Blood Collection (Table 16-3: Blood Components). The production of blood components is highly controlled by regulations and accreditation requirements in the interests of donor and recipient safety and therapeutic efficacy. Blood donors are carefully screened and tested, and blood products are made in specialized laboratories and other facilities.
Component Processing and Storage
Leukoreduction to remove white blood cells from red blood cells (RBCs) and platelets reduces the risk of human leukocyte antigen alloimmunization, febrile nonhemolytic transfusion reactions, and cytomegalovirus (CMV) transmission in patients who require these precautions.
Washing cellular components with saline is mostly done to remove plasma in patients with allergic transfusion reactions such as those who are immunoglobulin A deficient.
Irradiation of cellular components is performed to prevent transfusion graft-versus-host disease (GVHD) from directed-donor units from blood relatives and in highly immunosuppressed patients (those with leukemia, lymphoma, hematopoietic stem cell transplants, or congenital cellular immunodeficiencies) at risk for this complication.
Platelets are stored at room temperature to preserve clotting function, but this increases the risk of bacterial growth in contaminated units compared with other blood components.
RBC preservation solutions use CDPA (citrate for anticoagulation, phosphate as a buffer, adenine, and 1–2 g of dextrose to maintain adenosine triphosphate levels and RBC membrane integrity).
Plasma derivatives (albumin, immunoglobulins, clotting factors) are proteins processed from plasma for therapeutic infusions.
Albumin is produced in large quantities for intravascular volume support and is pasteurized at 60°C for sterility.
Immunoglobulins (Igs) are given for immune support or for immunomodulation to suppress native antibody production.