The MISSION of transfusion medicine is assuring safe blood products through good manufacturing practices controlled by quality standards skilled manpower and high end technology.

FUNCTIONS: - Transfusion medicine operates 24 X 7, 365 days for collection of blood from voluntary and replacement donors, testing of units collected, separation of whole blood into components and issuing the components when demand arises. It offers its full service to give the highest possible quality of blood components keeping patient safety as top priority.

QUALITY ASSURANCE
The components prepared are as per the drugs and cosmetics act following good manufacturing practices.

    a) Strict donor selection criteria and careful evaluation of donor’s questionnaires.

    b) All donor samples are screened for HIV, HBsAg, HCV, VDRL, Malarial parasites using automated random access with one-hour turn around time for sample analysis.

    c) Individual NAT for donor samples to check for viral particles in the window period.

    d) Standard quality component separation techniques, which yield Leucoreduced blood products minimizing transfusion reactions.

    e) Strict quality check for all products prepared and participation in External quality assurance programmes.

Components available: 1) Packed Red Cells 2) Fresh Frozen Plasma 3) Random Platelet Concentrate 4) Cryoprecipitate 5) Platelet rich plasma 6) Single Donor Platelet concentrate (Apheresis Platelets)

Components processing:

PACKED RED CELLS

Description Volume: 200 – 220 ml of red blood cell suspension derived from single blood donor. Storage - 35 days at 2 – 8º c. Indications Severe chronic anemia to reduce chances of overload. Hypo plastic anemia . Hemolytic anemia especially in aplastic crisis .

TRANSFUSION TRIGGER
It has now been reduced to 7.5gm/dl as opposed to 10gm/dl being used earlier, for surgical and leukemia patients however, transfusion requirement of each patient should be based on clinical status rather than Hb value or Hematocrit.

Administration :
Check the identity of patient properly before transfusion. Must be ABO & Rh D compatible with patients sample. Alternative blood group can be given at times if group specific blood is not available
e.g.
    1) For AB the alternative blood in order of preference should be A, B & O
    2) For A group --------------- O group
    3) For B group --------------- O group
No alternative blood for O group
Transfuse blood within ½ hr of issue from Blood Bank.

PLATELET CONCENTRATE
Description:
Derived from single blood donation.
Volume: 65-80ml
Should not have any visible RBC contamination (red cells less than 1.2X10⁹ red cells)

Storage: 5 days (Day of collection zero days) at 22º c± 2º)

Indication: Thrombocytopenia of any cause except ITP unless life saving. Platelet functional defects of any cause. Dosage: 1 unit of platelet concentrate /10 kg of body weight e.g. for 60 kg man 6 units of random donor platelet concentrate.

Administration:

• No special transfusion sets required except in patients requiring multiple transfusions.
• No cross matching required, however if contaminated with red cells- cross match is indicated.
• Use group specific platelets, however group non-specific platelets can be used if group specific platelets not available.
• Platelet don’t carry Rh antigen however in young ladies of child bearing age, don’t give Rh Positive platelets incase there is any RBC contamination.

FRESH FROZEN PLASMA

Description: Volume 180-220 ml Contains stable and labile coagulation factors, albumin & immuno-globulins Factor VIII Fibrinogen 150-230 mg/ pack Storage: Stored at - 400 c below & before use should be thawed at 370 c & once thawed should be stored at 4- 60 c & used within 24 hrs.

Indications:
Replacement of multiple coagulation factor deficiencies, which can occur in

• Liver disease
• Massive blood less
• Over dose of anticoagulants e.g. (Warfarin & dicumerol)
• DIC
• TTP

Dosage: 10-20ml/kg body wt.

Administration:

• To be given immediately within 6 hrs after thawing.
• Use standard blood administration set.

CRYOPRECIPITATE

Description:
Prepared from FFP by thawing it under controlled conditions at 4⁰ c. it contains approximately 80-100 IU of factor VIII & 150-300mg of fibrinogen per pack.

Storage: At -30⁰ c & below for 1 year.

Indications:
As an alternative to factor VIII concentrate in the treatment of: -

• Vonwillibrand disease
• Hemophilia A
• Factor XIII deficiency
• Fibrinogen deficiency e.g. DIC
• Infection risks are same as for whole blood.

Dosage:
Depends upon severity of the factor deficiency normally 4-6 packs to be repeated 12 hourly.

Administration:

• To be given immediately within 6 hrs after thawing .
• Use standard blood administration set .
• No compatibility testing required .

APHERESIS BLOOD COMPONENTS

Apheresis blood components is gaining importance because:

      1. Provide adequate adult dose from single donor.
      2. Reduce donor exposure to the patient, thus improves blood safety.
      3. Reduce bacterial contamination, especially in platelets.
      4. Lower chances of refractoriness to blood components.
      5. One donor can donate platelets twice a week provided platelet counts are adequate.