Blood whole

The blood is generally warmed to 37°C immediately prior to transfusion. Whole blood is often used to replace blood lost due to injury or surgery. The number of Units (1 Unit 510ml) administered depends upon the health and age of the recipient, along with the therapeutic indication. Administration of whole blood may also be undertaken to supply a recipient with a particular blood constituent (e.g. a clotting factor, immunoglobulin, platelets or red blood cells). However, this practice is minimized in favour of direct administration of the specific blood constituent needed. 

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Whole blood is seldom used ia modem blood transfusion. Blood is separated into its components. Transfusion therapy optimizes the use of the blood components, using each for a specific need. Red cell concentrates are used for patients needing oxygen transport, platelets are used for hemostasis, and plasma is used as a volume expander or a source of proteins needed for clotting of the blood. 

The discovery in 1900 of the existence of blood groups, together with improved understanding of the importance of sterile conditions, paved the way to modem blood transfusion therapy. In 1915, the feasibiUty of storage of whole blood was demonstrated. During World War I, the optimal concentration of citrate for use as an anticoagulant was determined. This anticoagulant was used until 1942, when the acid—citrate—dextrose (ACD) solution was developed. 

Blood can be collected ia the form of whole blood donations. In the United States, one unit, ie, 450 mL, of blood is collected from a healthy volunteer blood donor who is allowed to donate blood once every 10 weeks. A unit of blood is typically separated iato a red cell fraction, ie, red cell concentrate a platelet fraction, ie, random donor platelets (RDP) and plasma. 

Primary blood components iaclude plasma, red blood cells (erythrocytes), white blood cells (leukocytes), platelets (thrombocytes), and stem cells. Plasma consists of water dissolved proteias, ie, fibrinogen, albumins, and globulins coagulation factors and nutrients. The principal plasma-derived blood products are siagle-donor plasma (SDP), produced by sedimentation from whole blood donations fresh frozen plasma (FFP), collected both by apheresis and from whole blood collections cryoprecipitate, produced by cryoprecipitation of FFP albumin, collected through apheresis and coagulation factors, produced by fractionation from FFP and by apheresis (see Fractionation, blood-plasma fractionation). 

Packed red cells are prepared from whole blood. These are collected ia blood coUectioa units having integrally attached transfer packs. The red cells are sedimented by centrifugation, and the plasma and huffy coat are expressed from the bag. Further processiag of the packed red cells may be needed for a number of clinical indications. To reduce the white blood cell (WBC) contamination in a red cell product, two separation techniques are used. 

Transfusion-induced autoimmune disease has been a significant complication in the treatment of patients who require multiple platelet transfusions. Platelets and lymphocytes carry their own blood group system, ie, the human leukocyte antigen (HLA) system, and it can be difficult to find an HLA matched donor. A mismatched platelet transfusion does not induce immediate adverse reactions, but may cause the patient to become refractory to the HLA type of the transfused platelets. The next time platelets with an HLA type similar to that of the transfused platelets are transfused, they are rejected by the patient and thus have no clinical efficacy. Exposure to platelets originating from different donors is minimized by the use of apheresis platelets. One transfusable dose (unit) of apheresis platelets contains 3-5 x 10 platelets. An equal dose of platelets from whole blood donation requires platelets from six to eight units of whole blood. Furthermore, platelets can be donated every 10 days, versus 10 weeks for whole blood donations. 

Fig. 5. Separation in Latham bowl (a) whole blood is pumped down the feed tube and enters bowl at bottom (b) centrifugal force spins denser cellular components outside, leaving plasma or platelet-rich plasma (PRP) in inner band (c) when bowl is full, plasma flows out effluent tube, followed by platelets and then leukocytes, until bowl is almost completely full of ted cells (d) after draw is completed, bowl stops spinning and uncoUected components are...

Each blood component has specific storage requirements in terms of optimal temperature, additives, expiration, and storage containers. Red blood cells (RBC) from whole blood, provided in 200 mL units, have an expiration of 42 days. Fro2en, deglycerolized RBC, in 170 mL containers, and washed red cells, in 200 mL containers, both expire 24 hours after thawing and washing, respectively leukocyte-reduced RBC, in 200 mL containers, are viable for 24 hours. 

G. MyUyla, "Whole Blood and Plasma Procurement and the Impact of Plasmapheresis," in Ref 2. 

Full details of this work were pubHshed (6) and the processes, or variants of them, were introduced in a number of other countries. In the United States, the pharmaceutical industry continued to provide manufacturing sites, treating plasma fractionation as a normal commercial activity. In many other countries processing was undertaken by the Red Cross or blood transfusion services that emerged following Wodd War II. In these organisations plasma fractionation was part of a larger operation to provide whole blood, blood components, and speciaUst medical services on a national basis. These different approaches resulted in the development of two distinct sectors in the plasma fractionation industry ie, a commercial or for-profit sector based on paid donors and a noncommercial or not-for-profit sector based on unpaid donors. 

Plasma Collection. Human plasma is collected from donors either as a plasma donation, from which the red cells and other cellular components have been removed and returned to the donor by a process known as plasmapheresis, or in the form of a whole blood donation. These are referred to as source plasma and recovered plasma, respectively (Fig. 1). In both instances the donation is collected into a solution of anticoagulant (146) to prevent the donation from clotting and to maintain the stabiUty of the various constituents. Regulations in place to safeguard the donor specify both the frequency of donation and the volume that can be taken on each occasion (147). 

Procedures for the collection of whole blood are similar throughout the world. An interval from at least 8 weeks (United States) to 12 weeks (United Kingdom) is required between a donation of 450 mL blood, which yields about 250 mL plasma. In some countries a smaller volume of blood is collected, eg, 350—400 mL in Italy, Greece, and Turkey and as Httie as 250 mL in some Asian countries (147). Regulations concerning plasmapheresis donations vary more widely across the world eg, up to 300 mL of plasma can be taken in Europe in contrast to 1000 mL in the United States, both on a weekly basis. Consequentiy, both the mode of donation and the country in which it is given can have a profound effect on plasma collection (Table 6). 

Relatively Httie is known about the bioavailabiUty of pantothenic acid in human beings, and only approximately 50% of pantothenic acid present in the diet is actually absorbed (10). Liver, adrenal glands, kidneys, brain, and testes contain high concentrations of pantothenic acid. In healthy adults, the total amount of pantothenic acid present in whole blood is estimated to be 1 mg/L. A significant (2—7 mg/d) difference is observed among different age-group individuals with respect to pantothenic acid intake and urinary excretion, indicating differences in the rate of metaboHsm of pantothenic acid. 

Gum-Saline. Gum is a galactoso—gluconic acid having molecular weight of approximately 1500. First used (16) in kidney perfusion experiments, gum—saline enjoyed great popularity as a plasma expander starting from the end of World War I. The aggregation state of gum depends on concentration, pH, salts, and temperature, and its coUoid oncotic pressure and viscosity are quite variable. Conditions were identified (17) under which the viscosity would be the same as that of whole blood. 

Factor V. High in sialic acid content. Factor V is a large asymmetric single-chain glycoprotein that becomes an active participant in the coagulation cascade when it is converted to its active form by a-thrombin. Approximately 25% of human Factor V is found in the whole blood associated with platelets. Factor V is an essential cofactor along with Factor Xa plus phosphohpid plus Ca " in the conversion of prothrombin to thrombin. 

Esmolol is iv adrninistered. Maximal P-adrenoceptor blockade occurs in 1 min. Its elimination half-life is about 9 min. EuU recovery from P-adrenoceptor blockade is within 30 min after stopping the infusion. The therapeutic plasma concentrations are 0.4—1.2 lg/mL. It is metabolized by hydrolysis in whole blood by red blood cell esterases resulting in the formation of a primary acid metabohte and free methanol. The metabohte is pharmacologically inactive. The resulting methanol levels are not toxic. Esmolol is 55% bound to plasma protein, the acid metabohte only 10%. Less than 2% of parent dmg and the acid metabohte are excreted by the kidneys. Plasma levels may be elevated and elimination half-hves prolonged in patients with renal disease (41). 

Sulfides, thiols, and proteinacious organic matter, particularly plasma and whole blood, seriously depress and may even aboHsh the germicidal action of mercury compounds (qv). As of this writing approved uses for mercurials are limited to contact lens cleaning fluids, spoilage prevention of stored... 

Among the vitally necessary elements the most important are Fe, Zn, K, Ca, S. Some of them are imbedded in the stmcture of many ferments, amino acids, intracellular liquid, the other define transmembrane electrical potential. In the paper the contents of elements in whole blood and semm by X-ray fluorescence spectrometry is studied. 

In addition to COg, Cl and BPG also bind better to deoxyhemoglobin than to oxyhemoglobin, causing a shift in equilibrium in favor of Og release. These various effects are demonstrated by the shift in the oxygen saturation curves for Hb in the presence of one or more of these substances (Figure 15.35). Note that the Og-binding curve for Hb + BPG + COg fits that of whole blood very well. 

The different furanones 104 were tested for their potency as inhibitors of PGE2 production both in transfected Chinese hamster ovarian (CHO) cells expressing human COX-2 and in human whole blood. Compound 104r proved to be an orally active and selective COX-2 inhibitor that is devoid of the ulcerogenic effect at >100 times the dose for antiinflammatory, analgesic, and antipyretic effects (99BMC3187). 

Mefloquine human plasma/whole blood liq-liq extraction... 

D. L. Allen, K. S. Scott and J. S. Oliver, Comparison of solid-phase extraction and supercritical fluid exti action for the analysis of moipliine in whole blood , 7. Anal. Toxicol. 23 216-218 (1999). 

For additional evaluation of the effect of hydrophobization and the molecular weight of the polymers on the biological immuno-stimulating activity, we investigated the ex vivo cytokine (interIeukin-6 [IL-6], and tumor necrosis factor [TNFj-inducing activity from human peripheral whole blood cells of hydrophobized polymers by use of fractionated poly(M A-CDA) with narrow poly-dispersity. Since this assay uses the intact human cells, it shows more accurate results than in vitro assay using cultured cell line [25]. 

The ex vivo IL-6 and TNF-inducing activities of fractionated and modified or unmodified poly(MA-CDA) were performed according to the method reported [26] and shown in Figs. 12 and 13, respectively. A similar tendency was shown in IL-6 and TNF induction from peripheral whole blood cells by those of poIy(M A-CDA). 

Figure 12 IL-6 inducing activity of poly(MA-CDA)s from human peripheral whole blood cell culture. The doses of po-ly(MA-CDA)s were 1 mg/ml, 100 /xg/ml, and 10 /xg/ml. The doses of the LPS were 1 ng/ml and 100 pg/ml.

From these facts, we concluded that the cytokines from peripheral whole blood cells were induced by the action of the synthetic polycarboxylic polymer itself. Hydrophobization may contribute to the higher affinity... 

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