Results 1 – 42 of 42 Blood was drawn from ten healthy volunteer donors into citrate-phosphate- dextrose adenine (CPDA-1) anticoagulant and placed on the. The first anticoagulant preservative was introduced by Rous and Turner in in circulation 24hours after transfusion of stored blood in CPDA-1 for 35 days. CPDA #1: The preferred solution for longer-term storage of blood products. CPDA #1. Anticoagulant ml. This is the preferred solution for blood bank.
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In citrate-phosphate-dextrose with adenine CPDA-1 preservative was developed. The loss of red cells viability is correlated with the “lesion of storage” due to various biochemical changes:.
Giycosis results in the production of lactate, with subsequent decrease in pH. Whole blood collected in CPD has a pH7. Preservative solutions provide buffering capability to minimize pH changes and optimize the storage period.
Loss of ATP causes increase in amticoagulant rigidity and decrease in red cell membrane integrity and deformability. Decline of 2, 3-Dipnosphoglycerate 2,3-DPG A fall in pH in the stored blood results in a decrease in red cell 2,3-DPG level, which results in increase in hemoglobin-oxygen affinity.
DPG-depleted red cells have impaired capacity to deliver oxygen to the tissues. The degree of reduction of 2,3-DPG levels depends upon the preservativesolution used.
Preservation and Storage of Blood
The pathological effects of the transfusion of red cells with low 2,3-DPG levels and increased affinity with oxygen include increase in cardiac output and a decrease in mixed venous PO 2 tension. Myocardial functions improve following transfusion of blood with high 2,3-DPG levels during cardiovascularsurgery. In patients with shock the transfusion of DPG-depleted red cells makes a significant difference in recovery. After transfusion, the red cells continue to synthesize 2,3-DPG and levels return to expected normal values within 24 hours.
The acid-base status of the recipient, phosphorous metabolism anddegree of metabolism influence the rate of restoration of 2,3-DPG. Adenine Simon showed that in CPD solution supplemented with 17 mg 0.
Adenine synthesizes ATP and its level is This amount is present in 30 units of fresh CPD adenine 0. Temperature The lower temperature keeps the rate of glycolysis at lower limit and minimizes the proliferationof bacteria that might have entered the blood unit during venipuncture or from atmosphere. Traditional preservatives were put into use when whole blood was the major product. With the advent of component therapy use of red cells increased. This resulted in several problems in preservation.
Red cell concentrates relatively void of plasma are more viscous and difficult to infuse in emergency situations. This allows adequate plasma to remain for red cells nourishment and to improve flow properties. This results in lower plasma yields, affecting fresh frozen plasma and cryoprecipitate production. This new blood collection system has a primary bag containing a standard anticoagulant CPD and a satellite bag containing an additive solution.
Blood is collected in the primary bag containing anticoagulant solution. After the plasmais removed from the whole blood into another empty satellite bag, the additive solution is added to the red cells, thus providing nutrients to red cells for improved viability. The additive solution should be added to red cells within 72 hours since phlebotomy. One major benefit of the additive system is increase in the level of ATP, and red cells viability is enhanced, extending the shelf-life of the red cells to 42 days.
This facilitates better inventory control of blood as well as wider use in pre-deposit autologous donations. The additive solutions do not increase 2,3-DPG levels. Additive solution having mannitol are not routinely used for exchange or neonatal transfusion. There is no restriction on the use of additive solutions in any other type of transfusion recipients.
Heparin Heparin prevents coagulation by inactivating the prophylactic activity of thrombin after complexing with AT and thrombin. Dose of heparin for anticoagulation is 0. Heparinized blood should be used within 24 hours. Earlier heparinized blood was used in pen heart surgery but now usually it is not used as extracorporeal pumps are now usually primedwith crystalloids and not with blood. The effect of heparin can be neutralized with protamine sulphate. These solutions can be added at any time between 3 days post collection and 3 days after expiration of red cells.
The rejuvenated red cells are either washed with saline 2 Litres of unbuffered 0. Red blood cells rejuvenation solution, 50 ml sterile vial Rejuvesol, Cytosol Laboratories,Braintree, MA is commercially available. The rejuvenation process is expensive and time consuming and is rarely used. One of the factors is also the plastic material used for the bags.
The plastic material should be sufficiently permeable to CO2 in order to maintain higher pH during storage. It is known that DEHP leaches from plastic into anticoaguoant and cell membrane during storage and may be harmful to the patient.
The accumulation of excessive amount of acid due to glycosis even at low storage temperature is also a major problem in liquid preservation of red cells.
So there is need to develop improved plastic blood bags as well as preservative solutions. If glycerol cryoprotective agent is added to the cells they can be frozen and thawed without damage Polge et al. The effect of the glycerol is probably due to the fact that it limits ice formation and provides liquid phase in which salts are distributed as cooling proceeds excessive hypertonicity is also avoided Dpda, Glycerol which termeates red cells fairly rapidly during freezing is most effective in protecting the human redcells.
Frozen red cells are primarily used for autologous transfusion and the storage of rare group blood. For freezing red cells a cryoprotective agent is added to red cells that are less than 6 days old.
Glycerol is used most commonly c;da is added to the red cells slowly with vigorous shaking so that glycerol permeates into the red cells. The cells are rapidly frozen and stored in a freezer. The freezing ccpda storage temperature depends on the concentration of glycerol. Most blood banks use the high glycerol technique. Frozen cells are deglycerolized before transfusion.
Removal of glycerol is achieved by systematically replacing the antocoagulant with decreasing concentrations of saline. Commercially available Cell Washing System manufactured by several companies can be used.
Red cells stored in additive solutions can be frozen up to 42 days. The frozen red cells can be stored for 10 years. Method of freezing and preservation of red cells in frozen state:. The glycerolizing solution consists of 6. Appropriate volume of 6. After at least two minutes of equilibration, the remainder glycerol solution and the partiallyglycerolized cells are transferred to a ml polyolefin bag Hebia blood bag.
CPDA-1 | definition of CPDA-1 by Medical dictionary
They can then be stored at to C. Whole blood in Anticoagulanh is centrifuged at x g for seven minutes. Plasma is taken off and freezed. Low glycerol solution equal in volume to the red cells e.
The intracellular environment of glycerolized cells is hypertonic relative to plasma and the first solution used for reglycerolization must be also somewhat hypertonic.
This allows the glycerol to begin diffusing out of the red cells while the intracellular environment remains hypertonic.
Subsequently followed by washing anticosgulant solution progressively less hypertonic and finally with isotonic electrolyte solutioncontaining glucose. Then wash with one to two litres of 1. The washed cells are finally suspended in isotonic glucose solution and ready for transfusion.
The shelf-life of the processed unit is 24h. The washed cells are finally suspended in isotonic glucose saline and ready for transfusion. Shelf-lifeof the processed unit is 24 h. The washing can be carried out either by anticoauglant flow washing in the Haemonetic Blood processor or by continuous flow washing in Fenwal Elutramatic system or serial centrifugationin the IBM blood processor.
Protocols for each instrument should be followed as advised by the manufacturers. Blood is collected in CPDA-1 double pack. The pack is centrifuged at X g for 7 min and the plasma is removed. Transfer thawed red cells to dialysing tubing. Seal both ends by folding and clamp wnticoagulant paper dlip.
Suspend tubing by means of paper clip supported by an applicator stick in a large beaker saving 0. Cells in 4 dialysing tubings can be immersed in the same beaker for dialysing. Plastic Bag Maintenance of pH and function of platelets depend on the permeability of the storage bag to oxygen and carbon dioxide. They do not need agitation.
Post transfusion recovery of granulocytes in circulation and migration into inflammatory loci is better if transfused with in 8 hours of storage than that if granulocytes stored for 24 hours. Sturdy, well abticoagulant carriers with some type of refrigerant are used. Wet ice is a good refrigerant for red cell shipment.
Ice should be putat the top inside the anticoaguant so that the cool moves down through the shipping box. In cpdq that are extremely warm or where the shipment journey will be lengthy, ice may be placed at the bottom also of the container. Ice should not come in direct contact with blood at any time because it can cause hemolysis of the red cells or blood.
Dry ice is used to maintain the frozen state. Dry ice should be kept at the bottom and at the top inside the well-insulated container. These frozen products are fragile, Insulate the product by dry packing material or plastic air bubbles to check anficoagulant during shipment.
Physical storage conditions best suited for products maximum survival are also important. All storage equipment, whether a refrigerator, a freezer or a platelet environmental chamber should have anticoagulnat following facilities:.
Temperature recording charts should be changed regularly.