Thanks Pam ... very informative ... it's a pleasure working with you!

Bob

Thank you to all who were and are involved in the fraction guide- it will certainly be a great resource for the site!

Could someone help clarify one point on the chart for me? Our understanding about platelet gel is that it is a procedure that is performed with the patient's own blood. We have checked with the blood bank at our hospital and collection agencies in the area and none offer allogeneic platelet gel.

In our area, that would qualify platelet gel as a procedure and not a fraction. Is it different at hospitals in other parts of the country (or world)?

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Warren Behr
Bronson Blood Conservation

At Tampa General our perfusionists are in charge of the platelet gel in the cardiac OR (they use Magellan, see: http://www.medtronic.com/cardsurgery...an_ovrw.html); for the orthopedic patients the surgical nurses use the Symphony System (DuPuy/J&J, see: http://www.jnjgateway.com/home.jhtml...Bone_Grafting).

It's made up in the OR using a platelet separator; it doesn't come from the blood bank.

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Robin Atkins, Coordinator
Bloodless Medicine and Surgery
Tampa General Hospital
Tampa, FL 33606
(866) 662-5333

I think two important points about the platelet gel are that it uses only the patient's own unstored blood (which is mixed with a pharmaceutical agent that does not contain any blood products), and it is applied to operative surfaces. It does not re-enter the circulation. It is a matter of conscience for Jehovah's Witnesses whether or not to accept this procedure.

Liz Crum, MSN, RN, CCRN
Coordinator, Center for Bloodless Medicine and Surgery
Hackensack University Medical Center
Hackensack, NJ 07601
201-996-2963

The above replies are very helpful. It is true that in the strict sense, platelet gel is not a fraction but a substance is "manufactured" from autologous (the patient's own) blood during the course of a surgical operation. This will need to be made clear in the glossary.

I would also like to thank you for this concise explanation. We had to do a lot of research last Sept for a 77-yr old mother-in-law who was involved in a collision and sustained fractures in two vertebrae and broken ribs and collapsed lung and hematoma on the brain. One thing we were asked as a family is if she would take the cryoprecipitate. I called the local blood bank and they informed me as to how it was extracted and ended up being only 1/500th of whole blood. It had to be reconstituted before administration and they usually use plasma, but they could also do it with saline, I believe, or some similar substance that would ease the conscience of those who won't take plasma.
Kathy

How are blood fractions stored, are donors necessary for blood fractions or can they be extracted from other sources rather than pints of whole blood? I mean albumin and other fractions that are often passed quite naturally from mother to feotus in the womb.

I'm not quite sure what it is that you want to know. If you are asking whether blood fractions such as albumin are obtained from any source other than stored donor blood, the answer is that many fractions can now be "manufactured" by genetic engineering technology. There are, for instance, several companies that are marketing a recombinant human albumin for therapeutic and diagnostic usage. Here are a couple of them:
http://www.deltabiotechnology.com/
http://www.newcenturypharm.com/products.htm
However, while the small quantity of albumin in these preparations is suitable for diagnostic procedures and for use as a stabilizer for certain drugs, the larger volumes required when used as a resuscitation fluid are still generally derived from pooled donor plasma. The albumin is separated from the plasma by cold ethanol fractionation and the bottles (or bags) are usually held for at least two weeks at 30–32 degrees centigrade and examined for evidence of bacterial contamination before being made ready for clinical use.

In regard to autologous platelet gel: It is a medical procedure involving the use of your blood. In the U.S. it also is a fraction. Thrombin is mixed with the product. That is a form of a fraction. So, our perfusionists make sure that the person is ok with medical uses involving the use of their blood and fractions.

In regard to fractions: It is always good to check the package insert. For example, it will indicate if albumin is from human source. To my knowledge, there is no form of EPO available in the U.S. that is not made with human albumin as a stablizer. (Been down that road before and was unable to find any) MMR aslo has albumin as a stabilizer, as do many drugs. The process of isolating a fraction and sterilization and/ or washing with detergent is immense. It looks like a big beer processing plant. The fractions such as albumin, contain no RNA or DNA. Certainly, a more purified product than when you eat meat. Hope this helps as well. Great posts. Thanks

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Yvette Bunch

Neither Eprex nor NeoRecormon, available in the UK, contain albumin.