Journey of a Blood Bag- Blood Centre. Processing and Testing...contents of the 4 Buffy coat bags...
Transcript of Journey of a Blood Bag- Blood Centre. Processing and Testing...contents of the 4 Buffy coat bags...
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Journey of a Blood Bag- Blood Centre. Processing and Testing
Ruth Evans, OD Manager - Scientific and Clinical
NHSBT Filton
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Why do we separate whole blood into different components?
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Whole Blood Pack Type
• Identified at donor session
• Determines components that can be produced:
1. Whole Blood Filtration (Top and Top)– (red blood cells, plasma or cryoprecipitate)
2. Bottom and Top– (red blood cells, and platelets; rarely-
plasma and cryoprecipitate)
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Whole Blood Filter (WBF) Pack
Anticoagulant 63ml CPD
100ml SAG-M
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Overnight storage
• Regardless of bleed type most WB is stored overnight before processing
– Phagocytes in product engulf bacteria
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Leucodepletion of Whole Blood Donations
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Centrifugation - fast (3800 rpm)
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•Plasma
•Red Cells
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• Plasma
• Red Cells
Semi-automated press
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WBF Components
SAG-M additive solution added
Red Cells4°C +/- 235 days
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Freezing
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Fresh Frozen Plasma (FFP)
< -25°C3 years
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Bottom and Top (BAT) Pack
Anticoagulant CPD-A1
Additive SAG-M
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Centrifugation- fast
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• Plasma
• Buffy Coat (for platelets)
• Red Cells
BAT Components
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Leucodepletion of Red Cells
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Red Cells
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BAT – platelet pooling
• 4 BCs + 1 PAS• Same ABO group• Rh and CMV only neg if all neg• Unique pool number generated
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Platelet Pooling - Sterile Connecting Device (SCD)
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Platelet Pooling - SCD
•Sterile Connection•Joins tubing aseptically•Disposable copper blade•Creates a ‘train’
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PAS is washed through the “train” of bags to pool together the contents of the 4 Buffy coat bags into the terminal bag
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Centrifugation - slow (1300 rpm)
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Pooled Platelet
22°C +/-2 gently agitating
7 days (if bacterial monitoring)
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Special components:Cryoprecipitate
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Stored 22°C without agitation for 24 hours only
Must contain >5x109
cells per unit
Must be CMV neg (if patient CMV neg)
Granulocytes
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Donation Testing –Grouping
• Mandatory testing:
– ABO / RhD grouping– antibody screening
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Haemagglutination
POS
NEG
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PK7300
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Mandatory/ discretionary testing
• Why do we test for what we do test for?
• Why don’t we test for everything?
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Level of
NA/Ag/Ab
Point of exposure
Symptoms
Time
Agent/host/test interaction
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Stopped 2006 (deferral in season). Restarted 2012
West Nile virus
Anti-T. cruziT. cruzi
Anti-malariaMalaria
Anti-HBc, anti-HBs*Hepatitis B virus
Discretionary tests
?NAT?HEV
Anti-treponemes (inc other endemic infections)Syphilis
Anti-HTLV I & IIHTLV
Anti-HIV I & II (+HIV Ag, HIV RNA)HIV
Anti-HCV, HCV RNAHepatitis C virus
HBsAg, (+HBV DNA)Hepatitis B virus
Mandatory screening
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Malaria Distribution
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Vector of Chagas’ Disease
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Donor Infection Rates
HCV 1:12150
HBV 1:20500
HTLV 1:30750
Syphilis 1:32200
HIV 1:65000
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PRISM:- Principles of reaction HIV HBV HCV EIA
Latex microparticles
Washed through to filter
•Assay specific acridinium-labelled antibody (or antigen) conjugate added to reaction well
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Nucleic Acid Amplification Technology (NAT)
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Residual risks for NHSBT (blood) donations
0.17
5.9
0.026
39
0.46
2.2
Window period donation
No. (per million) entering the blood supply
1 per X million donations
HIVHCVHBVRisk due to
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Contaminated Platelets
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•Bacterial Screening – 7 Day Platelets
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