1. Blood component therapy This is the seperation of whole blood into its individual components to optimize individual therapeutic potency based on sound physiologic principles and understanding of the relative risks and benefits of each

2. Available blood components Whole blood Whole blood Packed rbc Packed rbc Leukocyte-reduced rbc Leukocyte-reduced rbc Platelets Platelets Leucocyte concentrate Leucocyte concentrate Fresh frosen plasma Fresh frosen plasma cryoprecipitate cryoprecipitate

3. Indications and use of blood components Whole blood Whole blood This precludes the production of components This precludes the production of components

4. Red blood cells Stored in as-1 soln – shelf life 42days Stored in as-1 soln – shelf life 42days No funtioning platelets No funtioning platelets Low levels of factors V and VIII Low levels of factors V and VIII

5. Leukocyte reduced RBCs Indications include Indications include Decrease HLA alloimmunisation Decrease HLA alloimmunisation Reduce CMV transfusion Reduce CMV transfusion Prevent febrile non-heamolytic reaction Prevent febrile non-heamolytic reaction

6. platelets Indication Indication Thrombocytopaenia with assoc bleeding Thrombocytopaenia with assoc bleeding Platelet dysfunction Platelet dysfunction

7. Types of platelet concentrate Single random donor unit Single random donor unit Multiple unit-6 to 10 units by apharesis Multiple unit-6 to 10 units by apharesis Hla matched platelets Hla matched platelets

8. Leucocyte concentrate Indications Indications Profound granulocytopaenia <500/cub mm Profound granulocytopaenia <500/cub mm With evidence of infection unresponsive to antibiotics With evidence of infection unresponsive to antibiotics

9. Fresh frozen plasma Used to replace labile factors Used to replace labile factors Abnormal PT and aPTT with clinical bleeding Abnormal PT and aPTT with clinical bleeding NOT for volume expansion NOT for volume expansion

10. croprecipitate Indications Indications Haemophilia A Haemophilia A Von Willebrand,s disease Von Willebrand,s disease hypofibrinogenemia hypofibrinogenemia

11. Risk of blood transfusion Transfusion reaction Transfusion reaction Infection transmission-Hiv hepatits HTLV Infection transmission-Hiv hepatits HTLV Transfusion related acute lung injury Transfusion related acute lung injury Graft-versus-host reaction Graft-versus-host reaction Immunomodulation Immunomodulation

12. Massive transfusion Defined as more than 10units of packed Rbc Defined as more than 10units of packed Rbc Or replacement of the patient blood volume in 24hrs Or replacement of the patient blood volume in 24hrs

13. Complications MT ACID-BASE changes ACID-BASE changes Hyperkalemia Hyperkalemia Hypocalcimea Hypocalcimea Decrease 2,3-DPG Decrease 2,3-DPG Dilutional thrombocytopaenia Dilutional thrombocytopaenia

14. Blod substitutes& alternatives Autologous blood Autologous blood Acute normovolumic hemodilution Acute normovolumic hemodilution Autologous cell salvage Autologous cell salvage iron supplements iron supplements Erythropoetin Erythropoetin Red blood cell substitutes Red blood cell substitutes