Red Blood Cells (RBCs) / Packed RBCs – As Licensed

Description

Blood Component: Packed Red Blood Cells (RBCs) are a blood product prepared from whole blood donations by removing most of the plasma.
Composition: This product consists of a high concentration of red blood cells suspended in a small volume of plasma and an additive solution. This process increases the hematocrit to approximately 55% to 80%.
Purpose: The primary purpose of packed RBCs is to increase the oxygen-carrying capacity of the blood. It does so by providing a concentrated source of hemoglobin.
Compatibility: Transfusion of packed RBCs requires strict ABO and Rh compatibility to prevent a potentially fatal transfusion reaction. Cross-matching is also performed to ensure compatibility.

High Oxygen-Carrying Capacity: Packed RBCs provide a highly concentrated source of hemoglobin, which is essential for improving tissue oxygenation in anemic or bleeding patients.
Volume Efficiency: By removing most of the plasma, packed RBCs allow for the administration of a large amount of red cells in a relatively small volume, reducing the risk of fluid overload in patients with cardiovascular compromise.
Reduced Transfusion Reactions: The removal of plasma (which contains antibodies and other proteins) generally reduces the risk of allergic or febrile non-hemolytic transfusion reactions compared to whole blood.
Extended Shelf Life: With the use of modern additive solutions, packed RBCs can be stored for up to 42 days, providing a stable and readily available supply for blood banks.

Treatment of Anemia: A primary indication is the treatment of symptomatic anemia from any cause (e.g., chronic blood loss, bone marrow failure, kidney disease) when the patient’s symptoms are attributable to a lack of oxygen-carrying capacity.
Massive Hemorrhage: Used as a key component of massive transfusion protocols to replace blood loss and maintain oxygen delivery in patients with severe, ongoing bleeding from trauma, surgery, or other conditions.
Pre-operative Optimization: Administered to correct severe anemia before surgery, thereby reducing the risk of perioperative complications.
Hemoglobinopathies: Used in the management of conditions like sickle cell disease and thalassemia to prevent complications and reduce the percentage of abnormal hemoglobin.

Source Material: Packed RBCs are prepared from whole blood donations. The blood is centrifuged, and the red cells are separated from the plasma and buffy coat.
Mechanism of Action: The therapeutic effect is to increase the number of red blood cells in the patient’s circulation. This elevates the hemoglobin and hematocrit levels, which, in turn, restores the blood’s capacity to transport oxygen from the lungs to the body’s tissues.
Modification: Packed RBCs can be further modified for specific patient needs, such as leukoreduction (to remove white blood cells and reduce the risk of febrile reactions and CMV transmission), irradiation (to prevent transfusion-associated graft-versus-host disease), or washing (to remove residual plasma proteins).
Risk of Transfusion Reactions: As a blood product, packed RBCs carry a risk of various transfusion reactions, including acute hemolytic reactions (due to ABO incompatibility), allergic reactions, fever, and infection transmission, though these risks are significantly minimized by modern screening and testing.

Temperature: Packed Red Blood Cells must be stored in a specialized blood bank refrigerator at a temperature between 1∘C and 6∘C.
Shelf Life: The standard shelf life is up to 42 days, depending on the type of additive solution used (e.g., CPDA-1, AS-1, AS-3, AS-5).
Pre-transfusion Handling: Before transfusion, the unit of packed RBCs must be visually inspected for any signs of hemolysis, clots, or discoloration. The transfusion must be initiated within a specified time frame after the unit is removed from the refrigerator.
Transport: During transport, the unit must be maintained within the required temperature range to preserve its viability and safety. This is often done using validated containers with temperature monitors.