Leaderboard

In my experience, if the platelet product is removed from the original container, the expiration period may be affected by the new storage container's ability to maintain optimal storage conditions. Apheresis platelets are collected in bags that are gas-permeable - if product is transferred to another type of bag (not validated for platelet storage), this should be considered when assigning the expiration date/time even if you volume-depleted using a sterile connecting device. I also consider this when removing the supernatant from CPDA or AS red blood cells (as in intrauterine or exchange transfusions) - you can do everything in a functionally closed system but when you remove the "food", the red cells do not exist in the same environment and cannot be expected to maintain the same functionality. The reason that the Technical Manual is not going to specify is that everything depends on the validation of functional survival of the stored platelet and there isn't data available to make a valid claim.

I seem to remember that the concentration of platelets in plasma is an important part of QC for the 5 day expiration, something about pH changes over time I think, which may be why platelets come as singles, doubles and triples? I would check/clarify with your blood bank/supplier. As applejw said; you are changing the environment, which may impact the functional survival of the stored platelets.

Patient phenotype is Fya + Fyb+ I just had not seen a Gata mutation result before had read about it. Thought it may be an additional molecular phenotype request but it was included in the panel reported

Technically, they cannot as they are not a law setting organization like the FDA. I would not go past the 4 hours, but we do not volume reduce. Platelets are living, "breathing" cells and you are greatly increasing their concentration and ability to transport oxygen.

Thanks Scott! In the newest AABB Tech manual: Method 6-13 Removing Plasma from Platelets: Notes #2: If a sterile connection device is used for removing plasma from a hemapheresis component or individual platelet concentrate, the unit is considered functionally closed and it is not necessary to impose a 4-hour expiration interval required for entered platelets. However, no data exist to support storage of reduced-volume platelet concentrates: therefore, it is preferable to transfuse them as soon as possible. Wouldn't it be easier if they could just tell me an exact acceptable expiration? haha

and often only with enzyme treated cells tested in an IAT....

Turnaround times for crossmatches...routine, ASAP and STAT. Turnaround times for emergency release/mass transfusion protocols. Patient blood management - track patient Hgbs vs transfusion rates, do peer comparisions (look at a specific group of physicians to see if they transfuse at higher Hgbs, look to see if there is an individual whose transfusion rate is higher than his/her peers, etc.) Specimen labeling - how many rejected, how many missing initials/collection times, how many WBIT (this delays patient care) Track transfusion rates for specific groups of patients - we monitor OB patients for transfusion if Hgb <8.0 Track ordering problems - duplicate orders, give order for nurses but no prepare order for Blood Bank - education needed for staff/physicians placing orders results in delay of care Transfusion documentation - check patient flowsheets for missing information (like no 15 min vitals, missing donor #, no signed consent, etc.) You could spend your whole life on stuff like that, so be selective. Don't just go through the motions with multiple graphs. Choose 1 or 2 things where you can have a positive impact on patient safety or quality of care. Once things are going smoothly with a project, continue monitoring as long as needed and add a new project. Hospital quality will love you for that because its something they can show inspectors from JC, the state, etc. (It can get the lab noticed in a good way!) One of our recent projects came about after receiving complaints about how long it took for us to send blood to the ED for traumas. We started out with what seemed to be a lab problem, but it quickly became obvious that it was much larger. We've now spent almost 3 years working on emergency release processes from order to transfusion, not just working on blood release times by Blood Bank. Using a multi-disciplinary approach with nursing, we developed job aides, educated, and documented to drop our TATs dramatically and improve the entire process. Nursing staff now has a better grasp of what is expected of them in those kinds of situations and they know what we are going to be doing about providing blood products. Physicians are aware that there is an actual protocol. It makes for pretty graphs for Quality, but most importantly, it greatly benefits patients. As an added bonus, you can develop strong team relationships with staff from other areas. This has the potential to make tackling future problems much easier. We are not a large facility. It sometimes stretches me pretty thin working on stuff like this, but its worth it over the long haul.