Red Cell Units Out of the Fridge.

[Malcolm Needs ☆]

From time-to-time there are some interesting threads on this site concerning how long a unit can be out of a fridge and then returned to the Blood Bank. Although I am fully aware that we all have to follow Guidelines and Regulations, there is, nevertheless, an interesting areticle that has just been published in Transfusion Medicine Reviews (I haven't had time to read it all yet myself) on this very subject for those who are interested. It is:

Brunskill S, Thomas S, Whitmore E, McDonald CP, Doree C, Hopewell S, Staves J, Cardigan R, Murphy MF. What is the maximum time that a unit of red blood cells can be safely left out of controlled temperature storage? Transfusion Medicine Reviews 2012; 26(3): 209-223.e3.

[Dansket]

Malcolm,

There is an article titled "Debunking the 30-Minute Rule" in the May 2010 edition of AABB News published by the American Association of Blood Banks. The author states, "It is unacceptable to use the 30-minute rule as an absolute and universal rule. It is acceptable, however, to include a specific time frame for the reissue of blood products in a facilitiy's policies and procedures if the time frame has been validated in that facility".

Furthermore article states that it has not been acceptable to use any other metric but temperature since the AABB published specific requirements for the reissue of blood in the eighth edition of the AABB Standards in 1976.

From a regulatory standpoint (AABB standards in US), it is unacceptable to reissue whole blood or red blood cells that have been allowed to warm above 10C or cool below 1C.

[Malcolm Needs ☆]

Yes, I saw that article Dansket, and I tend to agree, but, that notwithstanding, the Brunskill et al paper came out later. That having been said, the paper did say that the temperature to which the blood rose was far more important than the time out of the fridge - and so, I think we agree!