I have spent the last week speaking with different hospitals about neonatal exchange transfusions, specifically, whether removing excess anticoagulant is necessary or not.

some of them, even when using CPDA, are removing the excess anticoagulant, and other places are reconstituting the product without the removal of the additional CPDA.

What is everybody's thought on this? Should the excess anticoagulant (CPDA) be removed?

Thanks,

Robert

We remove the excess superrnatent and replace with AB plasma to make a "reconstituted whole blood" for the exchange.

Our facility does not have the resources to do the plasma removal. So we just add AB plasma and do not remove CPDA plasma.

What ISBT code are you using to label the product?

What ISBT code are you using to label the product?

It depends on what you start with. There are some starting types that have a "supernatant reduced, plasma added" version and some that only have "plasma added." If you are a member of ICCBBA, you can go to their website and pull up the complete Access file of products. Do a search with "added" as part of the field and look for red cells of the appropriate additive with whatever modifications (Resid Leuk <5log6, irradiated, etc.). Then choose one based on whether you removed anything before you added the plasma (if they have a code for the combination you need) or not. I know that is a little vague, but there are dozens of possible codes that could apply to your situation.

we don't use isbt yet, so our system has a code for reconstituted whole blood and we have manual hand made labels for that.

What centrifuge are you using? How long are you spinning the unit and at what RPM/RCF setting?