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Residual white cells in cellular blood products may interact with …

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Residual white cells in cellular blood products may interact with the recipient in one of the following ways:

1) The patient’s immune system recognizes the WBC’s as foreign and triggers cellular and/or humoral immune mechanisms to remove the foreign cells without incident.

2) The patient’s immune system recognizes the WBC’s as foreign and triggers cellular and/or humoral immune mechanisms, leading to a febrile, non-hemolytic transfusion reaction, a common occurrence following transfusion. FNHTA may be prevented by the use of leukoreduced blood components.

3) The patient is exposed to donor white cells and develops anti-HLA and/or anti-neutrophil antibodies. These antibodies have been associated with organ or marrow rejection, and have also been identified in cases of Transfusion Related Acute Lung Injury (TRALI).

4) The recipient and the donor of the cellular blood products share HLA haplotypes, and the donor WHC’s are not recognized as foreign. Lymphocytes from the donor may become active, replicate, and trigger Transfusion Associated Graft vs. Host Disease, a serious and potentially deadly reaction (>90% mortality). TA-GVHD is extremely rare, and may be prevented in at-risk patients by irradiation of cellular blood products.

Many additional clinical situations (such as immune modulation) may occur with white cell contamination of transfused products. Information on transfusion reactions, including following the transfusion of residual white cells, may be found at the National Library of Medicine web site, listed below:

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When animal cells such as red blood cells are placed in a hypotonic solution (distilled water), water molecules diffuse into the red blood cells by osmosis. The red blood cells gain water and swell and finally burst because they have no cell walls. the red blood cells are said to undergo haemolysis.

When red blood cells are placed in a hypertonic solution such as 4% sodium chloride solution (salt solution). water molecules diffuse out of the cell by osmosis. Water is rapidly lost. The red blood cells will shrivel and probably die. This process is called crenation of red blood cells.

If red blood cells are immersed in an isotonic solution (0.85% sodium chloride solution), water molecules flow across the membrane at the same rate in both directions. There is no net movement of water molecules across the membrane. The red blood cells maintain their shape. The concentration in the red blood cells is the same as the concentration in the environment, that is 0.85% sodium chloride solution.

Red blood cells have the important job of picking up oxygen from the lungs and carrying oxygen to all of the other cells of the body.
The cells of the body use oxygen as the fuel they need to do their jobs.
Red blood cells also give you color. If your skin is white the red blood cells give you the pink color in your skin. They also give your lips a nice pink color.

This red liquid is living tissue that carries oxygen and nutrients to all parts of the body, and carries carbon dioxide and other waste products back to the lungs, kidneys and liver for disposal. It fights against infection and helps heal wounds, so we can stay healthy.

Blood Components
Blood may be transfused as whole blood or as one of its components. Because patients seldom require all of the components of whole blood, it makes sense to transfuse only that portion needed by the patient for a specific condition or disease. This treatment, referred to as “blood component therapy,” allows several patients to benefit from one unit of donated whole blood. Blood components include red blood cells, plasma, platelets, and cryoprecipitated antihemophilic factor (AHF). Up to four components may be derived from one unit of blood.

Whole Blood is a living tissue that circulates through the heart, arteries, veins, and capillaries carrying nourishment, electrolytes, hormones, vitamins, antibodies, heat, and oxygen to the body’s tissues. Whole blood contains red blood cells, white blood cells and platelets suspended in a fluid called plasma.

If blood is treated to prevent clotting and permitted to stand in a container, the red blood cells, weighing the most, will settle to the bottom; the plasma will stay on top; and the white blood cells and platelets will remain suspended between the plasma and the red blood cells. A centrifuge may be used to hasten this separation process. The platelet-rich plasma is then removed and placed into a sterile bag, and it can be used to prepare platelets and plasma or cryoprecipitated AHF. To make platelets, the platelet-rich plasma is centrifuged, causing the platelets to settle at the bottom of the bag. Plasma and platelets are then separated and made available for transfusion. The plasma may also be pooled with plasma from other donors and further processed, or fractionated, to provide purified plasma proteins such as albumin, immunoglobulin (IVIG) and clotting factors.

Blood Cells Are Produced In Bone Marrow
Red Cells, White Cells And Platelets Are Made In The Marrow Of Bones, Especially The Vertebrae, Ribs, Hips, Skull And Sternum. These Essential Blood Cells Fight Infection, Carry Oxygen And Help Control Bleeding.

Red Blood Cells are perhaps the most recognizable component of whole blood. Red blood cells contain hemoglobin, a complex iron-containing protein that carries oxygen throughout the body and gives blood its red color. The percentage of blood volume composed of red blood cells is called the “hematocrit.” The average hematocrit in an adult male is 47 percent; the average hematocrit in adult females is 42 percent. There are about one billion red blood cells in two to three drops of blood, and, for every 600 red blood cells, there are about 40 platelets and one white cell. Manufactured in the bone marrow, red blood cells are continuously being produced and broken down. They live for approximately 120 days in the circulatory system and are eventually removed by the spleen.

Red blood cells are prepared from whole blood by removing the plasma, or the liquid portion of the blood. They can raise the patient’s hematocrit and hemoglobin levels while minimizing an increase in volume.

Patients who benefit most from transfusions of red blood cells include those with chronic anemia resulting from disorders such as kidney failure, malignancies, or gastrointestinal bleeding and those with acute blood loss resulting from trauma or surgery. Since red blood cells have reduced amounts of plasma, they are well suited for treating anemia patients who would not tolerate the increased volume provided by whole blood, such as patients with congestive heart failure or those who are elderly or debilitated.

Improvements in cell preservative solutions over the last 15 years have increased the shelf life of red blood cells from 21 to 42 days. Red blood cells may be treated and frozen for extended storage (up to 10 years).

White Blood Cells are responsible for protecting the body from invasion by foreign substances such as bacteria, fungi, and viruses. The majority of white blood cells are produced in the bone marrow, where they outnumber red blood cells by two to one. However, in the blood stream, there are about 600 red blood cells for every white blood cell. There are several types of white blood cells; Granulocytes and macrophages protect against infection by surrounding and destroying invading bacteria and viruses, and lymphocytes aid in the immune defense.

Red blood cells are the most common type of blood cell and the vertebrate body’s principal means of delivering oxygen to the body tissues via the blood. The cells are filled with hemoglobin, a biomolecule that can bind to oxygen. They take up oxygen in the lungs or gills and release it while squeezing through the body’s capillaries. The blood’s red color is due to the color of hemoglobin. In humans, red blood cells develop in the bone marrow, take the form of flexible biconcave disks, lack a cell nucleus, subcellular organelles and the ability to synthesize protein, and live for about 120 days.

White blood cells (WBCs), or leukocytes (also spelled “leucocytes”), are cells of the immune system defending the body against both infectious disease and foreign materials. Five different and diverse types of leukocytes exist, but they are all produced and derived from a multipotent cell in the bone marrow known as a hematopoietic stem cell. Leukocytes are found throughout the body, including the blood and lymphatic system.

Platelets, or thrombocytes, are small, irregularly shaped anuclear cells, 2-4µm in diameter, which are derived from fragmentation of precursor megakaryocytes. The average life span of a platelet is between 8 and 12 days. Platelets play a fundamental role in hemostasis and are a natural source of growth factors. They circulate in the blood of mammals and are involved in hemostasis leading to the formation of blood clots. Like red blood cells, platelets have no nucleus.
If the number of platelets is too low, excessive bleeding can occur; however, if the number of platelets is too high, blood clots can form (thrombosis), these can block blood vessels, and may cause a stroke and/or a heart attack. An abnormality or disease of the platelets is called a thrombocytopathy, which could be either a low number (thrombocytopenia), a decrease in function (thrombasthenia) or an increase in number (thrombocytosis).

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