Common red blood cell preparations are as follows:
(1) concentrated red blood cells: It is an important red blood cell product and has been widely used in clinic. Hematocrit is 70-90%, and more than 80% should be adjusted with normal saline. It is suitable for patients with chronic anemia, acute blood loss and cardiac insufficiency.
(2) Washing red blood cells: Wash red blood cells with normal saline for 3-6 times, so that the plasma protein content is very small, which can reduce the adverse reactions of blood transfusion and remove most anti-A and anti-B antibodies. Therefore, it is safer to give washed O-red blood cells to patients with other blood types when necessary. It is suitable for patients with autoimmune hemolytic anemia and those who are prone to produce antibodies after re-transfusion.
(3) Irradiating red blood cells. It is not a single red blood cell product, but a variety of red blood cell products are irradiated to kill immunocompetent lymphocytes and achieve the purpose of preventing TA-GVHD. Irradiated red blood cells are mainly suitable for blood transfusion, neonatal exchange transfusion, intrauterine transfusion, blood transfusion of close relatives, etc. of patients with immunodeficiency or immunosuppression.
(4) Red blood cells with few white blood cells: Removing white blood cells can reduce the adverse reactions caused by white blood cells. Now there are special filters to remove white blood cells, which can be used when there is a backlog of blood transfusion. Because it can prevent non-hemolytic fever reaction, it is suitable for people who need long-term repeated blood transfusion and prepare for transplantation.
(5) Others: There are still frozen red blood cells and young red blood cells. Among them, frozen red blood cells are suitable for long-term preservation in rare blood group, and young red blood cells are suitable for long-term blood transfusion patients.
Can be organized into tables for easy memory:
Let's look at an example:
The only choice is to prevent TA-GVHD, and red blood cell preparation should be the first choice:
A. Suspending red blood cells B. Washing red blood cells
C. irradiated red blood cells D. leukopenia red blood cells
Answer C. Analysis: The recipient has immune deficiency. When there are immunocompetent lymphocytes in the imported blood products, these immunocompetent lymphocytes proliferate in the host and attack the target cells, resulting in TA-GVHD. Irradiation of blood products can destroy the mitotic ability of immunocompetent lymphocytes and prevent the occurrence of TA-CVHD.