TME 29: Are all blood/ Packed red blood cells the same?

ChaptGPT thinks this is how blood is separated. This is not how we separate blood.

Packed Red Blood Cells: From Donation to Transfusion – A Behind-the-Scenes Look

Blood transfusions are lifesaving procedures, and packed red blood cells (PRBCs) are one of the most commonly used components. But have you ever wondered how these vital cells are separated from whole blood and how they can be further tailored for specific patient needs? Let's dive in!

1. The Journey Begins: Blood Donation

It all starts with a generous blood donor. Whole blood is collected in a sterile bag containing an anticoagulant to prevent clotting. This bag then embarks on a fascinating journey within the blood bank.

Click here to read more about different blood components.

Blood can be split into different components

2. Separation: The Birth of PRBCs

• Centrifugation: The magic happens in a centrifuge. This machine spins the bag of whole blood rapidly, causing the denser red blood cells to settle at the bottom. The yellowish liquid on top is plasma, which contains essential clotting factors, proteins, and other components.

• Extraction:  A skilled technician carefully separates the PRBCs from the plasma. The plasma can be used for other purposes, like making fresh frozen plasma (FFP).

3. The Power of PRBCs

PRBCs are like oxygen delivery trucks. They're packed with hemoglobin, the protein responsible for carrying oxygen throughout the body. Transfusing PRBCs helps:

• Treat anemia:  PRBCs boost red blood cell counts in patients with low levels (anemia) due to iron deficiency, cancer etc.

• Replace blood loss: After surgery, trauma, or during heavy bleeding, PRBCs restore lost blood volume and oxygen-carrying capacity.
  

4. Customizing PRBCs: Modifications for Specific Needs

Different medical situations and patient conditions call for PRBCs with specific characteristics. Here's a closer look at how we can modify PRBCs to meet these unique needs:

Leukoreduction: 

White blood cells, while essential for fighting infections, can sometimes cause complications during transfusions. Leukoreduction involves filtering out these white blood cells. This is crucial for:

• Patients with a history of febrile non-hemolytic transfusion reactions (FNHTRs), a common side effect caused by white blood cells.

• Immunocompromised individuals who are at higher risk of infection.

• Patients receiving multiple transfusions over time, as white blood cells can accumulate and lead to adverse reactions.

• Patients who are candidate for organ transplantation.

Irradiation: 

This specialized process involves exposing PRBCs to gamma radiation. It's like a targeted blast that disrupts the DNA of white blood cells, preventing them from multiplying and causing a dangerous condition called transfusion-associated graft-versus-host disease (TA-GVHD). Irradiation is essential for:

• Patients with severely weakened immune systems, such as those undergoing bone marrow transplants or receiving certain cancer treatments.

• Recipients who are closely related to the donor, as this increases the risk of TA-GVHD.

• Fetuses receiving intrauterine transfusions.

Frozen PRBCs: 

Freezing allows us to store PRBCs for extended periods, sometimes up to 10 years. This is invaluable for:

• Rare blood types that are difficult to find on short notice.

• Maintaining a reserve of PRBCs for emergency situations.

• Supplying remote areas where regular blood donations may not be readily available.

• Autologous donations (donating blood for your own future use), especially for scheduled surgeries.

• Patients with rare antibodies that make it difficult to find compatible blood donors.

Washed PRBCs: 

Washing PRBCs involves removing the plasma and other residual components. This reduces the risk of allergic reactions in individuals who are sensitive to plasma proteins. Washed PRBCs are primarily used for:

• Patients with a history of severe allergic reactions to transfusions.

• IgA-deficient individuals who lack a specific type of antibody and can have severe reactions to plasma.

• Infants and young children, as their immune systems may be more sensitive to plasma proteins.

By tailoring PRBCs through these modifications, we ensure that every patient receives the safest and most effective transfusion possible.

5. Safety First: Rigorous Testing

Before any PRBCs are transfused, they undergo extensive testing for infectious diseases like HIV, hepatitis, and syphilis. Blood type (A, B, AB, O) and Rh factor (positive or negative) are also meticulously checked to ensure compatibility between the donor and recipient.

Your blood will undergo rigorous testing

Your Blood Donation Matters!

Whether it's a simple PRBC transfusion or a more specialized product, blood donations save lives every day. Consider donating blood if you're eligible – you could be a part of this amazing process!

Important Note: This blog post is for informational purposes only and should not be considered medical advice. Always consult with your doctor if you have any questions or concerns about blood transfusions.