Deprecated: mysql_connect(): The mysql extension is deprecated and will be removed in the future: use mysqli or PDO instead in /home/ijtm/public_html/includes/connectdb.php on line 20

Deprecated: mysql_connect(): The mysql extension is deprecated and will be removed in the future: use mysqli or PDO instead in /home/ijtm/public_html/includes/DbSql.inc.php on line 13

Deprecated: mysql_connect(): The mysql extension is deprecated and will be removed in the future: use mysqli or PDO instead in /home/ijtm/public_html/includes/DbSql.inc.php on line 13
Indian Journal of Transfusion Medicine
  Indian Journal of Transfusion Medicine Indian Journal of Transfusion Medicine

Deprecated: mysql_connect(): The mysql extension is deprecated and will be removed in the future: use mysqli or PDO instead in /home/ijtm/public_html/includes/DbSql.inc.php on line 13

Deprecated: mysql_connect(): The mysql extension is deprecated and will be removed in the future: use mysqli or PDO instead in /home/ijtm/public_html/includes/DbSql.inc.php on line 13
image Image
Bottom Image
image Image
Journal Menu
Browse Journal
Current Articles
Last Articles
Archives
About the Journal
Bottom Image
Image SUBMIT YOUR ARTICLES Image
image Image
Important Links
Subscribe / Renew
Submit an Article
Submit Now!
Bottom Image
image Image
Newsletter Subscription

Deprecated: mysql_connect(): The mysql extension is deprecated and will be removed in the future: use mysqli or PDO instead in /home/ijtm/public_html/includes/DbSql.inc.php on line 13

Deprecated: mysql_connect(): The mysql extension is deprecated and will be removed in the future: use mysqli or PDO instead in /home/ijtm/public_html/includes/DbSql.inc.php on line 13
NAME
EMAIL
Unsubscribe
  
Bottom Image
 
image Image
Quality Management Procedure Of Platelet Concentrate

Nafis Ahmed

(Junior Lab Technologist)

Post Graduate Institute of Medical Education

and Research (PGIMER)

Sector-12, Chandigarh (India)

Mobile No.- 08054707499

                  - 07696825195

Email- nafistdrs@yahoo.co.in

 

ABSTRACT :-

Quality management of platelet concentrate the aims is high count or yield percentage of platelet concentrate. whole making a fresh whole blood to minimize the bacterial proliferation, low Red blood cells contamination and platelet shape and size is maintained. This journal describes ensure date specified platelet concentrate is issued to specified recipient (patient) and is safe and patient or recipient is recover early as possible of platelet count and recipient or patient recover a good health.

The method of platelet concentrate is dependents before preparation is selection of blood donor that is healthy , physically fit, not taking any analgesic medicine, safe and technical proper procedure , proper mixing of collecting blood, venipuncture techniques, proper collection time of whole blood , proper setting or programming of component refrigeration machine, right and right procedure is platelet rich plasma and platelet concentrate, storage of platelet concentrate, good separation uses instrument whose procedure is simple and safe, are also depend there increase quality of platelet concentrate. The main result is dependent of quality management in platelet concentrate is a 10% of selection of blood donor, 40% setting or programming of refrigerated centrifuge machine, 40% procedure or method of platelet separation and 10% of proper storage is a proper temperature and agitator of platelet concentrate.

If all above procedure is maintend are also increase quality of platelet concentrate about 80-90% yield of separating platelet from the whole blood.

 

INTRODUCTION :-

In the blood 2 types of material are present-

1.    Plasma

2.    Blood corpuscles – Red blood cell, White blood cell and platelets.

Platelet shape are oval round or coma and size is1-5l in blood. These are the smallest size of cells in blood a normal human body those found is 1,5000 to 4,00000 cubic milimeter. The human body infected acute and chronic infection , viral , infections , all anemias, radiation, toxic drugs, leukemia, multiple myeloma , lymphomas etc. this disease are decrease of platelets and patient go to thrombocytopenia. Platelets have a stoppage of bleeding. So platelet is important in our body.

 

MATERIALS :-

I investigated and experienced approximately 5 years and 6 months from 2005 to 2010 study and preparation in Santokba Durlabhji Memorial Hospital And Research Centre (SDMH), Jaipur, Rajasthan, India and Mittal Hospital and Research Centre (MHRC), Ajmer, Rajasthan, india in a blood banks of platelet concentrate approximately (2000- 2500) prepare a platelet concentrate of study and research is that proper donor selection, before Platelet Rich Plasma separated whole blood bag is proper storage at room temperature , setting or programming of refrigerated centrifuge machine and right methods and some precaution are handled the platelets concentrate , and a good functional of materials and equipments are making a high quality maintained of platelet concentrate.

METHOD:-

The method/procedure of preparation of platelet concentrate are divided in two parts -

(I) whole blood to Platelet Rich Plasma separation:-

1. First the freshly whole blood collected in a triple blood bag, the blood bags sold be kept at room temperature (20-240C) before preparing of Platelet Rich Plasma, until the platelets are to be removed.

2. Platelet must be seprated within 4-6 hours after collection of the unit of whole blood.

3. First after bleeding the fresh whole blood bags is approximately 30-45 minutes standing are vertical position at room temperature because these bags are room temp and vertical position at approximately this timing platelet are settle in the whole blood.

4. Tapping of whole blood bags is upper side, when the blood is upper side of position at bag is full down the lower sides, when the blood is stored, blood bag is upper side is keep empty because at time of Platelet Rich Plasma is separating places, the blood is react in a Platelet Rich Plasma bag and when platelet concentrate is separating to Platelet Rich Plasma this blood is reached into platelet concentrated bag and platelet is contaminated from red blood cells and platelet concentrate show a red colour contamination.

5. When the whole blood bags balancing uses of plastic pieces or rubber bungs.

6. Placing of whole blood bags with satellite bags vertical position in bucket and opposing cups with blood and satellite bags to be equal in weight , otherwise excessive accentric loads placed on rotor of centrifuge cause irregular wear and tear and eventual breakage.

7. Balanced buckets should be placed diagonally opposite in refrigerated centrifuge machine. Some refrigerated centrifuge machine made by some companies. Bucket cups there is front of each other. These refrigerated centrifuge machine cups in blood bag is a lable portion of blood bag is front of each other in another blood bag lable side.

8. All blood bags put in refrigerated centrifuge machine and ensure that tight of cap and refrigerated centrifuge machine not started because blood bag temperature is maintain to refrigerated centrifuge machine temperature and leave it undistrup about 20-30 minutes. Because whole blood platelet are shall be settle and in good quality of platelet in Platelet Rich Plasma or more percentage of yield of platelet is reaches in Platelet Rich Plasma bag and platelet concentrate bag.

9. After 20-30 minute refrigerated centrifuge machine is start the first round of approximate time low spine. When the first round is completed and machine is stop then after 3-5 minute all blood bag is out in refrigerated centrifuge machine and put undisturbed blood bags are laminar air flow or biosafety cabinet. This process is a high platelet count reached is Platelet Rich Plasma bag and platelet life and shape is maintained.

10. The use of plasma expresser machine is a presser a all and same of whole bags.

11. Plasma expresser machine uses at time this point is clear that separation to whole blood to Platelet Rich Plasma, the few of Platelet Rich Plasma is a whole time is normal, not flowing is high running and very slow flow all time the flow of separating is normal, because high flow is increase platelet red blood cells contamination. When the whole blood to separated Platelet Rich Plasma is 80% the separation of Platelet Rich Plasma flow is plasma expresser machine is very low and the Platelet Rich Plasma bag flow is very low. This procedure is when stopping when the all white buffy coat is reached the Platelet Rich Plasma bag. 90% white buffy coat is reached Platelet Rich Plasma bag then flow is stop and 5-10% white buffy coat is leave in Packed red cells (PRC). Because this buffy coated is mix of Red blood cells and if contaminate of platelet concentrate, this situation is used of blood pack clamp and clips.

12. Express the Platelet Rich Plasma into the transferred bag intended for platelet storage. Seal the tubing twice between the primary bag and the y connector of the two satellite bags and cut between the two seals. If additive solution is to be added, and it before sealing place the red blood cells at 2-60C refrigerator.

13. Platelet Rich Plasma bag is attached a satellite bag is binding that all Platelet Rich Plasma is one places stripper the Platelet Rich Plasma tube and this tube is a Platelet Rich Plasma is down to at all Platelet Rich Plasma fluid.

(II) Platelet Rich Plasma to platelet concentrate preparation :-

  1. Platelet concentrate is separated from Platelet Rich Plasma by heavy spine ( hard spine) with subsequent removal of supernatant plasma.
  2. Placing of Platelet Rich Plasma bag with satellite bag vertical position in bucket and opposing cups with Platelet Rich Plasma and satellite bag must be equal in weight. Balanced buckets should be placed diagonally opposite in refrigerated centrifuge machine.
  3. Platelet Rich Plasma bag and opposing equal weight Platelet Rich Plasma bag put in a refrigerated centrifuge machine cup and centrifuge machine is start at 220C using a heavy (hard) spin for appropriate time (for 7 minutes)
  4. After completion of II round, machine rotor is stop , then after 3-5 minutes all Platelet Rich Plasma bags is out of machine and undisturb put in a bio safety ( laminar air flow) cabinet.
  5. Express the platelet poor plasma into the satellite bag (transfer bag) and seal the tubing leave 40-70 ml of plasma with the platelet concentrate bag. Platelet is bottom of bag and adherence beg of walls.
  6. Separate platelet poor plasma is a satellite bag and platelet is a primary bag seal the both bag and containing between two seals and separate platelet poor plasma and platelet concentrate. platelet poor plasma put at -750C or below to ensure that it is frozen solid within 5-6 hours of phlebotomy.
  7. Leave platelet concentrate bag is undisturbed with the lable side down at 20-240C for approximately 01 hours. Then resuspend the platelet in plasma by gently mixing through hand to achieve uniform resuspension for 4-5 minute. Because the centrifuge plate aggregate irreversible if subjected to rough agitation. The procedure described permit re suspension without irreversible aggregation.
  8. Record the volume of platelet concentrate, ABO & Rh Group date of expiry on the lable side.  platelet concentrate put at 20-240c under constant agitation in platelet incubator with agitator till  used. The self life is platelet concentrate is 3-5 days depending on the type of plastic bags used. Place the container on a rotator at 20-400c. The slow gentle agitation should achieve uniform resuspension within 2 hours. Platelet should be respected before issue to ensure that no platelet aggregates are visible. The swirling ensures that uniformly viability of platelets.

RESULT :-

The quality management in platelet concentrate upon a : -

  1. Selection  of donor
  2. Quality of the blood bag container
  3. Technique of phlebotomy
  4. Storage temperature of blood bags before centrifugation
  5. Setting or programming of refrigerated centrifuge machine
  6. Platelet concentrate separating procedure or method
  7. Storage of platelet concentrate in Incubator & agitator in proper temperature

Quality Control Testing :-

Check on the efficiency of centrifugation and techniques continuous evaluation of platelet concentrate preparation is necessary. The optimal speed and time of centrifugation must be determined periodically for each refrigerated centrifuge machine to insure maximal yield of platelets. Platelets counts of the fresh whole blood should be determined the concentrate of platelets times of volume of blood equal the number of platelet collected

Example :- Platelet count in whole blood = 250 x103/cumm

Total Number of Platelets in whole Blood (in ml) =  whole Blood Platelet count x 1000 x volume of whole Blood (in ml)

                                                                                 = 250 x 103 x 1000 x 450

                                                                                 = 1.12x1011 platelets

Ist Round :- After the low spine (1st Round) platelet rich plasma is separated from whole Blood

A platelet count is present on this platelet rich plasma approximately 90% or more

Platelet count in platelet rich plasma = 459 x 103/cumm

Total Number of Platelets in platelet rich plasma (in ml) = Platelet Rich Plasma platelet count x 1000 x volume of Platelet Rich Plasma (In ml)       

 = 459 x 103 x1000 x 220 (in ml) 

 = 1.01x 1011 platelets

 

                                                   Platelet Count of Platelet Rich Plasma

% yield of platelets =                                                                                                  x 100

                                                   Platelet Count of Whole Blood

                            =    1.01x1011

                                             1.12x1011

                                     = 90.17%

Hard Spine or IInd Round = After the hard spine or IInd round platelet concentrate is separated from platelet rich plasma

A platelet connt is present on this platelet concentrate approximately 80% or more

Platelet count in platelet concentrate = 750 x 103 x 2 (dilution)

Total Number of platelets in platelet concentrate (In ml)   =  platelet concentrate in platelet count x 1000 x volume of platelet concentrate (in ml)    

= 750 x103 x 2 x 1000 x 56 (in ml) 

= 8.40 x1010  

Platelet count of platelet concentrate

% yield of platelets =                                                                        x 100

Platelet count of platelet rich plasma

 

8.40x1010

                                  =                         x 100

1.01x1011

                                 = 83.16%

This result are show that platelets count present in a whole blood  in 100% and separated platelet rich plasma in platelet count in 90% less than 10% of the platelets should be left in whole blood after the low spine (1st round).  The hard spine of IInd round after preparation a platelet concentrate the count of platelets is 83%. Platelets count in platelets concentrate is show that separated platelet concentrate from platelets rich plasma is 83 % less than 10% of the platelets should be left in platelet rich plasma.

DISCUSSION :-

Platelets are small granular structure present in blood that are fragments of the cytoplasm of megakaryocyts platelets transfusion key role is the treatment of thrombocytopenic patients. Thrombocytopenia is the decrease of circulating platelets and since the pressure of platelets is required for hemostasis Hemorrhagedue to  thrombocytopenia is controlled by the infusion of platelets either in the form  of platelets rich plasma, platelets concentrate or single donor platelet (SDP).

Platelet concentrate one good quality is increase platelet count approximately 5000-10000 (cum per bag  in a patients. Platelets count increase dependent in patients body surface area and clinical status. I experience & study that the first relation between platelet concentrate & blood donor are in the most useful if the donor shall be in good health, mentally alert & physically fit avoid certain drugs any enalgesic  eg. Aspine, good age, weight and Hb, these point are to be effected  to quality in platelets concentrate.

The second effected point of platelet concentrate is proper technique of phlebotomy of donor. A clean and aseptic venipuncture site to minimize bacterial contamination. Blood flow remains is continuously and proper mixing of blood and anticoagulant gently and periodically during collection (approximately over 30-45 seconds)

I experience and study if blood collection is 6-8 minutes is better count of platelets concentrate, if unit requiring more than 8-10 minutes to draw may not be suitable for preparation of platelets concentrate fresh frozen plasma and cryoprecipitates . In component room refrigerated centritage machine & Bio-safety cabinet near each other.

I study that the third and important point is setting  of refrigerated centrifuge machine. The blood components are prepared  by centrifuging at different relative centrifugal force (g) at Ely different time & different temperature conversion of relative centrifugal force (RCF) to Revolution per minute (RPM) depends upon Ely radius of centrifuge rotor

Preparation of Blood components  is possible to different specific gravity of cellular components is :-

  1. Red cell specific gravity – 1.08-1.09
  2. Platelets specific gravity – 1.03-1.04
  3. Plasma specific gravity – 1.02-1.03

Platelet rich plasma & platelets concentrate sepration time refrigerated centrifuge machine temperature is 20-240c if machine temp is low (1-60c) the platelets are to be removed from whole blood and platelet rich plasma.

I experience the last point to be effected of platelet concentrate is a method/ procedure of preparation of platelet concentrate. a proper method & some points is uses if seprated in platelet rich plasma & platelet concentrate time, the quality of platelet concentrate is very good & minimum contaminate from Red blood cells & maintained PH and storage these are the good practice & quality are improve of platelets.

CONCLUSION :-

Platelet concentrate are useful of neonates and baby cases, because neonates and baby cases there are required of 1-2 units of platelet concentrate and platelet concentrate are useful because large volume of plasma in platelet concentrate is harmful of neonates and baby cases and other benefit of neonates and baby cases that platelet concentrate are free from red blood cells contamination, so no chance of hemolytic diseased is occurs.

Platelet concentrate is best for other platelet components because platelet concentrate give to patients/recepients if available same groups, if not available same groups, given to AB groups, because AB groups of platelet concentrate in no any antibody present in plasma, so given any others groups, if a very severe conditions and patients save a life and not available same and AB groups of platelet concentrate this situation given to any others groups of platelet concentrate.

Platelet concentrate is more useful because platelet concentrate are available avery where and preparation procedure is simple and safe. platelet concentrate preparation coast are efficient and also platelet concentrate bag, is reliable and affordable coast of all others.

In future a filter bag is uses of platelet concentrate these prevent Graft versus host disease (GVHD), because platelet size are small and leukocyte sizes are very large, so lymphocytes are unfiltered and platelet are filtered from filter bag and prevent Graft versus host disease (GVHD).

Platelet agitation during storage helps the exchange of gases, maintenance of pH and reduced formation of platelet aggregates agitator (Flate Bag) with 1” to 1.5” stroke at 70-72 cycles/minutes at 20-240C temperature given a good quality result of platelet concentrate.

Platelet concentrate prevent hemolytic transfusion reaction because no red blood cells present in platelet concentrate, if a poor condition of very low quantity of red blood cells present in platelet concentrate is no harmful for patients and patients blood is accepted  and no reaction to very low quantity of red blood cells  for hemolytic transfusion reaction.

I believe that above mentioned approaches offer the most rational preparation of platelet concentrate. The also should be low red blood cells contamination, proper pH and platelets /yields are better to platelet concentrate bags. 

REFERENCE :-  

  1.  Blood Transfusion therapy volume II Dr. R.N. Makroo, 1995 page 4,5
  2.  Transfusion Medicine Technical Manual American Association of Blood Bank, 13th edition 1999, Page No. 714
  3. Blood Management, National plasma fractionation centre, KEM Hosptial, Parel Mumbai 2001, Page  No. 48,50
  4. North London Blood Transfusion Centre
  5. Transfusion medicine Technical Manual Page 170, by WHO & RN Makroo
  6. Transfusion medicine Technical Manual American Association of Blood Bank 13th edition 1999, page no. 745 
  7.  Transfusion Medicine Technical Manual American Association of blood Bank, 13th edition 1999, Page No. 726 
  8. Modern blood banking and transfusion practices by Denise M. Harmening 3rd edition year 1998, Page No. 223
  9. Transfusion Medicine Technical Manual by WHO, Dr R.N. Makroo, Page no. 221
  10. Transfusion Medicine Technical Manual American Association of blood bank 13th edition 1999, Page No. 162
  11. Transfusion Medicine Technical Manual American Association Of Blood Bank, 13th edition 1999, Page No.-457
  12. The Clinical Use of Blood, WHO, 2001, Page No.-110
  13. Transfusion Medicine Technical Manual, American Association of Blood Bank, 13th edition 1999, Page No.-274

 

 

 


33627319_Quality_Management_Procedure_of_platelet_concentrate.doc
Bottom Image
image Image
Mr. NAFIS AHMED
B.SC., D.M.L.T., B.ED.
View Full CV
Bottom Image
Image FOLLOW US RSS Feed Twitter Facebook in Image
Developed By LBM Infotech