Platelets

Platelets: Bubbles

abby.wolfe — Tue, 09 Jan 2024 14:41:00 +0000

Platelets: Bubbles

Small air bubbles can represent normal variation in a platelet unit, however if accompanied by aggregates and/or colour changes this may represent bacterial contamination. Platelets suspected to have bacterial contamination should NOT be transfused and any component suspected of bacterial contamination based on a visual inspection must be reported to Canadian Blood Services using the feedback form on blood.ca.

Platelets: Other causes of discolouration

abby.wolfe — Tue, 09 Jan 2024 15:08:41 +0000

Platelets: Other causes of discolouration

In addition to discolouration that may be associated with contamination from RBCs or bacteria, lipemia or icterus, a variety of donor factors, ranging from metabolic conditions to medications or large doses of vitamins taken by donors, can also discolour the plasma portion of platelet units:

Medications (acceptable for transfusion)
- Oral contraceptive pill: light green plasma
Vitamins (acceptable for transfusion)
- Vitamin A (including consumption of large quantities of carrots): bright orange plasma

Platelets: Particulate matter

abby.wolfe — Tue, 09 Jan 2024 14:30:25 +0000

Platelets: Particulate matter

Particulate matter can be the result of blood collection and/or component manufacturing processes. There are several categories of particulate matter that may be found within platelet units:

Clots and fibrin strands
- Clots may appear as white and opaque masses that do not dissipate with gentle manipulation.
- Clots and fibrin strands result from the activation of the clotting processes and can be a mixture of clotting proteins (including fibrin) and platelets. Blood is collected and processed in bags that contain anticoagulants to inhibit the clotting processes. Blood components containing clots and / or fibrin strands should NOT be transfused and should be reported to Canadian Blood Services.
Aggregates
- Aggregates may appear as small white and opaque masses that generally dissipate with gentle manipulation and/or agitation.
- Aggregates have been reported in some pathogen-reduced platelet components. Platelets containing visible particles are not inferior to particle-free concentrates.
- Placing units in landscape orientation on an agitator may help reduce aggregate formation.

An example of a platelet unit with white particulate matter.

Platelets: Bacterial contamination

abby.wolfe — Tue, 09 Jan 2024 14:21:59 +0000

Platelets: Bacterial contamination

Bacterial contamination is the presence of bacteria in the blood. Blood should be free of bacteria. Blood is collected and processed under sterile conditions to maintain this aseptic state. Pathogen inactivation through psoralen treatment further reduces the risk of bacterial contamination in platelets. All platelet units not treated with psoralen are tested for bacterial contamination by Canadian Blood Services. Bacterially contaminated blood components should NOT be transfused and any components suspected of bacterial contamination based on a visual inspection, must be reported to Canadian Blood Services using the feedback form on blood.ca. Contact the nearest distribution centre to report potential contamination and receive further instructions.

Possible (though rare) sources of bacterial contamination include the following:

Donor with asymptomatic bacteremia (i.e., subclinical bacteria in blood)
Inadequate cleansing of skin prior to venipuncture. (Please note: To minimize bacterial contamination, Canadian Blood Services uses a diversion pouch for the first portion of the blood donation. In addition to a strict protocol on skin cleansing, the diversion pouch prevents the skin plug and skin bacteria from entering the main unit.)
Loss of sterility during component manufacturing or handling.

Visual appearance

The presence of bacteria may produce gas resulting in excessive air bubbles.
The presence of bacteria may activate clotting resulting in clots and fibrin strands.
Cloudiness
Grey discolouration

Platelets: Icterus

abby.wolfe — Tue, 09 Jan 2024 15:01:55 +0000

Platelets: Icterus

Icterus, also known as jaundice, refers to a yellow discolouration caused by high bilirubin content in blood, and describes the yellow discolouration of skin, eyes, mucous membranes and plasma. A platelet unit with icterus may be acceptable for transfusion.

Causes of icterus in a platelet unit are donor related and may be related to:

Hemolytic anemia
Non-infectious hepatitis (e.g., alcohol liver disease)
Inherited liver disorders (e.g., Gilbert’s syndrome)
Gallstones

Visual appearance

Bright yellow to brown

Platelets: Red blood cell contamination

abby.wolfe — Tue, 09 Jan 2024 14:35:37 +0000

Platelets: Red blood cell contamination

RBC contamination occurs during manufacturing and results from ineffective separation of RBCs and platelets. In accordance with the most recent CSA Standards, Canadian Blood Services visually inspects components for hemolysis prior to placing them into inventory. At the hospital level, current standards do not stipulate an acceptable level of RBC contamination.

Visual appearance

The degree of red discolouration reflects the amount of RBC contamination varying from a light pink tinge to a marked red discolouration.

Platelets: Lipemia

abby.wolfe — Tue, 09 Jan 2024 14:15:52 +0000

Platelets: Lipemia

Lipemia is the presence of excessive amounts of lipid particles in the blood. Lipemia is not objectively measured; its presence is subjectively identified. Because grossly lipemic blood samples may interfere with infectious disease testing platforms, these units are discarded and are not distributed.

Causes of lipemia in a platelet unit are donor related and may be related to:

Fatty meals before blood donation
Chronic conditions such as hypercholesterolemia

Visual appearance

Lipemia may result in a milky white appearance

Platelets

Platelets: Bubbles

Platelets: Bubbles

Typical pooled platelet psoralen-treated (PPPT) unit

PPPT unit with bubbles

Typical apheresis platelet psoralen-treated (APPT) unit

APPT unit with bubbles

Platelets: Other causes of discolouration

Platelets: Other causes of discolouration

Typical pooled platelet psoralen-treated (PPPT) unit

PPPT unit with discolouration

Typical apheresis platelet psoralen-treated (APPT) unit

APPT unit with discolouration

Platelets: Particulate matter

Platelets: Particulate matter

Typical apheresis platelet unit in PAS

Apheresis platelet unit in PAS with aggregates

Typical pooled platelet psoralen-treated (PPPT) unit

PPPT unit with aggregates

Typical apheresis platelet psoralen-treated (APPT) unit

APPT unit with aggregates

Platelets: Bacterial contamination

Platelets: Bacterial contamination

Visual appearance

Typical pooled platelet unit

Pooled platelet units with bacterial contamination

Pooled platelet unit with bacterial contamination

Pooled platelet units with bacterial contamination

Pooled platelet units with bacterial contamination

Typical pooled platelet psoralen-treated (PPPT) unit

PPPT unit with bacterial contamination

Typical apheresis platelet psoralen-treated (APPT) unit

APPT unit with bacterial contamination

Platelets: Icterus

Platelets: Icterus

Visual appearance

Typical pooled platelet psoralen-treated (PPPT) unit

PPPT unit with icterus

Typical apheresis platelet psoralen-treated (APPT) unit

APPT unit with icterus

Platelets: Red blood cell contamination

Platelets: Red blood cell contamination

Visual appearance

Typical pooled platelet unit

Pooled platelet unit with RBC contamination

Pooled platelet unit with RBC contamination

Typical pooled platelet psoralen-treated (PPPT) unit

PPPT unit with RBC contamination

Typical apheresis platelet psoralen-treated (APPT) unit

APPT unit with RBC contamination

Platelets: Lipemia

Platelets: Lipemia

Visual appearance

Typical pooled platelet psoralen-treated (PPPT) unit

PPPT unit with lipemia

Typical apheresis platelet psoralen-treated (APPT) unit

APPT unit with lipemia