Segment Storage

[crldehart]

What methods do you use to store your unit segments?

We store the segments used for crossmatch in sealed tubes in a biohazard specimen transport bag (zip closure) kept at RT during the day. At the beginning of the next day shift, the dated bag is place in the specimen refrigerator on top of that day's patient specimen tubes. Tubes and segments are discarded after 10 days. It is a quick and easy way to save segments and also date the specimen racks.

[mollyredone]

We pull two segments from each unit as we process it, and attach a label from the back of the bag. We put these in a biohazard bag until full, write start and stop dates on the bag and refrigerate. We keep three bags at a time, so we throw out the oldest bag when a new one is full. I have gone digging through the bags when a patient developed a new antibody and was able to find the segments she got 2 months earlier and they were positive for the antigen that she developed an antibody to!

[Auntie-D]

have gone digging through the bags when a patient developed a new antibody and was able to find the segments she got 2 months earlier and they were positive for the antigen that she developed an antibody to!

That isn't unexpected though. It is however generating unnecessary work - this doesn't provide and direct benefit to the patient or affect patient management, all it does is satifies our own curiosity...

I still don't understand the general rational behind keeping the pigtails - if there is a suspected transfusion reaction the bag will come back anyway for culture - hey presto! Tag lines without doing any work at all

[Malcolm Needs ☆]

That isn't unexpected though. It is however generating unnecessary work - this doesn't provide and direct benefit to the patient or affect patient management, all it does is satifies our own curiosity...

I still don't understand the general rational behind keeping the pigtails - if there is a suspected transfusion reaction the bag will come back anyway for culture - hey presto! Tag lines without doing any work at all

I sort of agree with you, and sort of don't (it's the old saying, "I used to be indecisive, but now I'm not so sure!"), but, although I agree that 2 months is far too long, a cracking anamnestic delayed haemolytic transfusion reaction due to a reappearing anti-Jka (for example) would not necessarily show up straight away, and it may be nice to know if the units were Jk(a+), or, at least, incompatible post-transfusion cross-match?

[pluto]

That isn't unexpected though. It is however generating unnecessary work - this doesn't provide and direct benefit to the patient or affect patient management, all it does is satifies our own curiosity...

I still don't understand the general rational behind keeping the pigtails - if there is a suspected transfusion reaction the bag will come back anyway for culture - hey presto! Tag lines without doing any work at all

Agree 100%

I think it would be considered unusual to do this in UK

[mollyredone]

I only did it because I had time on my hands. It definitely isn't somehting we do on a normal basis. Can I help it if I thought it was fun??!

[Auntie-D]

I sort of agree with you, and sort of don't (it's the old saying, "I used to be indecisive, but now I'm not so sure!"), but, although I agree that 2 months is far too long, a cracking anamnestic delayed haemolytic transfusion reaction due to a reappearing anti-Jka (for example) would not necessarily show up straight away, and it may be nice to know if the units were Jk(a+), or, at least, incompatible post-transfusion cross-match?

But is it going to affect patient management?

[Malcolm Needs ☆]

Not necessarily the particular patient involved at the time, but it could point to a problem with the particular technology involved that was used for the initial antibody screen and cross-match. This is partly the point of SHOT/SABRE and partly why the UK Blood Services ask for pre-transfusion samples on any such cases - not to batter the person that did the initial testing, but to get information on any technologies that may be missing things.

[Mabel Adams]

In the US we are required by regulations to keep a sample of the donor unit for at least a week after transfusion, regardless of whether there is an immediate reaction.

One can argue that it is necessary to keep a segment from the time of crossmatching (if serologic) because one could discover after the hemolytic reaction that the segment crossmatched does not match the unit labeled and transfused. Quite rare I hope.

[vam3401]

When each unit is processed into the blood bank computer system upon receipt from our blood supplier, we pull one segment that is re-typed and two other segments that are saved. We use a unit number label from each unit to label a test tube and we store the two segments in this tube. These test tubes are stored in a test tube rack. We use several racks per week. Each week we discard the oldest segments (we keep the segments for 8 weeks). We write a discard date on the racks of segments using a piece of masking tape (high tech).