What is whole blood component fractionation?

Updated: Apr 16, 2019
  • Author: Linda L Maerz, MD, FACS, FCCM; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Whole blood is fractionated into specific components, as follows: PRBC, FFP, platelet concentrates, and cryoprecipitate; FFP may be further fractionated into individual factor concentrates as well. Fractionation maximizes the clinician’s ability to rationally use the components of each donated unit while simultaneously limiting unnecessary transfusions. A specific product may also be transfused with less volume. Additionally, the individual components require different storage temperatures; therefore, fractionation allows more effective product management. [9]

Blood component fractionation is based on centrifugation and flash-freezing technology. Whole blood is separated into red cells and platelet-rich plasma by slow centrifugation. High-speed centrifugation is then applied to the platelet-rich plasma to yield one unit of random donor platelets and one unit of FFP. FFP yields cryoprecipitate via a slow thaw process to precipitate the plasma proteins, which are then separated by centrifugation. Cryoprecipitate contains high concentrations of fibrinogen, factor VIII, factor XIII, von Willebrand factor, and fibronectin; hypofibrinogenemia is the most common transfusion indication for cryoprecipitate in the critical care environment or in the operating room.

Apheresis technology may be used to collect multiple units of platelets from a single donor. Single-donor apheresis platelets contain the equivalent of at least 6 units of random donor platelets and often have fewer inadvertently included leukocytes than pooled random donor platelets. Apheresis is most commonly used to obtain platelets for use in alloimmunized patients with a dense antibody presence that makes cross-matching difficult. Patients with blood dyscrasias and malignancies commonly fall into this category. [10]


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