Chapter 4 - Packed Red Blood Cells and Related Products

Abstract

This chapter presents a discussion on packed red blood cells (PRBCs) and related products. PRBCs are made from volunteer donations of whole blood and a number of different preparations of PRBCs are available to meet the needs of the individual patient in the context of his or her current clinical situation. The whole blood (WB) unit is collected from a volunteer donor into the primary blood bag of a multiple-bag system where it is mixed with anticoagulant-preservative solution. The WB unit is stored at room temperature if platelets are to be made from the unit; otherwise it is refrigerated. The WB unit is then centrifuged—usually within 8 hours of collection—to separate the WB into its two major components: PRBCs and platelet-rich plasma. The PRBCs remain in the primary blood bag following removal of the plasma. The duration of storage of the PRBC unit at 1–6°C in a monitored, blood storage refrigerator depends on the type of additive preservative solution with which it is mixed. Further, filtration for leukocyte reduction may be performed at the blood center prestorage leukoreduction in the blood bank or at the bedside. Special bedside filter sets are made for use with PRBC components and cannot be used interchangeably with filters made for platelets. PRBCs and other blood components may be irradiated for the prevention of transfusion-associated graft versus host disease. The minimum recommended dose of gamma radiation is 25 Gy. Because of the increase in supernatant potassium levels following irradiation, irradiated PRBCs must be transfused within 28 days of irradiation or before the original expiration date, whichever comes first. PRBC products should be administered only for the purpose of increasing oxygen-carrying capacity in anemic patients who are at risk for ischemic events.