Overnight storage of whole blood: cooling and transporting blood at room temperature under extreme temperature conditions.

BACKGROUND AND OBJECTIVES: Many countries allow the overnight storage of whole blood (WB) at ambient temperature. Some countries, such as Canada, also require a rapid cooling of WB with an active cooling system. Given the significant operational constraints associated with current cooling systems, an alternative method for cooling and transporting WB at 20-24°C was evaluated. MATERIALS AND METHODS: Phase 22 cooling packs (TCP Reliable Inc., USA) were used in combination with vacuum-insulated panel (VIP) boxes. Temperature profiles of simulated WB units were studied in extreme temperatures (-35 and 40°C). The quality of blood components prepared using Phase 22 packs and CompoCool-WB (Fresenius HemoCare, Germany) was studied. RESULTS: Phase 22 packs reduced the temperature of simulated WB bags from 37 to 24°C in 1·7 ± 0·2 h. Used in combination with VIP boxes, Phase 22 packs maintain the temperature of bags between 20 and 24°C for 15 and 24 h, compared to 2 and 11 h with CompoCool-WB, when exposed at -35 and 40°C, respectively. The quality of platelet concentrates and plasma was comparable, regardless of the cooling system used. For red blood cell units, per cent haemolysis on day 42 was slightly higher in products prepared after cooling with Phase 22 packs compared to CompoCool-WB (0·33 ± 0·15% vs. 0·21 ± 0·06%; P < 0·05). CONCLUSIONS: Phase 22 packs combined with VIP boxes are an acceptable alternative to butane-1,4-diol cooling systems. This system allows blood manufacturers to transport WB to processing facilities in a broad range of environmental conditions.

Quality and safety of red blood cells stored in two additive solutions subjected to multiple room temperature exposures.

BACKGROUND AND OBJECTIVES: Many international standards state that red blood cell (RBC) products should be discarded if left out of controlled temperature storage for longer than 30 min to reduce the risk of bacterial growth and RBC loss of viability. This study aimed to verify whether repeated short-time exposures to room temperature (RT) influence RBCs quality and bacterial proliferation. MATERIALS AND METHODS: Saline-adenine-glucose-mannitol (SAGM) and AS-3 RBC units were split and exposed to RT for 30 or 60 min on day 2, 7, 14, 21, and 42 of storage while reference units remained stored at 1-6°C. Red blood cell in vitro quality parameters were evaluated after each exposure. In a second experiment, SAGM and AS-3 RBC units were split and inoculated with Staphylococcus epidermidis (5 CFU/ml), Serratia marcescens (1 CFU/ml), and Serratia liquefaciens (1 CFU/ml). Reference units remained in storage while test units were exposed as described previously. Bacterial concentrations were investigated after each exposure. RESULTS: No differences were noticed between reference and test units in any of the in vitro parameters investigated. S. epidermidis did not grow in either reference or exposed RBCs. While S. marcescens did not grow in AS-3, bacterial growth was observed in RT-exposed SAGM RBCs on day 42. Similar growth was obtained for S. liquefaciens in the two additive solutions for both reference and test units. CONCLUSION: Short-time exposures to RT do not affect RBC quality and do not significantly influence bacterial growth. An expansion of the '30-minute' rule to 60 min should be considered by regulatory agencies.

Improved leucoreduction of red blood cell units prepared after a 24-h hold with the platelet-rich plasma method using newly developed filters.

BACKGROUND AND OBJECTIVES: A previous study indicated that the extension of whole blood (WB) storage from 8 to 24 h at 20-24 degrees C before the processing of platelet-rich plasma (PRP)-depleted red blood cell (RBC) units had a negative effect on the efficacy of leucoreduction filters. In this study, we further characterized the phenomenon and tested the leucoreduction capacity of two newly developed filters. MATERIALS AND METHODS: Whole blood was stored at 20-24 degrees C and processed at 4-h intervals between 8 and 24 h postcollection. Components were leucoreduced before storage. Efficacy of novel filters to leucoreduce 24-h-hold PRP-depleted RBC units was also evaluated. RESULTS: Using a conventional filter, the mean residual white blood cell (WBC) counts in leucoreduced PRP-depleted RBCs were comparable in units prepared within 12 h from collection but gradually increased upon extended preprocessing storage from 0.36 +/- 0.03 at 12 h to 0.46 +/- 0.21, 0.76 +/- 0.54 and 1.72 +/- 1.76 x 10(6) per unit at 16, 20 and 24 h, respectively. However, the mean residual WBC content in 24-h-hold RBCs was reduced to 0.60 +/- 0.39 x 10(6) and 0.46 +/- 0.13 x 10(6) per units using RC2D and the prototypes B-1582 rev B filters, respectively. CONCLUSION: For PRP-depleted RBC units, the extension of the WB room temperature storage from 8 to 24 h before processing is likely to require the introduction of newly developed filters having an increased leucoreduction capacity in order to meet the maximal residual WBC guideline in the RBCs.