Jump to content

whole blood respin !


Recommended Posts

hi can i ask 3 questions?

1-can we respin whole blood bag to get more plasma or if plasma seems reddish ?

2-for example if a doctor request for (wash -filter -irradiate) RBCs unit what is first step ,second ,third ?

3-If we want to separate cryo from FFP into transfer bag this procedure must done in closed system by connecting device or can we do it in open system then freeze it (  due to effect of freezing on bacteria ) ?

thanks

Link to comment
Share on other sites

Your questions need a bit more context I think, not really sure if you're talking transfusion service or blood center. But maybe this will help.

1) In a US blood center setting, when processing freshly collected whole blood into RBCs and a plasma product, a second spin is typically allowed if there is blood in the ports (which means that blood would go through the port into the plasma bag) or poor RBC/Plasma separation. Typically you'd clear the ports, gently remix the WB a bit and then respin. Additional WB spins are not allowed. The centrifuge settings should be validated for your WB processing and you shouldn't see reddish plasma too often.

2) We leukoreduce before the WB is separated into RBCs and Plasma, and bedside filters are standard. So not sure what you mean about the filter step.  Washing and irradiating could be done in either order, but sometimes your computer system may define your process (for a while at my current employer you had to irradiate before washing because our computer system wasn't set up to allow you to wash and then irradiate, that modification path wasn't defined in the computer system). Washing shortens your outdate drastically while irradiation only reduces it to 4 weeks or the existing expiration date if shorter, so irradiating first might make more sense.

3) If you don't use a sterile connection device during your cryo production you've got an open system, and remember that freezing doesn't actually destroy any introduced bacteria. If you are making pooled cryo, using an open system shortens your thawed shelf life from six hours to four hours, but if you sterile dock during that process you get six hours. I'm not actually sure about single cryo units, you probably still have the four shelf life on that product after thawing. (and if you make open system single units and then pool you'll only get the four hour shelf life even if you do sterile dock during pooling). Closed system for making singles and pooling is pretty much the standard practice.

Link to comment
Share on other sites

In second question i mean foe example if a doctor want washed -filtered- irradiated RBCs unit what is the correct order for the three procedures?first then second then third and why ?

In third question if we have FFP unit without satellite bag  can we connect satellite bag  to FFP units to prepare cryo ( open system ) and freezing will affect on any bacterial contamination or we must do this in closed system ?

Link to comment
Share on other sites

2 hours ago, sherif said:

In second question i mean foe example if a doctor want washed -filtered- irradiated RBCs unit what is the correct order for the three procedures?first then second then third and why ?

Most leukoreductions systems have times limits.  You want to get as many of the WBCs out as soon as possible to prevent them from breaking down and releasing cytokines.  I would see what your manufacturer requires for leukoreduction.

Once it is washed, it is an open system and only has a 24 hour expiration.  You could wash / irradiate in either order.  Irradiating will release potassium from the cells, but even if you irradiate after washing, the release during that 24 hour period will be minimal.

2 hours ago, sherif said:

In third question if we have FFP unit without satellite bag  can we connect satellite bag  to FFP units to prepare cryo ( open system ) and freezing will affect on any bacterial contamination or we must do this in closed system ?

Can you sterilely dock on the bag instead?

Link to comment
Share on other sites

thanks

but in second question if a doctor need this RBCs unit in the same day and i want to do the three procedures : filterate it then irradiate then wash or what ? and why ?

And in the third question if this procedure done in open system the 2 bag (CSP and CRYO ) are affected with their preparation( i mean their expire date )  or not ?

And in first question whole blood respin can cause RBCs hemolysis or not ?

Link to comment
Share on other sites

14 hours ago, sherif said:

but in second question if a doctor need this RBCs unit in the same day and i want to do the three procedures : filterate it then irradiate then wash or what ? and why ?

Filtering is to remove white blood cells.  They are not useful in transfusion and often cause transfusion reactions.  Irradiating "inactivates" the white cells by destroying the DNA within the cells and preventing them from engrafting in the recipient.  Washing removes plasma proteins, these can also cause transfusion reactions.

14 hours ago, sherif said:

And in the third question if this procedure done in open system the 2 bag (CSP and CRYO ) are affected with their preparation( i mean their expire date )  or not ?

http://www.aabb.org/resources/marketplace/Documents/Primer.pdf

14 hours ago, sherif said:

And in first question whole blood respin can cause RBCs hemolysis or not ?

I'm not sure, possibly, but unlikely.

Link to comment
Share on other sites

7 hours ago, Cliff said:

Filtering is to remove white blood cells.  They are not useful in transfusion and often cause transfusion reactions.  Irradiating "inactivates" the white cells by destroying the DNA within the cells and preventing them from engrafting in the recipient.  Washing removes plasma proteins, these can also cause transfusion reactions.

thanks but my question not about their benefits my question if i want to do the three procedures for RBCs unit will i start with filtering it then irradiate it finally wash it or what  ?

Link to comment
Share on other sites

12 minutes ago, sherif said:

thanks but my question not about their benefits my question if i want to do the three procedures for RBCs unit will i start with filtering it then irradiate it finally wash it or what  ?

I suspect it does not matter.

For the filtering, you need to follow the manufacturers instructions from the timeline for filtering.  Most require the product to be filtered early in its life.

If it were me, and this is based on preference, not any rules, I would:

  1. Filter
  2. Irradiate
  3. Wash

Filtering is likely required early in the products life, irradiating releases potassium, washing will help remove some of that potassium.

Link to comment
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
  • Recently Browsing   0 members

    • No registered users viewing this page.
  • Advertisement

×
×
  • Create New...

Important Information

We have placed cookies on your device to help make this website better. You can adjust your cookie settings, otherwise we'll assume you're okay to continue.