hours B) 8 hours C) 12 hours D) 24 hours

A) 4 hours Cryoprecipitate must be transfused within 4 hours of pooling in an open system. [AABB BB/TS Standards 2018, p58]

According to AABB Standards, Platelets prepared from Whole Blood shall have at least: A) 5.5×10^10 platelets per unit in at least 90% of the units tested B) 6.5×10^10 platelets per unit and 90% of the units tested C) 7.5×10^10 platelets per unit in 100% of the units tested D) 8.5×10^10 platelets per unit and 95% of the units tested

A) 5.5×10^10 platelets per unit in at least 90% of the units tested Per AABB Standards, at least 90% of the Platelets prepared from Whole Blood that are sampled must contain at least 5.5×10^10 platelets. [AABB BB/TS Standards 2018, p 30]

What are minimum temperature and maximum storage time for a unit of frozen RBCs? A) -65°C for 5 years B) -85°C for 10 years C) -65°C for 10 years D) -80°C for 10 years

C

What fluid is administered with the transfusion of blood components? A) Ringer's lactate B) 5% dextrose C) 0.9% saline D) all of the above

C

According to AABB Standards, at least 90% of all Apheresis Platelets units tested shall contain a minimum of how many platelets? A) 5.5×10^10 B) 6.5×10^10 C) 3.0×10^11 D) 5.0×10^11

C) 3.0×10^11 Per AABB Standards, at least 90% of Apheresis Platelets units sampled must contain at least 3.0×10^11 platelets. [AABB BB/TS Standards 2018, page 30]

In a quality assurance program, Cryoprecipitated AHF, must contain a minimum of how many international units of Factor VIII? A) 60 B) 70 C) 80 D) 90

C) 80 AABB Standards require that units be tested for Factor VIII levels and demonstrate 80 IU or higher. If the average value is less than 80 IU of Factor VIII, corrective action must be taken. [AABB BB/TS Standards 2018, p 29]

What percentage of red blood cells must be retained when preparing Red Blood Cells Leukocytes Reduced? A) 50% B) 70% C) 85% D) 100%

C) 85% Methods for preparing Red Blood Cells Leukocytes Reduced must retain at least 85% of the original red cells. [AABB BB/TS Standards 2018, p 27]

Which Apheresis Platelets product should be irradiated? A) autologous unit collected prior to surgery B) random stock unit given to a patient with DIC C) a directed donation given by a mother for her son D) a directed donation given by an unrelated family friend

C) a directed donation given by a mother for her son Blood products from blood relatives must be irradiated to inhibit the proliferation of T cells and subsequent GVHD. [Harmening 2012, p381-382]

How many platelets must be obtained in a plateletpheresis in order to meet acceptance criteria? A) 5.5×10^10 B) 3.3×10^11 C) 5.0×10^11 D) 3.0×10^11

D

What is the correct order of centrifugation in the preparation of platelets from the unit of whole blood? A) hard spin followed by hard spin B) lights spin followed by light spin C) hard spin followed by light spin D) light spin followed by hard spin

D

If the seal is entered on a unit of Red Blood Cells stored at 1-6°C, what is the maximum allowable storage period, in hours? A) 6 B) 24 C) 48 D) 72

B) 24 If the seal is broken during processing, components are considered to be prepared in an open system, rather than a closed system. The expiration time for Red Blood Cells in an open system is 24 hours. [AABB BB/TS Standards 2018, p 52]

What is rejuvenation solution? What is it do?

Used to restore 2,3-DPG and ATP levels and RBC units collected in CPD or CPDA-1 during storage for up to three days after expiration with a solution containing pyruvate, inosine, phosphate, and adenine. It extends the expiration date for freezing or transfusing the RBC unit, which may be necessary when a rare or autologous unit is involved. Requires washing to remove the inosine for transfusion because it may be toxic to the recipient

Name that AntiCoagulant Preservative! Purpose osmotic diuretic acts as membrane stabilizer

Chemical Mannitol

Name that AntiCoagulant Preservative! Purpose prevents excessive decrease in pH

Chemical sodium bisphosphate

How many units of each coagulation factor in 1 mL of FFP?

1 unit of each coagulation factor in every 1 mL of FFP

What is the minimum yield for Apheresis PLATELETS?

3.0 X 10^11

What is the maximum # of WBCs in a Leukocyte-Reduced unit of RBCs?

5.0 X 10^6

Which of the procedures listed below will increase the platelet concentration in the preparation of platelets? A) Centrifuge the blood at a low speed, remove the plasma and spin the plasma again at a low speed. B) Centrifuge the blood at a low speed, remove the plasma and spin the plasma again at a high speed. C) Centrifuge the blood at a high speed, remove the plasma and spin the plasma again at a high speed. D) Decrease the duration of rotation of the initial spin.

A) Centrifuge the blood at a low speed, remove the plasma and spin the plasma again at a low speed. Preparation of platelets is a two-step process. The whole blood unit should be centrifuged at a low speed on the first spin. The platelets will then remain in the plasma portion of the bag (platelet-rich plasma). The platelet-rich plasma is then centrifuged again at a higher speed, forcing the platelets to the bottom of the container. By taking part of the plasma off of the second spin, the platelets are at a higher concentration per unit volume. Centrifuging at low speed for both spins will not allow the platelets to concentrate in the sediment of the second spin. Centrifuging at high speed for both spins will actually make the first plasma platelet-poor. Decreasing the duration of the initial spin will increase the red blood cell contamination and decrease the overall platelet count.

What procedure utilizes leukapheresis to collect the buffy coat from whole blood? A) Photopheresis B) Plasmapheresis C) Therapeutic apheresis D) Erythrocytapheresis

A) Photopheresis Photopheresis utilizes leukapheresis to collect the buffy coat layer from whole blood. These cells are treated with 8-methoxypsoralen, exposed to ultraviolet A light and then reinfused into the patient. Photopheresis has been shown to be efficacious and has been approved by the Food and Drug Administration for the treatment of cutaneous T-cell lymphoma. Plasmapheresis is the removal and retention of the plasma, with return of all cellular components to the patient. Therapeutic apheresis (TA) involves the removal of a specific blood component, with return of the remaining blood constituents to the patient. However, with TA the component being removed is considered pathological or contributing to the patient's underlying disease state. Erythrocytapheresis, or red cell exchange, removes a large number of red blood cells from the patient and returns the patient's plasma and platelets along with compatible allogeneic donor red blood cells.

Which of the following is proper procedure for preparation of Platelets from Whole blood? A) light spin followed by a hard spin B) lights been followed by two hard spins C) 2 light spins D) hard spin followed by a light spin

A) light spin followed by a hard spin Whole blood-derived Platelets are prepared by a light spin to separate the red blood cells from the platelet-rich plasma (PRP), followed by a heavy spin of the PRP to concentrate the platelets. [Harmening 2012, p316]

Although ABO compatibility is preferred, ABO incompatibility is acceptable for which of the following components? A) PF24 B) cryoprecipitated AHF C) apheresis granulocytes D) apheresis platelets

B

Eight units of platelets were pooled in an open system without the use of a sterile connecting device. What is the new time of expiration of the pooled product? A) 2 hours B) 4 hours C) 6 hours D) 24 hours

B

The pH and platelet count of four bags of platelets were tested at the end of the allowable storage period. Which of the following results is an acceptable product? A) 5.5×10^9 and pH of 6.5 B) 6.0×10^10 and pH of 7.0 C) 4.2×10^11 and pH of 5.9 D) 3.0×10^10 and pH of 6.2

B

What are the temperature limits for shipping RBCs? A) 1°C to 6°C B) 1°C to 10°C C) 2°C to 8°C D) 20°C to 24°C

B

A unit of Red Blood Cells that expires in 32 days has just been irradiated. The expiration date of this unit will: A) Remain the same B) be reduced by 4 days C) be reduced by 14 days D) be reduced by two days

B) be reduced by 4 days When red blood cell products are irradiated, the expiration date will be the original date or 28 days from the date of the radiation, whichever is sooner. [AABB BB/TS Standards 2018 ,p52]

Six units of Red Blood Cells are issued to the OR at 9 AM in a cooler, validated to maintain a temperature of 1-10°C for two hours. 40 minutes later, the cooler containing the units of blood is returned to the blood bank as surgery was canceled. What should be done with these units? A) discard the units as they were issued to a specific patient B) inspect units and establish that appropriate temperature has been maintained C) continue to store cooler since surgery is rescheduled for tomorrow D) put units back into inventory is only 40 minutes has elapsed since issue

B) inspect units and establish that appropriate temperature has been maintained Blood may be returned to the blood bank after issue provided that 1) the container closure has not been disturbed, 2) at least one sealed segment is attached to the container, 3) visual inspection of the unit is satisfactory and documented, 4) the unit has been maintained at the appropriate storage or transport temperature. [AABB BB/TS Standards 2018, p43]

Name that AntiCoagulant Preservative! Purpose prevents coagulation by chelating calcium, also protects red cell membrane

Chemical Citrate

Name that AntiCoagulant Preservative! Purpose supports ATP generation by glycolytic pathway

Chemical Dextrose

Name that AntiCoagulant Preservative! Purpose acts as substrate for red cell ATP synthesis

Chemical Adenine

What is the minimum for Platelet-rich Plasma?

Contains a minimum of 5.5 x 10^10 platelets

A unit of Bread Blood Cells expiring in 35 days is split into five small aliquots using a sterile pediatric quad set in a sterile connecting device. Each aliquot must be labeled as expiring in: A) 6 hours B) 12 hours C) 5 days D) 35 days

D) 35 days Sterile connecting devices allow entry into donor units without affecting expiration date of the product. [AABB BB/TS Standards 2018, p 24]

What does plasma contain?

Plasma contains albumin, coagulation factors, immunoglobulins, and other proteins essential for metabolism

What is the typical hematocrit and volume of additive solution RBCs?

The typical hematocrit of AS RBCs is 55% to 65% with a volume of approximately 300 to 400 mL. The volume of RBCs without additive solution is approximately 165 to 275 mL.

Typical Indications for IRRAdiated Blood Components

certain groups of immunocompromised patients at particular risk of TA-GvHD: ---pts with Hematologic malignancies ---transplant recipients ---patients with congenital or T-cell immunodeficiency, eg, Wiskott-Aldrich ---recipients of granulocyte concentrates ---patients receiving nucleoside analogs: (flucytosine, Ribavarin,tenofovir, abacavir,Fludarabine,etc) --- treatment with purine analogue drugs: (Allopurinol,Nelarabine, a purine analog used for T-cell acute lymphoblastic leukemia,) pentostatin(Hairy cell Leukemia), cladribine (2-chlorodeoxyadenosine) --- patients with Hodgkin lymphoma ---recipients of donations from related donors ----HSCT pts ---fetuses and neonates who have received an intrauterine transfusion. ---infants with prematurity, low birth weight, or HDFN (Source: Practical Clinical Pathology, 2nd Ed, Mais, p104)

What comprises the ISBT 128 Label?

•Donation identification number •Blood group of donor •Product code and description •Expiration date Special testing