Blood and related products

Contents:- •Whole human blood•Dried human plasma•Preparation process of dried human plasma•Other blood products•Plasma substitutes

The whole human blood- Accepted donor – the one who is not suffering from

any disease transmitted by transfusion this includes syphilis, malaria and serum jaundice and is not anemic.

Collection- the blood is collected from median cubital vein in front of elbow into a sterile container containing an anti-coagulant solution.

Not more than 420ml is taken at one attendance immediately afterwards the container is sealed and cooled to 4-6 degree centigrade.

Testing- two tests are done ,a)serological test to confirm the absence of , b)to determine the ABO grouping of the cells, plasma and Rh grouping of cells.

Storage- blood must be kept at 4-6 degree centigrade in a sterile environment

Uses- in cases of severe loss of blood from the body, during hemorrhage, shock, uncontrollable diarrhea and vomiting.

Dried human plasmaWhole human blood has several disadvantages:-

It has poor keeping properties necessitating use within three weeks

It requires refrigerated storage It must be compatible with the blood of the recipient

Dried plasma, on the other hand ,has various advantages:-

Properly stored it keeps for at least five years If protected from light it can be stored for aleast five years

temperature provided this is below 20degrees It can be given to patients of any blood group

Major problems to be overcome for preparation-

Transmission of viral jaundice-by poolingNeutralisation of plasma agglutinins- by cross

neutralisation by soluble agglutinogens, most satisfactory ratio is 9 of A:9 of O:2of B or AB

Preparation process for dried human plasma:- Dried plasma is prepared from time expired citrated blood which has been centrifuged

to deposit the cell, more than 40% of supernatant fluid is siphoned off through sterile tubes

Then pooling is done and correct ratio of blood groups is chosen to neutralize powerful agglutinins, then samples are tested for sterility.

Then 400ml quantities are dispensed in MRC bottles and are subjected to freeze drying

Preliminary freezing- The bottles are sealed with bacteriologically efficient fabric pads covered by ring type closures and

then centrifuged at -18degree centigrade . The liquid snap-freezes and becomes distributed around the inside of the bottle

Primary drying – The bottles of frozen material are mounted horizontal in the drying chamber and high vacuum is

horizontally in the drying chamber and a high vacuum is applied. The ice sublimes on to a condensing coil kept at -50 degrees centigrade and a small heater provides the latent heat required for evaporation this stage takes about two days, after which the residual moisture content is about 2 percent

Secondary drying- This is done in another chamber by vacuum dessication over phosphorus pentoxide. It takes about a

day and the product is left with 0.5 percent moisture.

Storage - It is kept below 20 degrees centigrade and protected from moisture, sunlight and remains usable

for at least 5years

Usage- it is satisfactory alternative to whole blood in conditions where there is no loss of red

cells, for e.g. burns and scalps, where there is excessive fluid and protein loss. In case of emergency when whole human blood is unavailable

other blood products-Dried human serum- Preparation- blood is allowed to clot and

the supernatant serum being separated after the clot has retracted

Storage and usage- it is kept below 20degree centigrade and protected from light, moisture and oxygen

Usage- treatment of burns and scalps where there is extensive fluid and protein loss also used in cases of emergency when whole human blood is unavailable

Human plasma protein fraction-

Preparation- by fractionation of pooled citrated plasma(not more than 0.4%), an organic solvent is used having proper volatility and bacteriostatic activity, a stabiliser such as sodium caprylate whose function is to allow the preparation to be heated for hours at low temperature without denaturation of protein

For isotonicity NaCl is added, and to control the contamination bactericide is added

Human fibrinogen-

Uses – 1)to treat fibrinogen deficiency 2)in conjunction with thrombin

to assist adhesion of skin grafts

Human thrombin-

Use-in conjunction with fibrinogen fibrin clot is produced which is used in surgery to suture severed nerves and to assist adhesion of skin grafts.

Human fibrin foam-

Uses-as haemostat in surgery by dipping the piece into thrombin and applied to bleeding area

Normal human immunoglobulin injection-

Uses- Intravenous immunoglobulin is used in the treatment of imuno-thrombocytopenia, and autoimmune hemolytic anemia, in prevention of measles, infectious hepatitis and small pox.

RhD immunoglobulin is used to prevent exposure to D-positive red cells in D negative patients. (usually given in pregnancy and immediately after birth).

Plasma substitutes:-The limited supplies of plasma, the cost of producing the dried form and the risk of transmitting serum hepatitis stimulated attempts to find substitutes of non-human origin that could be used to restore the blood volume temporarily while the recipient replaced the lost protein.Examples-gum saline, polyvinylpyrrolidone , dextran.

Properties of ideal plasma substitutes-

Dextran:-

Same colloidal osmotic pressure Same viscosity A fairly low rate of excretion but

complete elimination Freedom from toxicity Freedom from antigenicity ,

pyrogenicity . High stability in liquid form at the

normal sterilising temperatures and during transport and storage

Ease of preparation, ready availability and low cost

Molecular weight such that molecule do not easily diffuse through capillary walls

To date this is the most satisfactory plasma substitute. It is polysaccharide produced when the bacterium Leuconostoc mesenteroides is grown in a sucrose containing medium

Dextran 40 injection:- A number of conditions , including

severe burns, crash injuries and acute peritonitis, are accompanied by severe degree of sludging in the blood. This can be reduced by administration of dextran 40 injection which ,because it contains polymers of low molecular weight, lowers plasma viscosity and improves capillary flow

Use short-term blood volume

expansion

Slide presentation by Diksha Kumari Roll no -22B.Pharm 5th semester

Thank you Reference:-1) Tutorial pharmacy by S.J Carter2) wikipedia3) Google