Whole blood (WB) is human

blood Blood is a body fluid in the circulatory system of humans and other vertebrates that delivers necessary substances such as nutrients and oxygen to the cells, and transports metabolic waste products away from those same cells. Blood is com ...

from a standard

blood donation A 'blood donation'' occurs when a person voluntarily has blood drawn and used for transfusions and/or made into biopharmaceutical medications by a process called fractionation (separation of whole blood components). A donation may be of wh ...

. It is used in the treatment of massive bleeding, in

exchange transfusion An exchange transfusion is a blood transfusion in which the patient's blood or components of it are exchanged with (replaced by) other blood or blood products. The patient's blood is removed and replaced by donated blood or blood components. This ...

, and when people donate blood to themselves (autologous transfusion). One unit of whole blood (approximately 450 mL) increases

hemoglobin Hemoglobin (haemoglobin, Hb or Hgb) is a protein containing iron that facilitates the transportation of oxygen in red blood cells. Almost all vertebrates contain hemoglobin, with the sole exception of the fish family Channichthyidae. Hemoglobin ...

levels by about 10 g/L. Cross matching is typically done before the blood is given. It is given by

injection into a vein Intravenous therapy (abbreviated as IV therapy) is a medical technique that administers fluids, medications and nutrients directly into a person's vein. The intravenous route of administration is commonly used for rehydration or to provide nutr ...

. Side effects include red blood cell breakdown,

high blood potassium Hyperkalemia is an elevated level of potassium (K+) in the blood. Normal potassium levels are between 3.5 and 5.0mmol/L (3.5 and 5.0 mEq/L) with levels above 5.5mmol/L defined as hyperkalemia. Typically hyperkalemia does not cause symptoms. Occ ...

infection An infection is the invasion of tissue (biology), tissues by pathogens, their multiplication, and the reaction of host (biology), host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmis ...

volume overload Volume overload refers to the state of one of the chambers of the heart in which too large a volume of blood exists within it for it to function efficiently. Ventricular volume overload is approximately equivalent to an excessively high preload ...

lung injury The lungs are the primary Organ (biology), organs of the respiratory system in many animals, including humans. In mammals and most other tetrapods, two lungs are located near the Vertebral column, backbone on either side of the heart. Their ...

, and

allergic reactions Allergies, also known as allergic diseases, are various conditions caused by hypersensitivity of the immune system to typically harmless substances in the environment. These diseases include hay fever, food allergies, atopic dermatitis, alle ...

such as

anaphylaxis Anaphylaxis (Greek: 'up' + 'guarding') is a serious, potentially fatal allergic reaction and medical emergency that is rapid in onset and requires immediate medical attention regardless of the use of emergency medication on site. It typicall ...

. Whole blood is made up of

red blood cells Red blood cells (RBCs), referred to as erythrocytes (, with -''cyte'' translated as 'cell' in modern usage) in academia and medical publishing, also known as red cells, erythroid cells, and rarely haematids, are the most common type of blood cel ...

white blood cells White blood cells (scientific name leukocytes), also called immune cells or immunocytes, are cells of the immune system that are involved in protecting the body against both infectious disease and foreign entities. White blood cells are genera ...

platelets Platelets or thrombocytes () are a part of blood whose function (along with the coagulation factors) is to react to bleeding from blood vessel injury by clumping to form a blood clot. Platelets have no cell nucleus; they are fragments of cyto ...

, and

blood plasma Blood plasma is a light Amber (color), amber-colored liquid component of blood in which blood cells are absent, but which contains Blood protein, proteins and other constituents of whole blood in Suspension (chemistry), suspension. It makes up ...

. It is best within a day of collection; however, it can be stored for up to three weeks if refrigerated (1-6 °C). The blood is typically combined with an

anticoagulant An anticoagulant, commonly known as a blood thinner, is a chemical substance that prevents or reduces the coagulation of blood, prolonging the clotting time. Some occur naturally in blood-eating animals, such as leeches and mosquitoes, which ...

and

preservative A preservative is a substance or a chemical that is added to products such as food products, beverages, pharmaceutical drugs, paints, biological samples, cosmetics, wood, and many other products to prevent decomposition by microbial growth or ...

during the collection process. The first transfusion of whole blood was in 1818; however, common use did not begin until the

First First most commonly refers to: * First, the ordinal form of the number 1 First or 1st may also refer to: Acronyms * Faint Images of the Radio Sky at Twenty-Centimeters, an astronomical survey carried out by the Very Large Array * Far Infrared a ...

and

Second World War World War II or the Second World War (1 September 1939 – 2 September 1945) was a World war, global conflict between two coalitions: the Allies of World War II, Allies and the Axis powers. World War II by country, Nearly all of the wo ...

s. It is on the

World Health Organization's List of Essential Medicines The WHO Model List of Essential Medicines (aka Essential Medicines List or EML), published by the World Health Organization (WHO), contains the medications considered to be most effective and safe to meet the most important needs in a health s ...

. Whole blood is also used to make a number of

blood products A blood product is any therapeutic substance prepared from blood, usually human blood; in some medicolegal contexts, the term refers specifically to human-blood-derived products. Blood products include whole blood, blood components, and blood pla ...

including red cell concentrates,

platelet concentrate Platelet concentrates are products containing platelet Platelets or thrombocytes () are a part of blood whose function (along with the coagulation#Coagulation factors, coagulation factors) is to react to bleeding from blood vessel injury by clum ...

cryoprecipitate Cryoprecipitate, also called cryo for short, or Cryoprecipitate Antihemophilic factor (AHF), is a frozen blood product prepared from blood plasma. To create cryoprecipitate, plasma is slowly thawed to 1–6 °C. A cold-insoluble precipita ...

, and

fresh frozen plasma Fresh frozen plasma (FFP) is a blood product made from the liquid portion of whole blood. It is used to treat conditions in which there are low blood clotting factors (INR > 1.5) or low levels of other blood proteins. It may also be used as the r ...

Medical use

Whole blood has similar risks to a transfusion of

red blood cell Red blood cells (RBCs), referred to as erythrocytes (, with -''cyte'' translated as 'cell' in modern usage) in academia and medical publishing, also known as red cells, erythroid cells, and rarely haematids, are the most common type of blood cel ...

s and is typically

cross-match Cross-matching or crossmatching is a test performed before a blood transfusion as part of blood compatibility testing. Normally, this involves adding the recipient's blood plasma to a sample of the donor's red blood cells. If the blood is incomp ...

ed to avoid hemolytic

transfusion reaction Blood transfusion is the process of transferring blood products into a person's circulation intravenously. Transfusions are used for various medical conditions to replace lost components of the blood. Early transfusions used whole blood, but ...

s. The use of whole blood is common in low- and middle-income countries. Over 40% of blood collected in low-income countries is administered as whole blood, and approximately a third of all blood collected in middle-income countries is administered as whole blood. Whole blood is sometimes "recreated" from stored

and

(FFP) for neonatal transfusions. This is done to provide a final product with a very specific

hematocrit The hematocrit () (Ht or HCT), also known by several other names, is the volume percentage (vol%) of red blood cells (RBCs) in blood, measured as part of a blood test. The measurement depends on the number and size of red blood cells. It is nor ...

(percentage of red cells) with

type O The ABO blood group system is used to denote the presence of one, both, or neither of the A and B antigens on erythrocytes (red blood cells). For human blood transfusions, it is the most important of the 47 different blood type (or group) cla ...

red cells and type AB plasma to minimize the chance of complications. Transfusion of whole blood is being used in the military setting and in the civilian setting, where it is being used in pre-hospital trauma care and in the setting of massive transfusion in the civilian setting. Whole blood can be ABO-type specific when the recipient blood type is known. When the recipient’s blood group is not known, particularly in pre-hospital transfusion, low-titer O universal donor whole blood (LTOWB) can be used; this requires that the donor plasma contains only low titers of anti-A and anti-B.

Processing

Historically, blood was transfused as whole blood without further processing. Most

blood banks A blood bank is a center where blood gathered as a result of blood donation is stored and preserved for later use in blood transfusion. The term "blood bank" typically refers to a department of a hospital usually within a clinical pathology labor ...

now split the whole blood into two or more components, typically

and a plasma component such as

Platelets Platelets or thrombocytes () are a part of blood whose function (along with the coagulation factors) is to react to bleeding from blood vessel injury by clumping to form a blood clot. Platelets have no cell nucleus; they are fragments of cyto ...

for transfusion can also be prepared from a unit of whole blood, whereby 4 or 5 buffy coats are pooled to produce a platelet component. Some blood banks have replaced this with platelets collected by

plateletpheresis Plateletpheresis (more accurately called thrombocytapheresis or thrombapheresis, though these names are rarely used) is the process of collecting thrombocytes, more commonly called platelets, a component of blood involved in hemostasis, blood clot ...

because whole blood platelets, sometimes called "random donor" platelets, must be pooled from multiple donors to get enough for an adult therapeutic dose. The collected blood is generally separated into components by one of three methods. A centrifuge can be used in a "hard spin" which separates whole blood into plasma and red cells or a "soft spin" which separates it into plasma, buffy coat (used to make platelets), and red blood cells. The third method is sedimentation: the blood simply sits overnight, and the red cells and plasma are separated by gravitational interactions, which is used predominantly in low-income countries.

Storage

Whole blood is typically stored under the same conditions as red blood cells and can be kept up to 35 days if collected with citrate-phosphate-dextrose-adenine-1 (CPDA-1) anticoagulant solution, or 21 days with other common anticoagulants such as citrate-phosphate-dextrose (CPD). If the whole blood is used to make

platelet Platelets or thrombocytes () are a part of blood whose function (along with the coagulation#Coagulation factors, coagulation factors) is to react to bleeding from blood vessel injury by clumping to form a thrombus, blood clot. Platelets have no ...

s, it is kept at room temperature until the process is complete. Whole blood processing must be completed within 24 hours to minimize the warm storage of red cells in the unit.

References

External links

Blood & Blood Products
from U.S.

Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a List of United States federal agencies, federal agency of the United States Department of Health and Human Services, Department of Health and Human Services. The FDA is respo ...

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