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Return of Plasma to the Blood Bank

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For several years now our Blood Bank has decided that any plasma that has been issued for more than 2 hours needs to be destroyed if it is returned to the Blood Bank.  This was changed by a technical specialist who has been gone from the job for 5 years but this strange rule still stands.  My problem with this is if it is sent out in a cooler that has been validated for 24 hours why destroy the plasma?  I would like to get this changed but need some good info for our current lead so she can make the change.  Looking for help please.  To me this is a no brainer but I seem unable to convince those in charge.

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As with packed cells, as long as the cooler is validated, and you document that the temp is OK when it is returned, I can see no reason you cannot accept plasma back.  In the US, you just want to ensure that any AABB recomendations for storage are met, then write up your new policy.

Scott

 

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Posted (edited)

I would tend to disagree - you don't know how the product is handled after it gets where it is going (OR, ER, wherever).  I don't believe that the temperature monitoring tabs are approved for plasma.  If they are, I think you'd have to use them to document that the product was stored appropriately while out of the BB.  I'd cite you otherwise. 

Edited by David Saikin

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Thanks Scott. That is my thought also but fighting the lack of common sense is an up hill battle sometimes 

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Posted (edited)

Plasma is hard to keep track of just by temperature alone.  If you are in a hurry - there is a good chance the plasma is going to be warmer that 1-6C when it leaves the Blood Bank to start with.  Even in a separate cooler, that means the temperature monitoring tabs won't work and there is no way to know what happens to the plasma that way.  Data loggers wouldn't work either.  Difficult situation. 

We will only accept plasma back if it is cold and in it's own cooler and will only keep it for 24 hours.  We do not extend FFP (any type) that was issued and returned into a Thawed Plasma product either.

 

Edited by cswickard
reworded

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On 5/16/2018 at 12:06 PM, David Saikin said:

I would tend to disagree - you don't know how the product is handled after it gets where it is going (OR, ER, wherever).  I don't believe that the temperature monitoring tabs are approved for plasma.  If they are, I think you'd have to use them to document that the product was stored appropriately while out of the BB.  I'd cite you otherwise. 

That's a good point.  Each Lab would have to use specific policies to ensure "that the temp is OK".  Here we use those Timestrip tabs, which we have validated for RBCs and thawed plasma.  But obviously if a unit of plasma goes out that is still warm from the thawer, the tabs are useless.  We have a log for all products sent out in coolers to OR, ER, etc.  If product is returned, return temp and inspection is documented there.

Scott

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I have a note: AABB 2015 (Ask the FDA... question 18) that issued plasma must be stored in a container that maintains proper temperature but that it is acceptable for return regardless of its temperature if properly stored.

You are really debating the "properly stored" question but I found the above interesting and useful for those units issued warm and brought back promptly before they cooled down.  I will be defining some circumstances in which we will accept them back.  This is a more common problem now that the "trauma packs" with plasma go out more routinely.

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