of blood and components Storage and transportation of 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 processing if 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 processing whole blood & red cells +1 - +6 C fresh frozen plasma - 18o C or lower cryoprecipitate - 18o C or lower platelet 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 Air circulation Units of the blood should be standing Upright in baskets laid flat on the shelf  Never store food items in blood bank refrigerator Never store blood in the door of 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 have not been tested or have been partially tested. restrictive access to such products released (approved): products available for use rejected (non-confirming): products do not conform 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 day top, middle, bottom shelf Documentation thermal 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

Temperature Data Loggers 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.

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 contamination Measure & 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 پلاكت در دماي 24-20 درجه سانتي گراد

Plasma

Two kind of plasma

Every month boxes have to get clean with disinfectant

The name of technician who is responsible for cleaning 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 The name of technician who is responsible for cleaning