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Hematology & Blood Transfusion

Blood Products (Types and Indications)

Overview of common blood components available and their primary clinical indications, focusing on Whole Blood and Red Cell Concentrates as per UCG scope for lower levels.

Also known as: Whole Blood, Packed Red Cells, Platelets, FFP, Cryoprecipitate

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Referral and warning signs

When to refer

Referral needed for conditions requiring components usually only available at RRH/UBTS (Platelets, FFP, Cryo).

Red flags

  • Not applicable - describes products.

Signs and symptoms

  • Not applicable - This describes products and indications.

Risk factors

  • Not applicable.

Diagnosis

Clinical assessment

Selection based on clinical need (O2 capacity vs volume vs factors vs platelets).

Investigations

  • CBC (Hb, Platelet)
  • Coagulation screen (INR, aPTT, Fibrinogen)
  • Assessment of bleeding / volume status.

Diagnostic criteria

Clinical and laboratory assessment indicating need for specific component.

Management

Pharmacological treatment

  • Whole Blood (WB): Content (RBCs, plasma, factors, some platelets). Use (Acute blood loss >20-30% with hypovolemia, Neonatal exchange <5d). Dose (Adult: 1 unit, reassess; Child: 20 mL/kg). Cautions (Volume overload, not for chronic anaemia/HF). ABO/RhD compatible.
  • Red Cell Concentrates (Packed Red Cells - PRC): Content (RBCs, minimal plasma). Use (Increase O2 capacity in symptomatic anaemia, Acute blood loss). Dose (Adult: 1 unit raises Hb ~1g/dL; Child: 10-15 mL/kg raises Hb ~2-3g/dL). Cautions (Slower infusion if overload risk). ABO/RhD compatible.
  • Platelet Concentrates: Use (Treat/prevent bleeding due to severe thrombocytopenia <10-50k or dysfunction). Availability (RRH/UBTS).
  • Fresh Frozen Plasma (FFP): Content (All coagulation factors). Use (Multiple factor deficiencies - liver disease, DIC, massive Tx, warfarin reversal if no PCC). Availability (RRH/UBTS).
  • Cryoprecipitate: Content (Fibrinogen, FVIII, FXIII, vWF). Use (Low fibrinogen - DIC, massive Tx). Availability (RRH/UBTS).

Monitoring

Monitor clinical response and adverse reactions for all transfusions.

Complications

  • See HEM007 (Transfusion Principles) and HEM009 (Transfusion Reactions).

Prevention

  • Appropriate use based on clear indications.

Patient education

  • Explanation of the specific blood product needed and why.

Uganda-specific notes

WB and PRC (incl. paediatric bags) main products via UBTS from HC4+. FFP, Platelets, Cryo restricted to RRH/UCI/Specialized centres.

References

  • Uganda Clinical Guidelines (UCG) 2023

    Chapter 11, Section 11.2.2

  • National Blood Transfusion Guidelines for Appropriate Use of Blood, MOH Uganda

    (Primary reference)

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