4 BLOOD COMPONENTS

A listing of the description, action, indications, side effects, dosage and

administration of blood components may be found in the "Circular of
Information for the Use of Human Blood and Blood Components and the
Circular for the Use of Cellular Therapy Products." This circular is available on
patient care units, and may also be obtained from the Blood Bank. The label of
each component, except Cryoprecipitated Antihemophilic Globulin, contains the
anticoagulant or preservative solution used for that component. A description of
the various anticoagulant and preservative solutions for blood components may
be found in Appendix B. A list of component abbreviations used on the patient's
medical record may be found in Appendix C. If additional information is
required, please consult the Blood Bank medical or supervisory staff. Not
included in this chapter are peripheral blood progenitor cells or bone marrow
used solely for bone marrow transplantation purposes.
Beginning May 1, 2006, requests for CMV seronegative blood components will
be filled with prestorage leukocyte-reduced blood components. 5/1/06
Red Cell Components
WHOLE BLOOD
This component is not available. Requests for Whole Blood will be referred to
the Blood Bank Medical Staff for review. When exchange transfusion of a
neonatal patient is required, the Blood Bank will provide Red Blood Cells
resuspended in Fresh Frozen Plasma.
RED BLOOD CELLS, Leukocyte-Reduced
Crossmatch:
Approximate

Required
340-400 mL AS-1 or AS-3 Additive sol.

Volume:

200 mL ACD-A Apheresis

42 days (AS-1 or AS-3 additive solution)

Outdate:

35 days CPDA-1
21 days ADC-A

55-65 % Additive solutions

Hematocrit:

70-80 % CPDA-1
56-59% ACD-A Apheresi

Storage
Conditions:
Minimum
Preparation

1-6C in a monitored blood refrigerator

20 minutes

Time:
Dose Adult:
1 unit per 1 gm Hgb rise desired
Pediatrics:
5-15 mL/kgm body weight
Description: Contains red cells from one unit of whole blood plus a small
amount of plasma and anticoagulant, and for AS-1 and AS-3 and AS-5 units,
approximately 110 mL of additive solution. Apheresis Red cells contain red
cells, and either anticoagulant ACD-A or sodium citrate. The transfusion of one
unit of red cells is expected to increase the hemoglobin 1-1.5 g/dL in the 70 kG
patient. All Red Blood Cells routinely issued have reduced leukocyte content
through prestorage filtration by our blood supplier. Such processing reduced the
risk of CMV transmission, febrile transfusion reactions and platelet transfusion
refractoriness. Beginning May 1, 2006, requests for CMV seronegative blood
components will be filled with prestorage leukocyte-reduced blood
components. 5/1/06
Indications: Patients whose symptomatic deficit of oxygen carrying capacity
cannot be corrected by alternative therapy. A hemoglobin or hematocrit should
be measured before each transfusion except in the case of severe hemorrhage.
Usually indicated when the Hgb is <6 g/dL. Rarely indicated when the Hgb is >
10 g/dL.

RED BLOOD CELLS, Washed

Crossmatch:
Appriximate
Volume:
Outdate:
Storage
Conditions:
Minimum
Preparation

Required
220 mL
24 hours after washing
1-6C in a monitored blood refrigerator
12-24 hours. Longer time intervals will be necessary if the
component is ordered at night or on weekends. This

Time:
component is ordered specially from the blood supplier.
Dose Adult: 1 unit per 1 gm Hgb rise desired
Pediatrics: 5-15 mL/kgm body weight
Description: A unit of Red Blood Cells that has been washed and resuspended
in a saline solution. If RBC Washed are ordered for a patient and subsequently
canceled, Blood Bank personnel will attempt to allocate the component to
another patient
Indications::Prevention of severe allergic reactions to plasma proteins, as for
patients with anti-IgA antibodies.
RED BLOOD CELLS, FROZEN DEGLYCEROLIZED
Crossmatch:
Approximate
Volume:
Outdate:
Storage
Conditions:
Minimum
Preparation

Required
200 mL
24 hours after deglycerolization
1-6C in a monitored blood refrigerator
12-24 hours. Longer intervals will be necessary if the

component is ordered at night and on weekends.

Time:
Dose Adult: 1 unit per 1 gm Hgb rise desired
Pediatrics: 5-15 mL/kgm body weight
Description: A unit of Red Blood Cells that was once frozen in glycerol and

has subsequently been thawed, deglycerolized and resuspended in a dextrosesaline solution. Only indate units may be frozen.
Indications:: The provision of blood for patients with antibodies requiring rare
units. The use of Frozen Deglycerolized Red Blood Cells to prevent febrile
transfusion reactions has been supplanted by the use of Leukocyte Reduced
Red Blood Cells.
Plasma Components
PLASMA: SDPL, SDPL1, SDPL2, SDPL3, SDPL4 (6/25/07)
Crossmatch:
Approximate
Volume:
Outdate:
Storage

Not required, a blood sample may be required to determine

patient ABO and Rh type
200-275 mL SDPL
5 days after thawing
After thawing, 1-6C in a monitored blood refrigerator;

Conditions:
Minimum

Return to Blood Bank immediately if not needed

45 minutes unless processing of a blood specimen is

Preparation

required. Thawed plasma is available in 22 minutes, Of

Time:
available, prethawed plasma is available in 15 minutes.
Dose:
10-15 mL/kg body weight
Description: Each unit of Plasmacontains the equivalent plasma obtained by
centrifugation and separation from one unit of whole blood. Plasma has the
same risk of disease transmission as Red Blood Cells. Plasma contains ABO
anitbodies. While the levels of Factors V and VIII in thawed Plasma decreases
slightly over 5 days, this is not clinically significant. Normal levels of
coagulation factors including fibrinogen (300-500 mg/unit) are present.
Indications::Plasma is indicated for patients with a documented deficiency of
coagulation factor for which there is not specific concentrate available. Patients
requiring coagulation factor VIII are best treated with coagulation factor VIII
concentrate (available from the pharmacy) or cryoprecipitated antihemophilic

globulin.
Plasma may be used for correction of coagulation factor deficiencies,
Warfarin reversal and microangiopathic hemolytic anemia such as thrombotic
thrombocytopathic anemia.
Plasma is indicated for patients with coagulopathy due to massive transfusion
and replacement of specific plasma proteins.
Contraindications:Plasma is not indicated for prophylactic use when the INR is
< 1.5 and the APTT is <1.5 times the upper linit of normal.
Infusion Instructions:
Rate: 10 mL/minute
Plasma components must be administered through a standard blood
infusion
The usual volume of Plasma is between 175 and 250 mL
Previously frozen plasma does not contain red blood cells. Plasma from Rh
positive donors may be given to patients who are Rh negative.

Platelets
PLATELETS LEUKOCYTE REDUCED (PPLR), Prepooled Platelets,
Leukocyte Reduced (PPLRP and PLP5)
Revised 10/9/07, 7/28/2008
Crossmatch:
Approximate

Not required; a blood sample may be required

45-60 mL/unit; usually dispensed as a pool of 5 units for a

Volume:

total volume of -225 to325 mL

Single units or Prepooled-5d outdate five days after the date

of collection
Outdate:

4 hours after pooling on-site.

Return component to Blood Bank immediately if component

Storage
Conditions:
Minimum
Preparation

is no longer required
20-24C (room temperature), with constant, gentle
agitation. DO NOT REFRIGERATE. Do not store on
patient units or in the operating room.
10 minutes if prepooled, 20 minutes if pooled; 2 hours if

volume reduced or washed

Time:
Dose Adult: 5 units
Pediatrics: 10-15 mL/kg body weight
Description: A minimum of 5.5 x 10 10th platelets harvested from one unit of
fresh whole blood in approximately 50 mL of donor plasma. Pooled platelets
usually represent a pool of five platelet units and contain 3.0 to 5.0 x 10 11th
platelets in approximately 300 mL of plasma .The product is leukocyte-reduced
at the time of preparation by the blood supplier. This results in the infusion of
less than 8.3 x 105 white blood cells per component. Prepooled platelets are
prepared in a standard dose of 5 units per pool and are tested for bacterial
contamination by a culture method. Individual whole blood platelets are tested
for bacterial contamination on site by the pH method.
Platelet Counts: A 10 minute or 1 hour and a 24-hour post-transfusion platelet
count is recommended to assess patient response.
Indications:: Treatment of thrombocytopenia or defects of platelet function.
Requests must be substantiated by appropriate coagulation tests and clinical
data. Prophylactic use of this component for a thrombocytopenic patient who is
not bleeding is not indicated if the platelet count exceeds 10 x 10 9th/L.
Patients undergoing major operative procedures generally should have platelet

counts above 70 x 10 9th/L for effective hemostasis. Each unit of random donor
platelets will raise the platelet count of an adult approximately 5-10 x 10 9th/L
under optimal conditions, although clinical response to platelet transfusions is
diminished by fever, hypersplenism, infection, DIC, some drugs and preformed
antibodies to platelet antigens. Rarely indicated if the platelet count is >100,000
unless there is platelet dysfunction. Persistent failure to respond to the
product may indicate a refractory state.
Contraindications:: Transfusion of platelets to patients with thrombotic
thrombocytopenic purpura (TTP) or heparin-induced thrombocytopenia is
absolutely contraindicated, except in cases of life-threatening hemorrhage,
because fatal intravascular coagulation may occur. Transfusion of platelets in
idiopathic thrombocytopenic purpura (ITP), posttransfusion purpura, and
highly alloimmunized patients is ineffective because of their shortened
intravascular survival time, although they may be used at the time of
splenectomy or to treat active bleeding.
Availability: Requests for platelet pooled components should be made only if
the component is to be transfused immediately. To ensure maximum benefit
and avoid unnecessary component loss, Pooled Platelets should be transfused
as soon as available. Platelets must not be refrigerated.
Compatibility: ABO and Rh compatible platelets will be selected and released
for transfusion. If this is not feasible because of limited inventory and/or
emergent need for the component, ABO and/or Rh incompatible platelets may
be issued.
Rh Incompatibility:It may be advisable to administer Rho (D) immune globulin
to selected Rh-negative patients who receive platelets from Rh- positive
donors, since sensitization to red cell antigens may occur from the few red cells
present in platelets.
PLATELETS, PHERESIS (Single Donor Platelets)

Crossmatch:
Appriximate
Volume:
Outdate:
Storage

May be required. See crossmatched platelets.

200-350 mL
24 hours or 5 days depending on collection system
20-24C (room temperature) with constant, gentle

Conditions:
Minimum

agitation. DO NOT REFRIGERATE

Preparation

24-48 hours after initial order, Pathology review required

Time:
Dose Adult:
1unit
Description: Each unit of this component is obtained by automated apheresis
from one donor and contains a minimum of 3 x 10 11th/L platelets (the
equivalent of the number platelets contained in 5units of random donor
platelets) plus 200-350 mL of plasma with acid citrate dextrose (ACD) as the
anticoagulant. Leukocyte reduced Single Donor Platelets contain less than 5 x
10 6th residual leukocytes.
Indications:: For aplastic anemia and clinical refractoriness. Most surgical
patients do not require platelet transfusion on a long-term basis and can be
transfused successfully perioperatively with random donor platelets.
HLA-Matched Platelets: HLA-matched Single Donor Pheresis Platelets are
available through the Southeastern Michigan Red Cross Blood Center. The
patient's HLA type must be determined prior to or concurrent with the initial
order. The diagnosis of this refractory state is based on both clinical
considerations and the lack of the anticipated increase in the initial platelet
count 10 minutes or l hour and 24 hours after transfusion with random platelets.
Ordering Procedure: Requests for HLA platelets require a Pathology consult
and approval.
CROSSMATCHED PLATELETS, PHERESIS
Crossmatch:
Approximate

Performed at the Southeastern Michigan Red Cross.

200-350 mL

Volume:
Outdate:
Storage

24 hours or 5 days depending on collection system

20-24C (room temperature) with constant, gentle

Conditions:
agitation. DO NOT REFRIGERATE
Availability:
24-48 hours after initial order
Description: Each unit of this component is obtained by automated apheresis
from one donor and contains a minimum of 3 x 10 11th/L platelets (the
equivalent of the number platelets contained in 5units of random donor
platelets) plus 200-350 mL of plasma with acid citrate dextrose (ACD) as the
anticoagulant. Leukocyte reduced crossmatched platelets contain less than 5 x
10 6th residual leukocytes. Crossmatched platelets are selected by a solid phase
technique that tests the patient's serum against donor platelets. Only platelets
considered non-reactive are issued as crossmatched platelets.
Indications:: For patients refractory to platelet transfusions. The diagnosis of
this refractory state is based on both clinical considerations and the lack of the
anticipated increase in the platelet count 10 minutes or l hour and 24 hours after
transfusion with random platelets.
Ordering Procedure: Requests for crossmatched platelets require a Pathology
consult and approval.
GRANULOCYTES, PHERESIS (GRAN)
Crossmatch:
Approximate
Volume:
Outdate:
Storage
Conditions:
Minimum
Preparation

Required
250-350 mL
24 hours
20-24C (room temperature) DO NOT REFRIGERATE

24-48 hours

Time:
Dose: 1 unit per day until afebrile or WBC is >0.9 x109

Description: Each unit contains approximately 1 x 10 10th granulocytes

obtained from a single donor by automated apheresis. This component also
contains 20-50 mL of red cells and may contain 2-3x10 11th platelets.
Indications:: Selected infected leukopenic patients with a granulocyte count of
less than 0.5 x 109/L who have not responded to more than 48 hours of
appropriate antibiotic therapy. Consult the Blood Bank before ordering
granulocytes.
Contraindications:HLA alloimmunization, transfusion reactions to
granulocytes. In some patients, granulocytes need to be collected from CMV
seronegative or HLA matched donors. Granulocyte transfusions should be
discontinued when the patient becomes afebrile, at the onset of transfusion
reactions, when the granulocyte count exceeds 1.0 x 10 9th/L or in the absence
of a clinical response after 14 days. Except in unusual circumstances,
granulocyte transfusions are not indicated when there is no expectation that the
patient's bone marrow will recover sufficiently to produce an adequate number
of endogenous granulocytes to sustain life.
Ordering Procedure: Requests granulocytes require a Pathology consult and
approval. Granulocyte transfusions must be ABO compatible with the recipient.
Availability: This component will not be available for transfusion until late
evening or after midnight, yet should be transfused as soon as available to
ensure maximum benefit.
Infusion rate:Over 3-4 hours
Administration Instructions:
Do not administer through a leukocyte- reduction or microaggregate blood
filter. Administer through a Standard blood filter (Abbott No. 1871 or
equivalent filter).
Granulocytes MUST NOT be transfused within 4-6 hours of IV
amphotercin or flucanazole administration.
Premedication with an antipyretic (acetaminophen is recommended) to

avoid the need to discontinue transfusion due to a severe febrile reaction.

Infuse SLOWLY over 4 hours. The rate of infusion is ultimately dictated by
the recipient's ability to tolerate the component volume and by adverse
reactions
Monitor the patient closely for moderate to severe symptoms such as
urticaria, hives, wheezing, dyspnea, severe headache, cyanosis, hypotension,
agitation and tachycardia.
If such symptoms develop, stop the transfusion, keep the IV line open and
notify the patient's physician and the Blood Bank physician on-call for further
instructions.
Document vital signs every 15 minutes during the entire procedure, every
30 minutes for four hours after the transfusion and then every four hours for 24
hours

CRYOPRECIPITATED ANTIHEMOPHILIC GLOBULIN (CRYO)

(CRYOT) (CRYOP) (PTCRY)
(PTCR5)
Revised 3/22/07, 12/27/07
Crossmatch:

Not required, a blood sample may be required

5-10 mL per bag; may be dispensed as single units for
neonatal patients and children or as pools for adults. As of

Approximate

January 2008, the prepooled dose is 5 per bag. For adults,

Volume:

two pools of 5 (PTCR5) are dispensed for the standard adult

dose of 10 unit. . PTCRY (prepool of 10) has been

Outdate:

discontinued by the blood supplier.

For Coagulation factor VIII: 6 hours after thawing;

Storage

P pooled CRYO: 4 hours after pooling

20-24C Do not store, transfuse immediately; DO NOT

Conditions:
Minimum

REFRIGERATE

Preparation

45 minutes for thawing and pooling

Time:
Dose: Fibrinogen replacement: adult dose 10 pooled units
Pediatrics: 5 mL/kg body weight
Description: CRYO is Cryoprecipitated protein derived from the fresh plasma
separated from a unit of whole blood. Each individual unit (bag) has
approximately 100 units of Factor VIII activity, as well as 150-250 mg of
fibrinogen, suspended in 5-23 mL of plasma.A pool of 5 units is expected to
raise the fibrinogen level 25 to 50 mg/dL.
Indications:: Treatment of patients with Von Willebrand's disease and the
treatment of Factor XIII deficiency. Factor VIII concentrate, available from the
Pharmacy, is the product of choice for most hemophiliacs.
CRYO serves as a therapeutic source of fibrinogen. It may be indicated when
the fibrinogen is less than 100 mg/dL. It may also be of value for surgical
patients with a hemorrhagic diathesis due to uremia. Consultation with the
Blood Bank Medical Staff is required in these instances. CRYO may also be
used to prepare "surgical fibrin glue" for topical hemostasis.
Pooling: Prepooled CRYO (PTCR5) is a standard dose of 5 units of CRYO as
of January of 2008. If prepooled doses are not available CRYO is thawed and
pooled by Blood Bank personnel before issue for the convenience of nursing
staff and to ensure nearly complete transfer of the component to the patient.
CRYO components must be transfused as soon as possible after thawing to
ensure maximum patient benefit.
Infusion Instructions:
CRYO from Rh positive donors may be given to patients who are Rh
negative.

 Infusion Rate 10 mL per minute.

Use either a standard blood administration set or a special blood component
administration set.
Do not use a leukocyte-reduction filter.
DO NOT REFRIGERATE CRYO as this causes reprecipitation and loss
of Factor VIII activity.
At the completion of transfusion, approximately 20-30 mL of isotonic saline
should be fed into the cryoprecipitate bag to rinse product adherent to the walls
of the bag. CRYO does not contain red blood cells.
Clinical response to the component can be measured with post-transfusion
coagulation studies.

PARTIAL UNITS
RED BLOOD CELLS, ALIQUOTS (RBC Divided, RBC Half)
Crossmatch:
Approximate

Required for patients older than 4 months of age

1/2 units: 100-150 mL/unit;

Volume:

syringes: 10 - 50 mL
35 days (CPDA-1 anticoagulant)

Outdate:
Hematocrit:
Storage
Conditions:
Minimum
Preparation

4 hrs if dispensed in a syringe

55% AS-1 or
70-80%, CPDA-1
1-6C in a monitored blood refrigerator
45 minutes

Time:
Description: Red Blood Cells prepared from a unit of whole blood that is
further divided into smaller volumes (aliquots). The hematocrit of each
individual unit ranges from 55 to 80% depending on the anticoagulant.
Availability: Orders for partial units of Red Blood Cells should specify the
volume required for transfusion. When components are packaged in syringes,
unless otherwise requested, an additional 10 mL of component will be added
routinely to the syringe to allow for transfusion tubing "dead space". The
maximum volume to be contained in a syringe is 50 mL.
Only group O blood is routinely available in syringes. A limited number of
prestorage leukocyte-reduced, sickle cell negative units are available for
newborn infants. Partial units may also be ordered for patients with congestive
heart failure when transfusion of a whole unit would be problematic.
PLASMA, ALIQUOTS (FFPT1-3, FFPHA-D, SDP1-2, SDPA)
Crossmatch:
Approximate

Not required, a blood sample may be required

variable; 50-100 mL in bags;

Volume:

50 mL maximum in syringes
4 hours after thawing;

Outdate:
Storage
Conditions:
Minimum
Preparation

4 hrs after dispensing into a syringe

After thawing, 1-6C in a monitored blood refrigerator

15-30 minutes for thawing and unit preparation

Time:
Description: Many partial units of Plasma are prepared from group AB donors
lacking anti-A and anti-B. The plasma is frozen within eight hours of collection
to preserve coagulation factors V and VIII (see Fresh Frozen Plasma).
Indications:: When prepared from AB donors this component is suitable for
transfusion to all neonates regardless of ABO type whenever a small volume of

plasma is required. It can be made available for other pediatric patients by

special request.
RESUSPENDED LEUKOCYTE REDUCED WHOLE BLOOD
Crossmatch:
Approximate
Volume:
Outdate:
Hematocrit:
Storage
Conditions:
Minimum
Preparation

Required in some circumstances

350-500 mL
24 hours after resuspension
42 or 50%
1-6C in a monitored blood refrigerator

1 hour

Time:
Description: Red Blood Cells from which the supernatant storage solution has
been removed and resuspended in Fresh Frozen Plasma Liquid to
approximately a 50% hematocrit.
Indication: Exchange transfusion of a neonate. Resuspended whole blood will
not be prepared for other purposes unless approved by the Blood Bank Medical
Staff.

Rho(D) IMMUNE GLOBULIN (RHIG, WRHO, RHIV )(1/12/11)

Dose: 300 micrograms anti-D
Storage
2-8C
Conditions:
Description: A concentrated solution of gamma globulin with a high level of
anti-D activity. Both an intramuscular and intravenous preparations are
available. Both preparations are latex and thimerisol free.
Indication: Prevention of alloimmunization of Rh-negative women due to fetal

maternal hemorrhage of Rh positive fetal cells, to prevent sensitization of an

Rh negative patient who received Rh positive platelets,or to prevent
sensitization due to the inadvertent administration of a small volume of Rh
positive Red Blood Cells. A sterilization procedure immediately postpartum is
not a contraindication to the administration of the product, if it is otherwise
clinically indicated.Indications for RHIG include abortion, antepartum
fetomaternal hemorrhage, amniocentesis, genetic amniocentesis, chorionic
villus sampling (CVS), percutaneous umbilical blood sampling (PUBS), at
approximately 26-28 weeks gestation and after delivery. The product circular
should be consulted for additional indications. The component is administered
intramuscularly within 72 hours of the potentially sensitizing event. It is
generally appropriate to administer the product even if this 72-hour period has
elapsed.It is necessary, on occasion, to administer platelets from Rh-positive
donors to Rh-negative patients. Although the platelets themselves do not carry
antigens of the Rh system, the component inevitably contains small amounts of
donor red cells that may sensitize of the recipient to the D antigen. In some
patients, particularly those who are young and non-immunosuppressed, it may
be advisable to administer RHIG when such a situation occurs. Consultation
with Blood Bank Medical Staff should be considered.
Intravenous Rh Immune Globulin (WRHO, RHIV)is indicated for the treatment
of ITP in Rh positive adults and children. The product circular should be used
for dosage and administration guidelines.
Specimen Requirements: Cord Blood Samples: When available, a cord blood
sample from the fetus or infant will be tested for the presence of the D antigen.
Maternal Samples: All pregnant women should have their Rh type determined
at the University of Michigan Hospitals Blood Bank. A blood specimen is
required for all Rh-negative women prior to the issuance of RHIG. A maternal
specimen collected one hour post procedure should be obtained for spontaneous
or therapeutic abortions after the 20th week of pregnancy, after hypertonic

solution pregnancy termination, or following delivery, in order to recognize the

rare patient with a massive fetomaternal hemorrhage. Antepartum blood
samples are satisfactory for spontaneous and therapeutic abortions before the
20th week of pregnancy.
For the treatment of ITP: The Rh type of the patient must be determined. If Rh
is not known, a venous specimen in a pink top tube is reuqired..
Determination of Dose: The Blood Bank routinely performs a screening test for
massive fetal-maternal hemorrhage postpartum to determine if additional
testing is required to establish the appropriate dose of RHIG. On request, this
screening test will be performed on specimens from antepartum patients.
VariZIG (TM) Varicella Zoster IgG
Crossmatch:
Not required; no patient sample required
Approximate Volume: 125 international units/vial
Dose: 1 vial per 10 kg body weight to a maximum of 5 vials
Administration: administered intramuscularly within 72 hours of exposure
Indication: Indicated for immunosuppressed patients with a recent exposure to
chicken pox.
This product is available only to patients who particiapte in research study. It is
not stocked and must be ordered and shipped as needed. Release, consent and
study forms are required. Refer to Pharmacy Web
pagehttp://ummcpharmweb/di/DispensingProcedures/VariZIGDispensingProce
dures.pdf for information on ordering.

AUTOLOGOUS COMPONENTS
Crossmatch:
Outdate:
Storage

Required for RBC components

21 days to 42 days depending on the anticoagulant
1-6C in a monitored blood refrigerator

Conditions:
Minimum

Donations must be scheduled and units collected at least four

Preparation

days in advance of proposed date of use. At least two week

Time:
prior donation is recommended.
Description: Whole Blood or Red Blood Cells collected from a patient/donor
and stored for future use.
Requirements: Patient with a hemoglobin of at least 11 gm/dL (33%
hematocrit) who is not bacteremic and who has an anticipated blood need
greater than 2 units during the dating period of the component may donate.
Patients should be given oral iron therapy.
Indication: Patient request when there is some reason to believe that there is a
risk of blood transfusion for an up coming operative procedure. In rare
circumstances autologous blood may be collected when it is difficult to find
compatible blood due to antibodies directed at red cell antigens.
Collection Sites:
The University of Michigan Hospitals does not collect Autologous Whole
Blood. Donations may be made at any licensed or registered blood donor center
in Michigan, at any hospital in Michigan that routinely collects donor units, or
any U.S. hospital or donor center outside the state of Michigan that is licensed
by the Office of Biologics, Food and Drug Administration (allows for the
interstate shipment of blood). In order to coordinate shipping, payment and
tracking of units, the University of Michigan Hospitals Blood Bank must be
notified in advance that the patient is donating autologous blood.
There are additional fees assessed by the agency collecting the blood. These
fees are charged regardless if the unit is transfused and are not generally
reimbursed by healthcare insurance programs.
In rare circumstances autologous blood may be frozen and stored off site for up
to three months. There are additional fees for freezing and deglycerolization.

DIRECTED DONOR COMPONENTS

Units shipped from donor centers may not be prestorage leukocytereduced. Such units will be issued with a leukocyte-reduction filter to be
used for transfusion of the components. 5/1/06
Crossmatch:
Outdate:
Storage
Conditions:
Availability

Required for RBC components

21 days to 42 days depending on the anticoagulant
1-6C in a monitored blood refrigerator
Four working days from the time of donation must be
allowed for processing and shipping of units

Indications:
There are few, if any, indications for the use of directed donor blood
components. Directed donor units are collected for patients with an anticipated
blood need, at the request of the patient (parent or guardian) and the patient's
physician. Directed Donor units must be fully processed, and only donor units
meeting American Association of Blood Banks and Office of Biologics, Food
and Drug Administration requirements may be used for transfusion.Due to the
special handling, an additional service fee is charged per unit donated.
These additional are not covered under most health insurance plans. In
addition, there are additional fees for directed donor units as they must be
irradiated to prevent posttransfusion graft-versus-host disease.
Donations for patients being treated at the University of Michigan Hospitals
may be made at any licensed or registered blood donor center in Michigan, at
any hospital in Michigan that routinely collects directed donor units, or any
U.S. hospital or donor center outside the state of Michigan that is licensed by
the Office of Biologics, Food and Drug Administration (allows for the interstate
shipment of blood). In order to coordinate tracking, payment and shipping of
units donated at other centers, the University of Michigan Hospitals Blood
Bank must be notified in advance that the patient has selected his/her own

donors.
IRRADIATED BLOOD PRODUCTS
Red Blood Cells and Whole Blood outdating reduced to no
Outdate:

Preparation

more that 28 days past the date of irradiation or the original

outdate, whichever is sooner. The outdate of platelet
components does not change with irradiation.
An additional 15 minutes is required to prepare irradiated

Time:
components
Description: Blood components exposed to approximately 2500 cGy. All
components except progenitor cell components, previously frozen plasma and
cryoprecipitate should be irradiated.
Indications: Patients who are at high risk of graft-vs-host disease. This includes
patients who are congenitally immunodeficient, have altered immune status
secondary to malignant neoplasms, or are neonates who have received an
intrauterine transfusion. It may also be indicated for bone marrow transplant
recipients or patients undergoing treatment with chemotherapeutic agents.
Directed donor units are irradiated to prevent graft-vs-host disease.
Contraindications: Irradiated Red Blood Cells have an increased plasma
potassium and decreased in vivo survival
Availability: The physician must indicate irradiated components in the order for
blood components.
OTHER PLASMA DERIVATIVES
Plasma derivatives such as serum albumin solutions, coagulation factor
concentrates and other immune serum globulins are available by prescription
from the Pharmacy.
Special Leukocyte-reduction Filters
Follow the manufacturer's instructions contained on the filter packaging for
priming the filter.

 Use infusion pumps only if the manufacturer's instructions indicate that

infusion pumps may be used. Inappropriate use of such pumps may result in
loss of filter effectiveness or filter material being infused especially if the pump
rate exceeds the flow rate of the filter.