Use of red blood cells stored in saline suspension for immediate spin crossmatch.

The purpose of this study was to validate a procedure for using red blood cell suspensions stored for up to 10 days in an immediate spin crossmatch. Ten group A and 10 group B SAG-M donor unit segments were opened on day 0. The red cells were divided into 2 tubes and each diluted with saline to a 3% to 5% cell suspension. The cell suspensions were tested using a standard immediate spin technique against pooled group A, group B, and group O plasma each day for 10 days. One set of cells was stored refrigerated as a 3% to 5% cell suspension. Saline was removed from the parallel set of cells before storage. All 480 tests that were expected to be negative were negative. On 2 separate occasions 1+ or 2+ reactions that disappeared before the cell button was completely resuspended were noted. All 960 tests that were expected to be positive were positive. All but 4 results were graded as 3+ or 4+. Four 2+ reactions occurred with 2 units that were typed as A1 negative. Our results indicate that cells stored refrigerated in normal saline as a 3% to 5% cell suspension may be used for immediate spin crossmatch for up to 10 days.

Implementation of a redistribution system for near-outdate red blood cell units.

CONTEXT: Many remote hospitals keep small on-site stocks of red blood cell (RBC) units for emergency use and to support patient care programs. In Canada, the blood supplier does not accept returned units into inventory. Discard rates can, therefore, be high. OBJECTIVE: To transport near-outdate RBC units to a high-usage hospital site, which would reduce overall discard rates, thereby increasing overall stock levels available in the blood system. DESIGN: A blood transportation system was developed and validated. The validation was presented to a high-usage site that agreed to accept near-outdate RBC units transported by this system. Stocks at the remote hospitals were optimized without increasing system-wide discard rates. The redistribution program was implemented in 4 remote sites in northern Alberta, Canada. The final disposition of each transported unit was tracked. Data from the first 2 years were analyzed. RESULTS: Between April 1, 2003, and March 31, 2005, 106 RBC units were successfully transported to and transfused at the high-usage site. The majority of the units were group O. None of the transfused units were involved in any reported transfusion reactions. The success rate of the transportation system varied among the sites (59%-78% successfully transported and transfused). Changes to the transport system were implemented as problems were discovered. The use of a temperature monitor in each shipment allowed for concurrent revalidation after each change. CONCLUSIONS: Redistribution systems can be an effective way to reduce RBC unit discard rates. Even simple transportation systems have many factors affecting the RBC unit temperature. Novel temperature stabilizing materials may make future transportation of RBC units more reliable.