Storage and transportationof blood and components

Dr Sima Zolfsghari Anaraki MD-ACP

IRANIAN BLOOD TRANSFUSION CENTER

Storage and Transportation

Blood & blood products are labile biological materials which need to be kept under the right conditions to ensure that they remain viable, safe and clinically effective

Blood and products need to be transported under the right condition

to maintain product viability to ensure product security

storage

storage conditions need to be

appropriate and correct for each product

temperature cleanliness agitation (platelets)

storage needs to be secure to prevent unauthorized access

to people to insects / vermin etc

storage needs to be monitored to ensure that the correct conditions are maintained

continuous temperature monitoring alarm system on all storage equipment

Storage Temperature for Blood And Components

Storage before processingif unit will be processed for Plt preparation within 8h

storage at + 22 - + 24o C

if unit will be processed for plasma preparation within 6-8h

storage at +1 - +10 o C

Storage after processingwhole blood & red cells +1 - +6 Cfresh frozen plasma - 18o C or lowercryoprecipitate - 18o C or lowerplatelet concentrate + 22 - + 24o C

Importance of Safe Storage

Blood must be stored at a

temperature

between + 1o c to + 6o c. to maintain oxygen carrying

capacity to maintain its viability to minimize growth of any bacterial

contamination

Plasma must be rapidly frozen and

stored

at - 18o c or lower to maintain coagulation factor

levels (fVIII, fV)

Proper Storage of Blood

Units of the blood should be standingUpright in baskets laid flat on the shelf

Air circulation

Never store blood in the door ofrefrigerator

Never store food items in

blood bank refrigerator

Check for signs of deterioration of blood during storage

Look for Hemolysis in the

plasma.

Look for any change in the

colour in the Red Cells e.g.

Purple/ Black indicate

contamination.

Look for any clots.

Storage Precautions of Blood And Components

Blood to be stored at +1- +6o C Never allowed to freeze - red cells FFP stored below - 18o C or lower Temperature of refrigerators must be checked twice a day Door of freezer must be kept closed If plasma is to be thawed, temperature should never go above +37o C If frozen plasma thawed, it should be kept at +1 - + 6o C and used within 24 hours

Storage of Untested/quarantined Blood

Label storage area according to status

quarantine (unavailable): products that havenot been tested or have been partially tested.restrictive access to such products

released (approved): products available for use

rejected (non-confirming): products do notconform and are awaiting disposal

Ensure that there is no mix up of quarantined products with tested (approved) products

Monitoring and Checking

Monitoring of the cold chain temperature monitoring start, during, destination

Monitoring the distribution system time taken from A to B integrity of the packaging upon arrival

Labeling accuracy clarity adequacy

Monitoring Temperature of Refrigerators

Use of thermometers early in the morning & at the end of working daytop, middle, bottom shelf

Documentationthermal charts / manual records

Temperature record

Date Time Shelf Temp Action

I9/12 8am High 4o c none

19/12 2 pm low 10o c to be checked in 1 hour

19/12 8 pm low 6o c none

Transportation

Distribution conditions need to be appropriate for the product

temperature time taken

Packaging needs to be appropriate sturdy enough to protect the product able to maintain the product at correct temp should have adequate label (content, handling and storage)

The Cold Chain

System for storing & transporting blood and components in as safe a way as possible to maintain all the functions of the component

Two essential parts of cold chain people to organize and manage storage and transportation equipment to store and transport blood and plasma safely

Maintaining the Cold Chain

The cold chain is central to the storage and distribution of blood and products

the correct temperature must be maintained

The cold chain runs from donor to the patient

The length of the time that products are not at the correct storage temp must be defined

Procedures for detail action to be taken in case of “out of specification” products must be in place

Transportation of Blood and Products

Transport containers must be kept

clean and regularly disinfected condensation often occurs, the moisture being an ideal place for bacteria to multiply

If sealed ice packs are used, they must be regularly cleaned and disinfected

If ice packs are home-made using ice, the ice must be changed regularly to prevent growth of contaminants

Transportation

Distribution needs to be secure

BTS transport or external agency

the product should arrive at its destination in

the time expected

the product has not been damaged in transport

the product has not been interfered with

Protecting the Product

Packaging that protects the product from physical damage Packaging that maintains the optimum temperature Clean packaging to minimize the risk of microbial contamination Physical separation of cellular products from any ice packs used to maintain temperature Reliable transportation

Documentation

Documentation is needed to record key

parameters during storage and distribution temperature at the start, during, destination

product dispatched and actually received times of dispatch and receipt destination of product integrity of the product integrity of the transport container allowable “out-of-specification” temp and

duration

Temperature Data Loggers Tempreture .deta loggers is a small device housed in a fully Weld sealed,crevice free,robust hygenic plastic tag. Device uses patented induction technique for set up & deta down load powered by an internal battery. Device can be programmed to log at intervals from 1 min.upto 255 minutes with a temperature range of –30°C to + 70°C

Comprehensive & user friendly

window software.

Device helps in validation of

packing

methods used for transportation

of

blood/blood components.

Device helps to validate fridges

&

freezers used for storage.

Temperature Data Loggers

Reception of Blood / Product

Record the time of arrival

Measure & record the temperature in the

container Inspect blood or the product for any signs

of hemolysis or contaminationMeasure & record the temperature of blood

(sandwich method)

Summary

Storage and transportation of blood & product need to be controlled to ensure that the quality of product is maintained from donor to patient

Storage conditions need to be defined, implemented and monitored

Distribution conditions are especially important

The cold chain needs to be maintained

Monitoring is essential

Red blood cell package

Platelet package

حمل ونگهداري پالكت در دمايدرجه سانتي گراد 24-20

Plasma

Two kind of plasma

Every month boxes have to get clean with disinfectant

Every 3 months freezer & refrigerator have to be clean with disinfectant

The name of technician who is responsible for

cleaning

The name of technician who is responsible for

cleaning

Every 3 months freezer have to be clean with disinfectant and defrost