Fresh frozen plasma transfusion. Plasma, fresh frozen

Date: 04.03.2020

Component characteristic... Plasma can be isolated during fractionation from a dose of whole blood or prepared by apheresis and frozen within 6 hours after collection with the labeling of fresh frozen plasma (European Committee Standards). Complete freezing of donor plasma to a temperature of -30 ° C should be carried out within 1 hour (Standards of the European Committee), and according to the current technical regulations - within 40 minutes.

Fresh frozen plasma maintains normal levels of all coagulation factors (must contain at least 70 IU factor VIII per 100 ml and the same amount of other labile factors and natural coagulation inhibitors) (European Committee Standards). Fresh frozen plasma is allowed to be stored for up to 36 months at temperatures below -25 ° C. According to the current Standards of the European Committee, the content of cellular elements in fresh frozen plasma should not exceed the following indicators: erythrocytes should be
In Russia, all freshly frozen plasma is subject to a mandatory quarantine process: fresh frozen plasma is harvested and stored using the above technology for 6 months, after which the donor is re-examined for the presence of blood-borne infections.

Only after the measures taken - receiving negative results of serological examination - fresh frozen plasma is marked as "quarantined" and can be used for transfusion. Thus, the possibility of transmission of infection (HIV, hepatitis B and C) from donors during the period of the sero-negative "window" is eliminated.

Clinical application and indications.
Fresh frozen plasma transfusions are indicated for replenishment of coagulation factors in patients with laboratory-confirmed deficiency (prothrombin time or partial thromboplastin time is more than 1.5 times longer, which corresponds to factor activity less than 30%, international normalized ratio> 1.6- 2.0).

Fresh frozen plasma is usually used in the treatment of acquired forms of coagulopathy: in patients with liver disease, disseminated intravascular coagulation syndrome, or the effect of an overdose of anticoagulants (including, if necessary, quickly induce the reverse action of warfarin) who have active bleeding or require surgery.

Fresh frozen plasma is also used to treat patients receiving massive blood transfusions with laboratory evidence of dilutional coagulopathy.

Fresh frozen plasma is preferable to use for therapeutic plasma exchange in patients with thrombotic thrombcytopenic purpura and hemolic-uremic zyndroma. Fresh frozen plasma after cryoprecipitate isolation can also be used to treat thrombocytopenic purpura. It may be necessary to transfuse fresh frozen plasma in case of hereditary deficiencies of coagulation factors, in situations where factor preparations are not available (to compensate for the deficiency of factors II, V, X, XI).

Contraindications Fresh frozen plasma should not be used to replace circulating blood volume, to correct hypoalbuminemia, and as an alternative to parenteral nutrition in patients with nutritional deficiencies. In these situations, competent infusion therapy with crystalloid, colloidal solutions and synthetic plasma substitutes and the use of parenteral nutrition drugs will allow the recipient to avoid blood-borne infectious complications, allergic reactions and TRALI.

Dose and rate of administration.

The average dose and rate of administration of fresh frozen plasma depend on the specific clinical situation and the course of the underlying disease.

It is justified to prescribe fresh frozen plasma at the rate of 10-15 ml / kg of body weight and accompany transfusions with control of clinical and laboratory data to assess the effect and determine the interval between injections of fresh frozen plasma doses. It is accepted that transfusion of 1 ml of fresh frozen plasma provides 1 unit of activity of all factors, including labile V and VIII. To increase factor activity by 20% in adult patients (when controlled immediately after transfusion), the transfused dose of fresh frozen plasma can vary from 10 to 20 ml / kg (equivalent to 3-6 doses of fresh frozen plasma). The rate of administration of fresh frozen plasma is determined by the clinical need of the patient and the state of his hemodynamics. Fresh frozen plasma should be transfused through a 170-260 micron filter.

Transfusion rules. Fresh frozen plasma should be thawed at 37 ° C using special thawing equipment and transfused as soon as possible, but no later than 24 hours after thawing. Fresh frozen plasma should be transfused from an AB0-compatible donor with the recipient. RhD-compatible plasma should be transfused to women of childbearing age

Expected effect and parameters of patient monitoring. Correction of the deficiency of coagulation factors should be assessed by the clinical picture and dynamics of laboratory parameters of the patient's coagulation status: prothrombin time, partial thromboplastin time, or assessment of the activity of coagulation factors. In patients with thrombotic thrombocytopenic purpura, a pronounced clinical effect is expected.

FFP contains all plasma proteins, including all clotting factors. FFP transfusion is indicated for isolated clotting factor deficiencies, for eliminating the action of warfarin, and for coagulopathy due to liver disease. In adults, transfusion of a single dose of FFP increases the concentration of each clotting factor by 2–3%. The initial therapeutic dose is 10-15 ml / kg. FFP is also indicated for massive blood transfusions if bleeding continues despite platelet transfusion. FFP is transfused for antithrombin III deficiency and thrombotic thrombocytopenic purpura.

Transfusing one dose of FFP carries the same risk of transmission as transfusing one dose of whole blood. In addition, some patients become sensitized to plasma proteins. ABO compatibility is generally observed but not strictly required. Like the erythrocyte mass, the FFP must be warmed up to 37 0 C before transfusion.

Platelets

Platelet transfusion is indicated if thrombocytopenia or thrombocytopathy is detected against the background of bleeding. In addition, due to the increased risk of spontaneous bleeding, prophylactic platelet transfusion is indicated for thrombocytopenia.< 10 000-20 000/мкл.

Thrombocytopenia< 50 000/мкл приводит к увеличению интраоперационной кровопотери. In patients with thrombocytopenia, the platelet concentration should be increased to 100,000 / μL before surgery or other invasive procedure. One standard dose of platelet mass increases the platelet count by 5000-10,000 / μL. Thrombocyte concentrate obtained by thrombocytapheresis from one donor is equivalent to 6 standard doses of platelet mass. If the patient received platelet transfusion earlier, then the increase in their concentration will be less than expected. Thrombocytopathies also increase intraoperative blood loss; their diagnostic criterion is a combination of a normal platelet concentration with an extended time

bleeding. Thrombocytopathy associated with increased tissue bleeding is also an indication for platelet transfusion. ABO compatibility is desirable but not required. Platelets are viable for 1-7 days after transfusion. ABO compatibility increases platelet lifespan. The presence of several red blood cells in platelet mass from an Rh-positive donor transfused into an Rh-negative recipient can cause Rh sensitization (i.e., the production of anti-B antibodies). Moreover, transfusion of large volumes of platelet mass incompatible with the ABO system can cause a hemolytic reaction: each dose of platelet mass contains 70 ml of plasma, which contains anti-A or anti-B antibodies. The administration of an Rh-negative patient with Rh-immunoglobulin prevents Rh-factor sensitization during platelet transfusion from a Rh-positive donor. If the patient has developed antibodies to antigens of the HLA system (these are antigens of lymphocytes that accidentally got into the platelet concentrate) or specific platelet antigens, then the selection of platelets according to the HLA system or from one donor is shown. The risk of sensitization is reduced with transfusion of platelets obtained by thrombocytopheresis.

Granulocytes

Granulocytes obtained by leukapheresis are transfused for resistant bacterial infection in patients with neutropenia. Transfused granulocytes circulate in the blood for a very short time, which requires daily transfusion of 10-30 XlO 9 granulocytes. Irradiation of these cells reduces the risk of graft-versus-host reactions, the degree of damage to the pulmonary endothelium and other complications, but can disrupt the function of granulocytes. The appearance of filgrastim (granulocyte colony-stimulating factor), as well as sargramostim (granulocyte-macrophage colony-stimulating factor) practically eliminated the need for granulocyte transfusion.

8. Transfusion of correctors of plasma-coagulation hemostasis

8.1. Characteristics of correctors of plasma-coagulation hemostasis

8.2. Indications and contraindications for plasma transfusion

fresh frozen

8.3. Features of transfusion of fresh frozen plasma

8.4. Transfusion reactions of fresh frozen plasma

Plasma is a liquid part of blood, devoid of cellular elements. The normal plasma volume is about 4% of the total body weight (40 - 45 ml / kg). Plasma components maintain a normal volume of circulating blood and its liquid state. Plasma proteins determine its colloidal-oncotic pressure and balance with hydrostatic pressure; they also support the blood coagulation and fibrinolysis systems in equilibrium. In addition, plasma ensures the balance of electrolytes and the acid-base balance of the blood.

In medical practice, fresh frozen, native plasma, cryoprecipitate and plasma preparations are used: albumin, gamma globulins, blood coagulation factors, physiological anticoagulants (antithrombin III, protein C and S), components of the fibrinolytic system.

8.1. Characteristics of correctors of plasma-coagulation hemostasis

Fresh frozen plasma is understood to mean plasma that, within 4-6 hours after blood exfusion, is separated from erythrocytes by centrifugation or apheresis and placed in a low-temperature refrigerator, which provides complete freezing to a temperature of -30 ° C per hour. This mode of plasma preparation ensures its long-term (up to a year) storage. In fresh frozen plasma, labile (V and VIII) and stable (I, II, VII, IX) coagulation factors are retained in an optimal ratio.

If cryoprecipitate is removed from the plasma during fractionation, then the remaining part of the plasma is the supernatant fraction of plasma (cryosupernatant), which has its own indications for use.

After separation of water from the plasma, the concentration of total protein, plasma coagulation factors, in particular, IX, increases significantly - this plasma is called "native concentrated plasma".

The transfused fresh frozen plasma should be of the same group with the recipient according to the AB0 system. Rh compatibility is not mandatory, since fresh frozen plasma is a cell-free environment, however, with volumetric transfusions of fresh frozen plasma (more than 1 liter), Rh compatibility is required. Compatibility for minor erythrocyte antigens is not required.

It is desirable that the fresh frozen plasma meets the following standard quality criteria: the amount of protein is not less than 60 g / l, the amount of hemoglobin is less than 0.05 g / l, the level of potassium is less than 5 mmol / l. The transaminase level should be within the normal range. The test results for markers of syphilis, hepatitis B and C, HIV are negative.

After thawing, the plasma must be used within an hour; the plasma cannot be re-frozen. In emergency cases, in the absence of one-group fresh frozen plasma, transfusion of AB (IV) plasma to a recipient with any blood group is allowed.

The volume of fresh frozen plasma, obtained by centrifugation from a single dose of blood, is 200 - 250 ml. When carrying out double donor plasmapheresis, the plasma output can be 400 - 500 ml, hardware plasmapheresis - no more than 600 ml.

8.2. Indications and contraindications for fresh frozen plasma transfusion

Indications for prescribing transfusions of fresh frozen plasma are:

Acute disseminated intravascular coagulation (DIC) syndrome, complicating the course of shocks of various origins (septic, hemorrhagic, hemolytic) or caused by other reasons (amniotic fluid embolism, crash syndrome, severe injuries with tissue crushing, extensive surgical operations, especially on the lungs, blood vessels, head brain, prostate), massive transfusion syndrome.

Acute massive blood loss (more than 30% of the circulating blood volume) with the development of hemorrhagic shock and disseminated intravascular coagulation;

Liver diseases, accompanied by a decrease in the production of plasma coagulation factors and, accordingly, their deficiency in the circulation (acute fulminant hepatitis, liver cirrhosis);

Overdose of indirect anticoagulants (dicumarin and others);

When performing therapeutic plasmapheresis in patients with thrombotic thrombocytopenic purpura (Moshkovitz disease), severe poisoning, sepsis, acute disseminated intravascular coagulation syndrome;

Coagulopathy due to a deficiency of plasma physiological anticoagulants.

It is not recommended to transfuse fresh frozen plasma in order to replenish the circulating blood volume (there are safer and more economical means for this) or for parenteral nutrition purposes. Caution should be given to prescribing fresh frozen plasma transfusion in persons with a burdened transfusion history, in the presence of congestive heart failure.

8.3. Features of transfusion of fresh frozen plasma

Transfusion of fresh frozen plasma is carried out through a standard blood transfusion system with a filter, depending on clinical indications - jet or drip, in acute disseminated intravascular coagulation syndrome with severe hemorrhagic syndrome - jet. It is forbidden to transfuse fresh frozen plasma to several patients from one container or bottle.

When transfusing fresh frozen plasma, it is necessary to perform a biological test (similar to the transfusion of blood gas carriers). The first few minutes after the start of the infusion of fresh frozen plasma, when a small amount of the transfused volume has entered the recipient's circulation, are decisive for the occurrence of possible anaphylactic, allergic and other reactions.

The volume of transfused fresh frozen plasma depends on the clinical indication. In case of bleeding associated with disseminated intravascular coagulation, the administration of at least 1000 ml of fresh frozen plasma at the same time under the control of hemodynamic parameters and central venous pressure is indicated. Often it is necessary to re-inject the same volumes of fresh frozen plasma under dynamic control of the coagulogram and clinical picture. In this state, the introduction of small amounts (300 - 400 ml) of plasma is ineffective.

In acute massive blood loss (more than 30% of the circulating blood volume, for adults - more than 1500 ml), accompanied by the development of acute disseminated intravascular coagulation, the amount of fresh frozen plasma transfused should be at least 25-30% of the total volume of transfusion media prescribed to replenish blood loss, t .e. not less than 800 - 1000 ml.

In chronic disseminated intravascular coagulation, as a rule, transfusion of fresh frozen plasma is combined with the appointment of direct anticoagulants and antiplatelet agents (coagulological control is necessary, which is a criterion for the adequacy of the therapy). In this clinical situation, the volume of fresh frozen plasma transfused once is at least 600 ml.

In severe liver diseases, accompanied by a sharp decrease in the level of plasma coagulation factors and the development of bleeding or the threat of bleeding during the operation, transfusion of fresh frozen plasma at the rate of 15 ml / kg of body weight is indicated, followed, after 4 to 8 hours, by repeated transfusion of plasma in a smaller volume ( 5 - 10 ml / kg).

Immediately before transfusion, fresh frozen plasma is thawed in a water bath at a temperature of 37 ° C. In thawed plasma, fibrin flakes may appear, which does not prevent its use with the help of standard devices for intravenous transfusion with a filter.

The possibility of long-term storage of fresh frozen plasma makes it possible to accumulate it from one donor in order to implement the principle "one donor - one recipient", which sharply reduces the antigenic load on the recipient.

8.4. Transfusion reactions of fresh frozen plasma

The most severe risk of transfusing fresh frozen plasma is the possibility of transmission of viral and bacterial infections. That is why today much attention is paid to methods of viral inactivation of fresh frozen plasma (plasma quarantine for 3-6 months, treatment with detergent, etc.).

In addition, immunological reactions associated with the presence of antibodies in the plasma of the donor and recipient are potentially possible. The most severe of them is anaphylactic shock, clinically manifested by chills, hypotension, bronchospasm, and chest pain. Typically, this reaction is due to an IgA deficiency in the recipient. In these cases, the cessation of plasma transfusion, the introduction of adrenaline and prednisolone are required. If it is vital to continue therapy with fresh frozen plasma transfusion, it is possible to prescribe antihistamines and corticosteroid drugs 1 hour before the start of the infusion and to re-administer them during the transfusion.

8.5. Cryoprecipitate transfusion

Recently, cryoprecipitate, which is a drug obtained from donated blood, is considered not so much as a transfusion medium for the treatment of patients with hemophilia A and von Willebrand disease, but as a starting material for further fractionation in order to obtain purified factor VIII concentrates.

For hemostasis, it is necessary to maintain a factor VIII level of up to 50% during operations and up to 30% in the postoperative period. One unit of factor VIII corresponds to 1 ml of fresh frozen plasma. Cryoprecipitate obtained from one blood dose must contain at least 100 U of factor VIII.

The calculation of the need for cryoprecipitate transfusion is as follows:

Body weight (kg) x 70 ml / kg = blood volume (ml).

Blood volume (ml) x (1.0 - hematocrit) = plasma volume (ml)

Plasma Volume (ml) x (Factor VIII Level Required - Factor VIII Level Available) = Transfusion Factor VIII Required (U)

Required amount of factor VIII (U): 100 U = number of doses of cryoprecipitate required for a single transfusion.

The half-life of the transfused factor VIII in the recipient's circulation is 8 to 12 hours, therefore, as a rule, repeated cryoprecipitate transfusions are necessary to maintain the therapeutic level.

In general, the amount of cryoprecipitate transfused depends on the severity of hemophilia A and the severity of bleeding. Hemophilia is classified as severe with a factor VIII level of less than 1%, moderate - with a level in the range of 1 - 5%, mild - with a level of 6 - 30%.

The therapeutic effect of cryoprecipitate transfusions depends on the degree of distribution of the factor between the intravascular and extravascular spaces. On average, one fourth of the transfused factor VIII contained in cryoprecipitate is transferred into the extravascular space during therapy.

The duration of cryoprecipitate transfusion therapy depends on the severity and localization of bleeding, and the patient's clinical response. For major surgery or tooth extractions, maintain a factor VIII level of at least 30% for 10 to 14 days.

If, due to some circumstances, it is not possible to determine the level of factor VIII in the recipient, then one can indirectly judge the adequacy of therapy by the activated partial thromboplastin time. If it is within the normal range (30 - 40 s), then factor VIII is usually higher than 10%.

Another indication for the appointment of cryoprecipitate is hypofibrinogenemia, which is rarely observed in isolation, often being a sign of acute DIC. One dose of cryoprecipitate contains on average 250 mg of fibrinogen. However, large doses of cryoprecipitate can cause hyperfibrinogenemia, fraught with thrombotic complications and increased erythrocyte sedimentation.

Cryoprecipitate must be AB0 compatible. The volume of each dose is small, but the transfusion of many doses at once is fraught with volemic disorders, which is especially important to take into account in children with a lower blood volume than adults. Anaphylaxis, allergic reactions to plasma proteins, and volemic overload can occur with cryoprecipitate transfusion. The transfusiologist must constantly be aware of the risk of their development and, when they appear, carry out appropriate therapy (stop transfusion, prescribe prednisolone, antihistamines, adrenaline).

2.1. Immunoserological tests for transfusion of blood gas carriers

2.2. Immunoserological studies during transfusion of correctors of hemostasis and fibrinolysis, means of correcting immunity

3. Technique of immunoserological research

3.1. Determination of blood group AB0

Accounting for the results of determining the blood group AB0

3.2. Determination of Rh-affiliation

4. Tests for individual compatibility of donor and recipient blood

4.1. Antiglobulin two-stage test tube

4.2. Plane compatibility test at room temperature

4.3. Indirect Coombs test

4.4. Compatibility test using 10% gelatin

4.5. Compatibility test using 33% polyglucin

5. Causes of errors in determining the blood group, Rh affiliation and conducting tests for individual compatibility and measures to prevent them

5.1. Technical errors

5.2. Difficult blood types

6. Biological sample

7. Transfusion of blood gas carriers

7.1. Indications for transfusion of blood gas carriers

7.2. Characteristics of blood gas carriers and features of their use

7.3. Efficacy Criteria for Blood Gas Carrier Transfusion

7.4. Features of transfusion of blood gas carriers in pediatrics

Selection of blood components according to the AB0 system for transfusion for children under 4 months of age

7.5. Autodonation of blood components and autohemotransfusion

8. Transfusion of correctors of plasma-coagulation hemostasis

8.1. Characteristics of correctors of plasma-coagulation hemostasis

8.2. Indications and contraindications for fresh frozen plasma transfusion

8.3. Features of transfusion of fresh frozen plasma

8.4. Transfusion reactions of fresh frozen plasma

8.5. Cryoprecipitate transfusion

9. Transfusion of platelet concentrates

9.1. Characterization of platelet concentrate

9.2. Indications and contraindications for platelet concentrate transfusion

9.3. Efficiency criteria for platelet concentrate transfusions

9.4. Preventive transfusion of platelet concentrate

9.5. Conditions for transfusion of platelet concentrate

10. Transfusion of leukocyte concentrate

10.1. Characteristics of leukocyte concentrate

10.2. Indications and contraindications for leukocyte concentrate transfusion

10.3. Features of leukocyte concentrate transfusion

10.4. Criteria for the effectiveness of leukocyte concentrate transfusion

10.5. Prophylactic leukocyte concentrate transfusions

10.6. Adverse Reactions During Leukocyte Concentrate Transfusion

11. Post-transfusion complications

11.1. Immediate and late complications of blood component transfusion

Complications of blood component transfusion

11.2. Massive transfusion syndrome

8.2. Indications and contraindications for fresh frozen plasma transfusion

Indications for prescribing transfusions of fresh frozen plasma are:

Acute massive blood loss (more than 30% of the circulating blood volume) with the development of hemorrhagic shock and disseminated intravascular coagulation;

Liver diseases, accompanied by a decrease in the production of plasma coagulation factors and, accordingly, their deficiency in the circulation (acute fulminant hepatitis, liver cirrhosis);

Overdose of indirect anticoagulants (dicumarin and others);

When performing therapeutic plasmapheresis in patients with thrombotic thrombocytopenic purpura (Moshkovitz disease), severe poisoning, sepsis, acute disseminated intravascular coagulation syndrome;

Coagulopathy due to a deficiency of plasma physiological anticoagulants.

8.3. Features of transfusion of fresh frozen plasma

Of the various types of plasma listed above, fresh frozen plasma (FFP) is the most valuable and effective therapeutic agent. The high healing properties of FFP are explained by the preservation of all protein coagulation factors in it, including labile ones, during 12 months of storage at a temperature of 30-40 ° C.
When defrosting the FFP, it is recommended to use an additional (second) plastic bag to guarantee the protection of the seal in the water bath.
Thawed (at a water temperature of 37-38 ° C) plasma should not contain turbidity, fibrin flakes, clots (if they are present, plasma is not suitable for transfusion). In transfusion practice, donor plasma should be used that is compatible with the ABO antigens and the recipient's Rh factor. However, in urgent cases, it is permissible to use small volumes of plasma of group A (P) and B (P1) for patients of group 0 (1) and plasma of group AB (IV) for patients of any group.
Thawed plasma cannot be stored and should be used no later than 1-2 hours after thawing in order to avoid loss of activity of coagulation factors. With FFP transfusions, urticarial or allergic reactions may occur, and anaphylactic-type reactions are possible, although rare. In this regard, patients sensitized to parenterally administered protein should not undergo plasma transfusions. When justifying the indications for the use of transfusions of various types of plasma, including FFP, one should keep in mind the main point that some of the protein coagulation factors in plasma are stable (fibrinogen - factor I, prothrombin - factor I, Christmas factor IX, factors XI, XII and XIII), and the other part is labile (proaccelerin - factor V, proconvertin - factor VII, antihemophilic - factor VIII).
Labile factors V, VII and VIII quickly (12-24 hours) lose their activity in stored whole canned blood or plasma isolated from it. At the same time, in fresh frozen plasma, the activity of these factors remains completely for 12 months or more. The activity of stable factors (I, II, IX, X, XI, XII, XIII) persists for a longer time in whole blood, as well as in native and frozen plasma. This important provision about the safety of clotting factors should serve as a rationale for the use of native or fresh frozen plasma in some form of coagulopathy (see Chapter XII).
LITERATURE

Agranenko V.A. Blood preparations and blood substitutes. - M .: 1956 .-- 163 p.
Agranenko V.A., Melkikyan N.A. Cryopreservation of erythrocyte mass recovered after long-term storage // Probl. hematol. and blood transfusion. 1977. - No. 5. S. 45-50.
Agranenko V.A., Golubeva V.L. Citroglucophosphate is an effective preservative solution for blood // Sov. honey. - 1979. - No. 9. - S. 19-22.
Agranenko V.A. et al. Conservation of erythroconcentrate depleted in leukocytes and platelets (methods of obtaining and transfusion advantages) // Probl. hematol. and blood transfusion. - 1980. - No. 9. - S. 15-19.

Agranenko V.A., Lisovskaya I.L., by the Company, A.U. Functional usefulness of platelets in preserved blood 1-7 days of storage // Probl. hematol. and blood transfusion. - 1981. - No. 2. - S. 36-41.
Agranenko V.A. et al. On the functional properties of granulocytes obtained by the method of automatic cytapheresis // Probl. hematol. and blood transfusion. - 1981. - No. 3. - S. 18-20.
Agranenko V.A., Fedorova L.I. Frozen blood and its clinical use. - M .: Medicine, 1983 .-- 120 p.
Agranenko V.A., Markova N.A. and other Restoration of the usefulness of canned blood after long-term storage // Hematol. and transfusiol. - 1983. - No. 10. - S. 53-54.
Agranenko V.A., Fedorova L.I. Cryopreservation of erythrocytes // Cryopreservation of cell suspensions. - Kiev: Naukova Dumka, 1983 .-- S. 79 ~ 97.
Agranenko V.A., Ermalovich S.V. Cryopreservation of leukocytes // Ibid. - S. 98-106.
Agranenko V.A., Kompaniets A.M. Platelet cryopreservation // Ibid. - S. 107-116.
Agranenko V.A. et al. Methods for the isolation of platelet and leukocyte concentrates from the leucotrombocyte layer of preserved blood // Hematol. and transfusiol. - 1985. - No. 11. - S. 54-59.
Agranenko V.A., Suvorova I.A. and other New preservative solution for blood with adenine, nicotinamide and phosphates // Hematol. and transfusiol. - 1985. - No. 2. - S. 12-18.
Agranenko V.A., Azovskaya S.A. et al. Therapeutic efficacy of transfusion of restored ("rejuvenated") erythrocytes in anemic conditions // Hematol. and transfusiol. - 1986. - No. 10.-С. 3-7.
Agranenko V.A. and other Cryopreservation of granulocytes with a solution of "leukocryodmats" // Ibid. - 1986. - No. 12. - S. 26-28.
Agranenko V.A., Sukhanov Yu.S. Preservation and cryopreservation of blood cells - achievements and prospects // Ibid. - 1987. - No. 10. - S. 10-14.
Agranenko V.A., Suvorova I.A. et al. Morphofunctional usefulness of blood and erythrocyte concentrate preserved in polymer containers and glass bottles // Ibid. - 1987. - No. 7. - S. 28-32.
Agranenko V.A. et al. Isolation of platelet concentrates from the leucotrombocyte layer of donor blood and their conservation // Ibid. - 1991. - No. 3. - S. 29-32.
Almazov V.A. and other Physiology of human leukocytes. - L .: Nauka, 1979 .-- 232 p.
Vorobiev A.I., Gorodetsky V.M., Kryuchkov M.I. Obtaining platelet mass and its use in the treatment of leukemia // Plasmapheresis and gravitational surgery. - Yerevan, 1991 .-- S. 94-98.
Gavrilov O.K., Rusanov V.M. Blood preparations and their clinical use // Handbook of blood transfusion and blood substitutes. - M .: Medicine, 1982 .-- S. 76-92.
O.K. Gavrilov, V.M. Rusanov Blood preparations // Guide to general and clinical transfusion. - M .: Medicine, 1979. - S. 176-189.
Gorodetsky V.M. Obtaining platelets from one donor by intermittent thrombocytapheresis and their use in amegakaryocytic thrombocytopenia: Abstract of the thesis. dis. Cand. honey. sciences. - M., 1981 .-- 32 p.
Gorodetsky V.M., Vorobiev A.I. Obtaining a therapeutic dose of platelets from one donor // Gravitational blood surgery. - M., 1983 .-- S. 153-154.
D.M. Grozdov Natural blood substitutes // Blood transfusion. - M .: Medicine, 1951. - S. 257-287.
Huseynov Ch.S. Physiology and pathology of platelets. - M .: Medicine, 1971.S. 126-156.
Zabelina TS Colony-forming ability of hematopoietic cells in patients with chronic myeloid leukemia: Author's abstract. dis. Cand. honey. sciences. - L., 1979 .-- 128 p.
Kalinin N.N. Plasmacytapheresis on blood fractionators (principles and methods of conducting, effect on the body): Author's abstract. dis. doct. honey. sciences. - M., 1984 .-- 32 p.
Kartashevsky N.G. et al. Clinical significance of transfused blood microclots // Surgery. - 1974. - No. 12. - S. 56-60.
Kompaniets A.M. Preservation of platelet concentrates and their therapeutic efficacy: Author's abstract. dis. doct. honey. sciences. - M., 1992 .-- 42 p.

3-5515

Leontovich V.A., Abezgauz N.N. Freezing of peripheral blood white cells for their long-term storage // Probl. hematol. and blood transfusion. - 1966. - No. 9. - S. 24-30.
Leontovich V.A., Abezgauz N.N., Troshina V.M. Method of freezing granulocytes with dimethylacetamide // Sovr. probl. cryobiol. and cryomed. - M., 1975 .-- S. 75-84.
Pushkar N.S., Belous A.M. Actual problems of cryobiology. - Kiev: Naukova Dumka, 1981 .-- 584 p.
E.P. Svedentsov Modern methods of obtaining platelet concentrate for clinical purposes // Transfuz. honey. St. Petersburg. - 1995. - No. 5. - S. 27-28.
Tibilova N.N., Agranenko V.A. et al. Influence of room temperature on the safety of preserved blood // Hematol. and transfusiol. - 1988. - No. 5. - S. 21-25.
Filatov A.N. Procurement and transfusion of plasma and blood serum // Guidelines for blood and blood substitutes transfusion. - L .: Medicine, 1973 .-- S. 205-220.
Goldman U, Lowenthal F. (her.) Leucocytes: separation, collection and transfusion // Acad. Press., 1975. - 602 p.
Chaplin Y. Editorial retrospective, frozen red cells // New Engl. J. Med. - 1984. - No. 311. - P. 1696-1698.
Calhoun L. Blood product preparation and administration. Ch. 13, p. 305-333 // Petz L. et al. (ed.) / Clinical practice of Transfusion Medicine. - N.Y .: Churchill Leuingstone, 1996.
Huestis Zgt;., Bove /., Bush Sh. (ed.) Practical Blood Transfusion // Little, Brown company, 1981 .-- 470 p.
Mollison P., Engelfriet C, Contreras M. Blood transfusion in clinical medicine. - 9th. edition. - Oxford, 1993 .-- 1015 p.
Rasz Z, Thek M. Buffy coat of platelet rich plasma. Comparison of two processing platelet techniques // Vox Sang. - 1984. - No. 47. - P. 108-113.
Technical manual // Amer. Ass. of blood banks. - 10th edition. Arlington. - 1990 .-- 665 p.
Valeri C. Blood banking and the use of frozen blood products // CRC Press, 1976 .-- 417 p.