azizka71

Dr. Gary Moroff has published articles on the effects of temperature and lack of agitation on in vitro markers of platelet function.  Here are the ones that I could quickly find in Transfusion:
 
http://onlinelibrary.wiley.com/doi/10.1046/j.1537-2995.1990.30590296375.x/abstract
http://onlinelibrary.wiley.com/doi/10.1111/j.1537-2995.2008.01690.x/abstract
http://onlinelibrary.wiley.com/doi/10.1111/j.1537-2995.2006.00756.x/abstract
http://onlinelibrary.wiley.com/doi/10.1111/j.1537-2995.2010.02869.x/abstract

Are you in the UK? If so we were recently told by NBTS that it is 24 hours if they have not been out of temperature and they pass the 'swirl test' for integrity.

YES, 24 hours, at Room temperature and without agitation.

Ask your blood supplier.  Most of them have done validation studies for how long platelets can remain in the shipping container without agitation.

Make and stain a smear looking for platelet clumping. If present consider a recollection advising phlebotomy to collect a sodium citrate specimen in addition to the normal EDTA specimen in case of EDTA sensitivity in the patient. If the recollected EDTA specimen still demonstrates platelet clumping, run the citrate sample and correct the platelet result by multiplying by 1.1 for dilution correction.

The other thing to consider is the resulting low volume of cells in the unit would mean that the haemoglobin of the person receieving the unit may not rise sufficiently, thus inceasing the number of donor exposures. In all the labs I have worked at we always give multiply transfused patients the 'fattest' units to try and limit the number of donor exposures a bit.

In the USA, the Hgb/Hct determination is generally performed using a sample from a finger-stick puncture and generally includes either a screening test utilizing Copper Sulfate or quantitative tests such as a spun microhematocrit or a Hemocue assay.  

Hi,
I do not know what country you are in, but the Hemocue is widely available and used by many hospitals in Saudi Arabia and in the Middle East.

I agree completely with SMW and Malcolm on this. This doctor needs intensive training and should be reprimanded for not following protocol. You cannot just look at donor to certify him fit to donate, Hb has to be done and should be more than 12.5 gms/dl. plus other physical exams.
There are many disadvantages in copper sulphate method which makes it unsuitable especially in a camp or multi-donor settings. We also do Hb by Hemocue method.

Totally agree SMW - although I have more sympathy with the donor (who may have been mistaken, or not understood the rules) than the doctor.

In my opinion, all components from this donation should be considered non-conforming and discarded. The donor has demonstrated that they are an unreliable historian and who knows what other questions were not answered truthfully!  For this reason, the donor should also be permanently deferred and any prior donations from this individual recalled. More significantly, since it appears there was willful disregard to follow required policies and procedures when approving individuals for donation, ALL products from all donors qualified by this doctor should also be recalled/withdrawn.  Willful disregard to followed required policies and procedures would generally be considered grounds for termination.  

In my opinon, the only individual that should be transfused with this unit is the donor!  In the USA (and I'm certain some other countries who can chime in), a Hgb or Hct is required to be perforrmed on the donor and must meet pre-determined acceptability criteria BEFORE a collection is even initiated.  

One other attribute of QC I didn't see mentioned. You are also QC'ing the user. Is the staff performing the testing correctly? There is more to the testing than just the reagents being functional. Therefore, I see the need for QC of all methods in use at least once each day of use.

Hi azizka71,
What is your email, and I will send you my SOP?
Dalene