Summary information about blood products and haemostatic agents
see www.blood.co.uk/hospitals/products for a full compendium of information about blood components.
Tables 1−5 provide summary information about each main class of blood product. (Links: Table 1, Table 2, Table 3, Table 4, Table 5) Details of the quality standards and the manufacture and composition of blood components are prepared by the UK blood services. The blood services’ quality assurance procedures are designed to maintain compliance with these specifications. The services are regulated and inspected by the Medicines and Healthcare products Regulatory Agency (MHRA).
Until the late 1970s, most blood was transfused without being further processed to separate plasma or platelets. This blood was termed ‘whole blood’. It is now used rarely in current practice in the UK, although in many countries it accounts for most transfusions. Almost all whole blood donations are processed to separate red cells, platelets and plasma. The donor’s blood is drawn into a plastic pack containing 63 ml of an anticoagulant-preservative solution, usually Citrate Phosphate Dextrose (CPD) or CPDA1. The citrate binds calcium and acts as an anticoagulant, and the glucose and adenine support red cell metabolism during storage. The whole blood unit is filtered to remove white cells, most of the plasma is removed, and an additive solution is added. To prepare platelet concentrate, the white cell and platelet layer (the so-called buffy coat) is isolated and from this the platelets are separated, pooled and filtered to remove white cells.
Table 1 Prescribing and use information common to all blood components
Must be compatible with recipient's ABO type
RhD negative females with childbearing potential must be given RhD negative red cells or platelets to avoid risk of Rh sensitisation, and should also receive Kell-negative red cells
Desirable that other RhD negative recipients receive RhD negative red cells and platelets
Compatibility with other red cell antigen systems
Recipients of red cell transfusions must be tested to detect and identify other red cell alloantibodies that could cause adverse reactions: red cells lacking these antigens must be selected by the blood bank
Prevent risk of graft-versus-host disease (GvHD)
For patients at risk, cellular blood components must be gamma irradiated
Meet special requirements for intrauterine and neonatal transfusions
Specification of components is intended to minimise risks of infectious, immunological and metabolic complications of fetal and neonatal transfusions
Ensure that patients receive the correct blood components, correctly administered
Follow local procedures or protocols for ordering and administering blood components
Infuse through a blood administration set
Record details of each blood component infusion in the patient's case record