Whole blood

• A unit of whole blood consists of 450ml of blood plus 63ml of anticoagulant (leucocyte depleted)
• Blood stored at 4°C is given a shelf life of 5 weeks in the UK, when at least 70% of the transfused cells should survive
• Whole blood is rarely used for transfusion, as donated blood is processed into red cell concentrates and other blood components

Red cell concentrates

• All plasma is removed and replaced with about 100ml of optimal additive solution
• used to increase the oxygen-carrying capacity of patients with major haemorrhage, and to treat non- bleeding patients with severe anaemia by maintaining the haemo- globin above 70 g/L (higher threshold in cardiovascular disease)

Fresh frozen plasma (FFP)

• FFP is prepared by freezing the plasma from 1 unit of blood to −30°C to maintain the concentration of coagulation factors.
• most suited for 'clinically significant' but without 'major haemorrhage' in patients with a prothrombin time (PT) ratio or activated partial thromboplastin time (APTT) ratio > 1.5
• typically 150-220 mL
• can be used prophylactically in patients undergoing invasive surgery where there is a risk of significant bleeding
• In contrast to red cells, the universal donor of FFP is AB blood because it lacks any anti-A or anti-B antibodies

Cryoprecipitate

• contains concentrated Factor VIII:C, von Willebrand factor, fibrinogen, Factor XIII and fibronectin, produced by further processing of Fresh Frozen Plasma (FFP). Clinically it is most commonly used to replace fibrinogen
• much smaller volume than FFP, typically 15-20mL
• most suited for patients for 'clinically significant' but without 'major haemorrhage' who have a fibrinogen concentration < 1.5 g/L