Prestorage Filtration

[Liz]

I want to go to 100% prestorage filtration. The thing is we are a hospital based Blood Bank with the donor room and the rest. Moreover, I have nearly 100% one-time donors. That means that we will be discarding ~ 10% of the units because we perform the infectious screening after we collect. That will be a huge financial loss. Am I justified financially? No. This is of course for patient-care but I cannot justify it if it’s a financial loss.

The reason I am (and the Blood Utilization Committee is) thinking of this is because of the 0.7 % reported NHTRs and the fact that we presently filter ~ 50% upon request (but not prestorage).

Option 2:

If I go for filtering AFTER I perform the infectious screening and use the sterile connecting device to connect the filter, the inconvenience is that the units may sit for more that 8 hours. What is the policy on the 24 hour FFP? And, what happens once the units are put in the cold quarantine storage, should I then filter in the cold?

I would be happy to have some thoughts on this and on others’ practices.

Thank you!

[ColleenA]

Most of the time when you filter after the collection it is just the RBC that you are filtering. The usual processing of the WB into the RBC and FFP are completed on day one and then after the units have been tested and found to be acceptable you can sterile dock on a LR filter to the RBC. The ones that we use are good for 5 days after the collection. This is still considered pre-storage LR. It is easier to get a WB to go through a LR filter but if you have additive RBCs you should not have too many issues. The only other problems we have had are with donors that are hemoglobin S positive. These units are known to cause filter failures as well as QC failures when counting WBCs to show LR.

Good luck.

[Liz]

Thank you, which filters do you use?

What do you mean "good for 5 days" after collection? and do you have references?

This is good info.

Thank you

[KarSzpy]

I want to go to 100% prestorage filtration. The thing is we are a hospital based Blood Bank with the donor room and the rest. Moreover, I have nearly 100% one-time donors. That means that we will be discarding ~ 10% of the units because we perform the infectious screening after we collect. That will be a huge financial loss. Am I justified financially? No. This is of course for patient-care but I cannot justify it if it’s a financial loss.

The reason I am (and the Blood Utilization Committee is) thinking of this is because of the 0.7 % reported NHTRs and the fact that we presently filter ~ 50% upon request (but not prestorage).

Option 2:

If I go for filtering AFTER I perform the infectious screening and use the sterile connecting device to connect the filter, the inconvenience is that the units may sit for more that 8 hours. What is the policy on the 24 hour FFP? And, what happens once the units are put in the cold quarantine storage, should I then filter in the cold?

I would be happy to have some thoughts on this and on others’ practices.

Thank you!

Hi,

I saw your post above. Where are you located? I work with Terumo Medical Corporation and we can have someone discuss several options with you to see what may work for your situation.

Talk to you soon,

Karen Szpyhulsky

[ColleenA]

The filters that we use are distributed by Fenwall but are called Sepacell filters. The 5 days that I was referring to are that you have up to 5 days to perform the sterile connection and filter the unit. This is listed in the manufacturers package insert.

[Liz]

Thank you Colleen for the help.

[Malcolm Needs ☆]

Hi Liz,

I think that I am correct in saying that all units of blood in the NHSBT are deliberately kept for about 8 hours before leukocyte depletion, and this is seen as an advantage in that this gives the leukocytes time to phagocytose any (or, in any case, most) free bacteria in the unit.

I'm back at work tomorrow (boo!!!!!!!!) after two weeks wonderful holiday in the Highlands of Scotland (and being used as fresh fodder for the midges) and will check this and get back to you.

Malcolm

[Malcolm Needs ☆]

Hi Liz,

I think that I am correct in saying that all units of blood in the NHSBT are deliberately kept for about 8 hours before leukocyte depletion, and this is seen as an advantage in that this gives the leukocytes time to phagocytose any (or, in any case, most) free bacteria in the unit.

I'm back at work tomorrow (boo!!!!!!!!) after two weeks wonderful holiday in the Highlands of Scotland (and being used as fresh fodder for the midges) and will check this and get back to you.

Malcolm

Well, only about a month late!

In fact, it turns out that the NHSBT are happy to keep the units for 24 hours prior to leukocyte depletion, although this does often take place before the 24 hours are up.

Sorry it has taken so long for me to keep my promise.

:redface::redface:

[Liz]

Hello Malcolm, at what temperature are the RBC units stored for 24 hours?

[Malcolm Needs ☆]

Well, I assumed that they would be held between 2 and 6oC, but I thought that I had better check this with one of the top people on the donation side of things, and it would appear that they can be kept at ambient temperature (about 20oC in the UK), which amazed me.

[Liz]

Hmm interesting. I would have kept them at ambient temp until I pulled off the plasma and then stored them at 2-6 C. Interesting.

Thank you