Guide to Blood Plasma Products and Their Applications – Part One
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Guidelines for Transfusions
Guidelines for Transfu- sion Prepared by: Community Transfusion Committee Lincoln, Nebraska CHAIR: Aina Silenieks, MD MEMBERS: L. Bausch, M.D. R. Burton, M.D. S. Dunder, M.D. D. Voigt, M.D. B. J. Wilson, M.D. COMMUNITY Becky Croner REPRESENTATIVES: Ellen DiSalvo Christa Engel Phyllis Ericson Kelly Gillaspie Pat Gilles Vic Grdina Jessica Henrichs Kelly Jensen Laurel McReynolds Christina Nickel Angela Novotny Kelley Thiemann Janet Wachter Jodi Wikoff Guidelines For Transfusion Community Transfusion Committee INTRODUCTION The Community Transfusion Committee is a multidisciplinary group that meets to monitor blood utilization practices, establish guidelines for transfusion and discuss relevant transfusion related topics. It is comprised of physicians from local hospitals, invited guests, and community representatives from the hospitals’ transfusion services, nursing services, perfusion services, health information management, and the Nebraska Community Blood Bank. These Guidelines for Transfusion are reviewed and revised biannually by the Community Trans- fusion Committee to ensure that the industry’s most current practices are promoted. The Guidelines are the standard by which utilization practices are evaluated. They are also de- signed to provide helpful information to assist physicians to provide appropriate blood compo- nent therapy to patients. Appendices have been added for informational purposes and are not to be used as guidance for clinical decision making. ADULT RED CELLS A. Indications 1. One of the following a. Hypovolemia and hypoxia (signs/symptoms: syncope, dyspnea, postural hypoten- sion, tachycardia, angina, or TIA) secondary to surgery, trauma, GI tract bleeding, or intravascular hemolysis, OR b. Evidence of acute loss of 15% of total blood volume or >750 mL blood loss, OR c. -
27. Clinical Indications for Cryoprecipitate And
27. CLINICAL INDICATIONS FOR CRYOPRECIPITATE AND FIBRINOGEN CONCENTRATE Cryoprecipitate is indicated in the treatment of fibrinogen deficiency or dysfibrinogenaemia.1 Fibrinogen concentrate is licenced for the treatment of acute bleeding episodes in patients with congenital fibrinogen deficiency, including afibrinogenaemia and hypofibrinogenaemia,2 and is currently funded under the National Blood Agreement. Key messages y Fibrinogen is an essential component of the coagulation system, due to its role in initial platelet aggregation and formation of a stable fibrin clot.3 y The decision to transfuse cryoprecipitate or fibrinogen concentrate to an individual patient should take into account the relative risks and benefits.3 y The routine use of cryoprecipitate or fibrinogen concentrate is not advised in medical or critically ill patients.2,4 y Cryoprecipitate or fibrinogen concentrate may be indicated in critical bleeding if fibrinogen levels are not maintained using FFP. In the setting of major obstetric haemorrhage, early administration of cryoprecipitate or fibrinogen concentrate may be necessary.3 Clinical implications y The routine use of cryoprecipitate or fibrinogen concentrate in medical or critically ill patients with coagulopathy is not advised. The underlying causes of coagulopathy should be identified; where transfusion is considered necessary, the risks and benefits should be considered for each patient. Specialist opinion is advised for the management of disseminated intravascular coagulopathy (MED-PP18, CC-PP7).2,4 y Cryoprecipitate or fibrinogen concentrate may be indicated in critical bleeding if fibrinogen levels are not maintained using FFP. In patients with critical bleeding requiring massive transfusion, suggested doses of blood components is 3-4g (CBMT-PP10)3 in adults or as per the local Massive Transfusion Protocol. -
Association Between ABO and Duffy Blood Types and Circulating Chemokines and Cytokines
Genes & Immunity (2021) 22:161–171 https://doi.org/10.1038/s41435-021-00137-5 ARTICLE Association between ABO and Duffy blood types and circulating chemokines and cytokines 1 2 3 4 5 6 Sarah C. Van Alsten ● John G. Aversa ● Loredana Santo ● M. Constanza Camargo ● Troy Kemp ● Jia Liu ● 4 7 8 Wen-Yi Huang ● Joshua Sampson ● Charles S. Rabkin Received: 11 February 2021 / Revised: 30 April 2021 / Accepted: 17 May 2021 / Published online: 8 June 2021 This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply 2021, corrected publication 2021 Abstract Blood group antigens are inherited traits that may play a role in immune and inflammatory processes. We investigated associations between blood groups and circulating inflammation-related molecules in 3537 non-Hispanic white participants selected from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Whole-genome scans were used to infer blood types for 12 common antigen systems based on well-characterized single-nucleotide polymorphisms. Serum levels of 96 biomarkers were measured on multiplex fluorescent bead-based panels. We estimated marker associations with blood type using weighted linear or logistic regression models adjusted for age, sex, smoking status, and principal components of p 1234567890();,: 1234567890();,: population substructure. Bonferroni correction was used to control for multiple comparisons, with two-sided values < 0.05 considered statistically significant. Among the 1152 associations tested, 10 were statistically significant. Duffy blood type was associated with levels of CXCL6/GCP2, CXCL5/ENA78, CCL11/EOTAXIN, CXCL1/GRO, CCL2/MCP1, CCL13/ MCP4, and CCL17/TARC, whereas ABO blood type was associated with levels of sVEGFR2, sVEGFR3, and sGP130. -
Cryosupernatant Plasma
Cryosupernatant Plasma APPLICABILITY: This document applies to Other Names: Cryopoor Plasma AHS, Covenant Health, and all other health Class: Human blood component care professionals involved in the transfusion of blood components and products in Alberta INTRAVENOUS OTHER Intermittent Continuous ROUTES DIRECT IV SC IM OTHER Infusion Infusion Acceptable No Yes No No No N/A Routes* * Professionals performing these restricted activities have received authorization from their regulatory college and have the knowledge and skill to perform the skill competently. DESCRIPTION OF PRODUCT: . Cryosupernatant Plasma (CSP) is prepared from slowly thawed Frozen Plasma that is centrifuged to separate the insoluble cryopreciptate from the plasma. The remaining Cryosupernatant plasma is then refrozen. The approximate volume of a unit is 273 mL . CSP has reduced levels of Factor VIII and von Willebrand Factor (vWF), and does not contain measurable amounts of Factor VIII or fibrinogen. Donors are screened and blood donations are tested for: . ABO/Rh and clinically significant antibodies . Antibodies to human immunodeficiency virus (HIV-1 and HIV-2), hepatitis C virus (HCV), human T-cell lymphotropic virus type I and II (HTLV-I/II), hepatitis B core antigen (HBcore) . Hepatitis B Surface Antigen (HBsAg) . Presence of viral RNA (HIV-1 and HCV) and viral DNA (hepatitis B virus (HBV)) . Syphilis AVAILABILITY: . Not all laboratories/transfusion services stock CSP. Product is stored frozen, and as a result requires preparation time prior to issuing. Patient blood type should be determined when possible to allow for ABO specific/compatible plasma transfusion INDICATIONS FOR USE: . Plasma exchange in patients with Thrombotic Thrombocytopenic Purpura (TTP) or Hemolytic Uremic Syndrome (HUS). -
Guidelines for Transfusion and Patient Blood Management, and Discuss Relevant Transfusion Related Topics
Guidelines for Transfusion and Community Transfusion Committee Patient Blood Management Community Transfusion Committee CHAIR: Aina Silenieks, M.D., [email protected] MEMBERS: A.Owusu-Ansah, M.D. S. Dunder, M.D. M. Furasek, M.D. D. Lester, M.D. D. Voigt, M.D. B. J. Wilson, M.D. COMMUNITY Juliana Cordero, Blood Bank Coordinator, CHI Health Nebraska Heart REPRESENTATIVES: Becky Croner, Laboratory Services Manager, CHI Health St. Elizabeth Mackenzie Gasper, Trauma Performance Improvement, Bryan Medical Center Kelly Gillaspie, Account Executive, Nebraska Community Blood Bank Mel Hanlon, Laboratory Specialist - Transfusion Medicine, Bryan Medical Center Kyle Kapple, Laboratory Quality Manager, Bryan Medical Center Lauren Kroeker, Nurse Manager, Bryan Medical Center Christina Nickel, Clinical Laboratory Director, Bryan Medical Center Rachael Saniuk, Anesthesia and Perfusion Manager, Bryan Medical Center Julie Smith, Perioperative & Anesthesia Services Director, Bryan Medical Center Elaine Thiel, Clinical Quality Improvement/Trans. Safety Officer, Bryan Med Center Kelley Thiemann, Blood Bank Lead Technologist, CHI Health St. Elizabeth Cheryl Warholoski, Director, Nebraska Operations, Nebraska Community Blood Bank Jackie Wright, Trauma Program Manager, Bryan Medical Center CONSULTANTS: Jed Gorlin, M.D., Innovative Blood Resources [email protected] Michael Kafka, M.D., LifeServe Blood Center [email protected] Alex Smith, D.O., LifeServe Blood Center [email protected] Nancy Van Buren, M.D., Innovative -
Therapeutic Apheresis, J Clin Apheresis 2007, 22, 104-105
Apheresis: Basic Principles, Practical Considerations and Clinical Applications Joseph Schwartz, MD Anand Padmanabhan, MD PhD Director, Transfusion Medicine Assoc Med Director/Asst Prof Columbia Univ. Medical Center BloodCenter of Wisconsin New York Presbyterian Hospital Medical College of Wisconsin Review Session, ASFA Annual meeting, Scottsdale, Arizona, June 2011 Objectives (Part 1) • Mechanism of Action • Definitions • Technology (ies) • Use • Practical Considerations • Math • Clinical applications – HPC Collection Objectives (Part 2) • Clinical applications: System/ Disease Specific Indications • ASFA Fact Sheet Apheresis •Derives from Greek, “to carry away” •A technique in which whole blood is taken and separated extracorporealy, separating the portion desired from the remaining blood. •This allows the desired portion (e.g., plasma) to be removed and the reminder returned. Apheresis- Mechanism of Action •Large-bore intravenous catheter connected to a spinning centrifuge bowl •Whole blood is drawn from donor/patient into the centrifuge bowl •The more dense elements, namely the RBC, settle to the bottom with less dense elements such as WBC and platelets overlying the RBC layer and finally, plasma at the very top. Apheresis: Principles of Separation Platelets (1040) Lymphocytes Torloni MD (1050-1061) Monocytes (1065 - 1069) Granulocyte (1087 - 1092) RBC Torloni MD Torloni MD Separate blood components is based on density with removal of the desired component Graphics owned by and courtesy of Gambro BCT Principals of Apheresis WBC Plasma Torlo RBC ni MD Torloni MD RBC WBC Plasma G Cobe Spectra Apheresis- Mechanism of Action Definitions • Plasmapheresis: plasma is separated, removed (i.e. less than 15% of total plasma volume) without the use of replacement solution • Plasma exchange (TPE): plasma is separated, removed and replaced with a replacement solution such as colloid (e.g. -
Blood Collection and Handling Tube Additives, Tube Type Most Laboratory Tests Are Performed on Plasma, Serum, Or Whole Blood
Blood Collection and Handling Tube Additives, Tube Type Most laboratory tests are performed on plasma, serum, or whole blood. To preserve the specimen in the form required by the test, collection tubes contain additives that either prevent coagulation (for plasma and whole blood recovery), or activate coagulation (for serum recovery). Please refer to individual test requirements. Drawing Order When multiple tubes are drawn, it is important to prioritize the drawing order to prevent a Table 1. Vacutainer Order Of Draw tube additive from contaminating the next tube and altering the chemical composition of the 1. Navy Blue (metals testing) following specimen. Coagulation tests are highly susceptible to interference from 2. Blood culture bottles / SPS tubes contamination from tissue fluid and tube additives; therefore these tests are usually collected 3. Coagulation tests: first when a series of tubes are collected. Prior to collecting tests for coagulation (i.e. Blue top a. Clear top “waste” tube tube) a plain Clear top tube containing no additive must be partially filled and discarded. b. Light Blue top This “waste” tube prevents tissue thromboplastins from contaminating the Blue top tube. Blue top tubes must be allowed to fill to the line indicated on the tube, exhausting the 4. Gold top vacuum. See Table 1, “Vacutainer Order of Draw” for proper collection order of vacutainer 5. Plain Red top tubes. 6. Dark Green top (heparin) 7. Light Green top Certain blood collection techniques have been identified as possible sources of error in 8. Lavender or Pink top laboratory testing. Avoid the following sources of test error when collecting blood: 9. -
Ubc Department of Medicine 2005 Annual Report
UBC DEPARTMENT OF MEDICINE 2005 ANNUAL REPORT TABLE OF CONTENTS MESSAGE FROM DR. GRAYDON MENEILLY….….….….………………………………3 MISSION STATEMENT.……………………………………………………...……………….7 ORGANIZATION CHART.………………………………………………...………………….9 UBC DEPARTMENT OF MEDICINE COMMITTEE STRUCTURES………………..…11 UBC DEPARTMENT OF MEDICINE ADMINISTRATIVE OFFICE...………………….13 UBC DEPARTMENT OF MEDICINE COMMITTEES..………………………………….. 15 Department Heads, Associate Heads, UBC Division Heads, Educational Program Directors & Associate Directors.………………………………………… 17 Research………………………………………………………………………………………….19 Committee for Appointments, Reappointments, Promotion and Tenure.………………………. 21 Teaching Effectiveness Office.…………………………………………………………………..25 DIVISION REPORTS.…………………………………………………………………………27 Allergy & Immunology.………………………………………………………………………… 29 Cardiology.……………………………………………………………………………………….33 Critical Care Medicine.…………………………………………………………………………..45 Dermatology.……………………………………………………………………………………. 49 Endocrinology.………………………………………………………………………………….. 55 Gastroenterology.…………………………………………………………………………….…. 59 General Internal Medicine.……………………………………………………………………… 63 Geriatric Medicine.……………………………………………………………………………… 67 Hematology.…………………………………………………………………………………….. 71 Infectious Diseases.………………………………………………………………………………75 Medical Oncology.……………………………………………………………………………… 81 Nephrology.…………………………………….……………………………………………..… 87 Neurology.……………………………………….…………………………………………….... 93 Occupational Medicine…………………………………………………………………………109 Physical Medicine & Rehabilitation.…………………………………………………………...113 Respiratory -
A Fatal Case of Severe Hemolytic Disease of Newborn Associated with Anti-Jkb
J Korean Med Sci 2006; 21: 151-4 Copyright � The Korean Academy ISSN 1011-8934 of Medical Sciences A Fatal Case of Severe Hemolytic Disease of Newborn Associated with Anti-Jkb The Kidd blood group is clinically significant since the Jk antibodies can cause acute Won Duck Kim, Young Hwan Lee* and delayed transfusion reactions as well as hemolytic disease of newborn (HDN). In general, HDN due to anti-Jkb incompatibility is rare and it usually displays mild Department of Pediatrics, Dongguk University, College of Medicine, Gyeongju; Department of Pediatrics*, clinical symptoms with a favorable prognosis. Yet, we apparently experienced the Yeungnam University, College of Medicine, Daegu, second case of HDN due to anti-Jkb with severe clinical symptoms and a fatal out- Korea come. A female patient having the AB, Rh(D)-positive boodtype was admitted for jaundice on the fourth day after birth. At the time of admission, the patient was lethar- gic and exhibited high pitched crying. The laboratory data indicated a hemoglobin value of 11.4 mg/dL, a reticulocyte count of 14.9% and a total bilirubin of 46.1 mg/dL, Received : 18 October 2004 a direct bilirubin of 1.1 mg/dL and a strong positive result (+++) on the direct Coomb’s Accepted : 11 February 2005 test. As a result of the identification of irregular antibody from the maternal serum, anti-Jkb was detected, which was also found in the eluate made from infant’s blood. Despite the aggressive treatment with exchange transfusion and intensive photother- apy, the patient died of intractable seizure and acute renal failure on the fourth day Address for correspondence of admission. -
05-2019 Human Plasma Fraction.Pdf
ANNEX 4 WHO RECOMMENDATIONS FOR THE PRODUCTION, CONTROL AND REGULATION OF HUMAN PLASMA FOR FRACTIONATION Adopted by the 56th meeting of the WHO Expert Committee on Biological Standardization, 24-28 October 2005. A definitive version of this document, which will differ from this version in editorial but not scientific detail, will be published in the WHO Technical Report Series. Page 2 TABLE OF CONTENTS Page TABLE OF CONTENTS................................................................................................................. INTRODUCTION............................................................................................................................ 1 INTERNATIONAL BIOLOGICAL REFERENCE PREPARATIONS ............................ 2 LIST OF ABBREVIATIONS AND DEFINITION USED ................................................... 3 GENERAL CONSIDERATIONS........................................................................................... 3.1 Range of products made from human blood and plasma ....................................................... 3.2 Composition of human plasma............................................................................................... 3.3 Pathogens present in blood and plasma.................................................................................. 4 MEASURES TO EXCLUDE INFECTIOUS DONATIONS ............................................... 4.1 Appropriate selection of blood/plasma donors....................................................................... 4.2 Screening of -
There Are Four Basic Components That Comprise Human Blood: Plasma, Red Blood Cells, White Blood Cells and Platelets
There are four basic components that comprise human blood: plasma, red blood cells, white blood cells and platelets. Red Blood Cells Red blood cells represent 40%-45% of your blood volume. They are generated from your bone marrow at a rate of four to five billion per hour. They have a lifecycle of about 120 days in the body. Platelets Platelets are an amazing part of your blood. Platelets are the smallest of our blood cells and literally look like small plates in their non-active form. Platelets control bleeding. Wherever a wound occurs, the blood vessel will send out a signal. Platelets receive that signal and travel to the area and transform into their “active” formation, growing long tentacles to make contact with the vessel and form clusters to plug the wound until it heals. Plasma Plasma is the liquid portion of your blood. Plasma is yellowish in color and is made up mostly of water, but it also contains proteins, sugars, hormones and salts. It transports water and nutrients to your body’s tissues. It is made up of: • Hormones. • Antibodies. • Enzymes. • Glucose. • Fat particles. • Salts. White Blood Cells Although white blood cells (leukocytes) only account for about 1% of your blood, they are very important. White blood cells are essential for good health and protection against illness and disease. Like red blood cells, they are constantly being generated from your bone marrow. They flow through the bloodstream and attack foreign bodies, like viruses and bacteria. They can even leave the bloodstream to extend the fight into tissue. -
7342.002: Inspection of Source Plasma Establishments, Brokers
Compliance Program Guidance Manual Chapter 42 – Blood and Blood Components Inspection of Source Plasma Establishments, Brokers, Testing Laboratories, and Contractors - 7342.002 Implementation Date: 6/1/2016 Completion Date: 1/31/2019 57DI-44 Source Plasma Product Codes: 57DI-55 Source Leukocytes Human 57DI-65 Therapeutic Exchange Plasma (TEP) 42002F Source Plasma Level 1 Inspection (all systems) Program Assignment Codes (PACs): 42002G Source Plasma Level 2 Inspection (two systems) 42002A Pre-License 42832 Pre-Approval In a Federal Register notice dated May 22, 2015 (80 FR 29842), the Food and Drug Administration (FDA) announced changes to the regulations for blood and blood components including Source Plasma that became effective on May 23, 2016. These changes were made, in part, to make the donor eligibility and testing requirements more consistent with current practices in the blood industry, to more closely align the regulations with current FDA recommendations, and to provide flexibility to accommodate advancing technology. Among other updates and changes to this Compliance Program, the following Attachments have been substantially revised to include the new requirements: Attachment C – Donor Eligibility System – Donor Screening & Deferral Attachment D – Product Testing System – Transfusion-Transmitted Infections (Relevant Transfusion Transmitted Infection(s)) Attachment F – Quarantine/Storage/Disposition – Donation Suitability, Restrictions on Distribution, Hold FIELD REPORTING REQUIREMENTS A. General FDA/Office of Regulatory Affairs