Just as with different foods or vaccines and other protective products, there are various storage conditions for blood as well. Blood storage conditions are generally applied and include a cold chain, as in the other issues we have mentioned.
The cold chain, which is an important stage for blood storage conditions, covers the preservation and transportation of blood and other components at the required temperature from the moment they are taken until they reach the other person to be transferred. Just as the deterioration of the cold chain in foods can cause the deterioration of the food and the poisoning of the person consuming it, the deterioration of the cold chain in the blood also poses a danger to the person to whom the blood will be transferred.
In order to provide blood storage conditions; blood bank coolers, plasma freezers, incubators, blood transport boxes, and similar equipment providing a deep-freezing environment are used. These types of equipment have become even more reliable with the advancement of technology.
Blood Storage Conditions for Blood and Red Blood Cells
Red blood cells and blood storage conditions always require a blood bank refrigerator. They should be stored in these cabinets at 2-6 degrees Celsius. An integrated temperature monitoring apparatus is placed in these refrigerators for red blood cells and blood, and this apparatus gives a warning via an alarm if the temperature is not evenly distributed among the elements inside. The most important point to ensure blood storage conditions is to catch and maintain the right temperature. Bacterial contamination and growth in the blood are reduced to a minimum at 6 degrees Celsius, which is specified as the aforementioned upper limit. In this way, the correct blood storage conditions are provided.
If the lower limit for blood storage conditions is 2 degrees Celsius, it prevents the hemolysis of red blood cells. For this reason, it is essential that the temperature of the red blood cells is not lowered below this lower level. Otherwise, when the cells are transferred in a hemolyzed state, it can cause serious kidney problems and bleeding that can lead to death.
Blood Bags Shelf-Life
Although the shelf-life varies for each blood bag, the average shelf-life can be expressed as 35-42. If the temperature of the room where the blood bag is located is going to be above 25 degrees Celsius, additional equipment such as a blood transport box or isolator carrier should be provided to keep the temperature below 10 degrees Celsius. The blood in the blood bags transported in this way must be transferred within 30 minutes. If use is not required at that time, blood should be returned to the center immediately.
Fresh Frozen Plasma
Fresh frozen plasma is plasma that is taken 6 to 8 hours after donating blood and is quickly frozen. This item is stored in Blood Transfusion centers at a minimum of -40 degrees Celsius. If the aforementioned blood storage conditions are not met, coagulation factors (such as Factor VIII and Factor V) begin to deteriorate and the amount of blood decreases. This goes against the purpose of the transfusion. The shelf-life determined for this item is one year.
Fresh frozen plasma must be thawed prior to transfusion. This process is done in blood centers and is performed using the plasma melting bath method. The ideal storage condition for fresh frozen plasma should be transported in a blood transport box with a temperature of 2-6 degrees Celsius at 30-37 degrees Celsius (it has a life of 30-45 minutes this way). Fresh frozen plasma should be transfused within thirty minutes of thawing. If fresh frozen plasma is not used immediately, it can be transfused within 24 hours by maintaining it in this temperature range (2-6 degrees Celsius). Thawed plasma cannot be re-frozen and must be destroyed in these cases. For this reason, fresh frozen plasma should be processed when and where it is really needed.
Erythrocyte suspension is the expression used for blood that has ¾ of its plasma or all of it removed. When the erythrocyte suspension is prepared completely, it will contain an average of 200 ml of erythrocytes. When preservatives are added, this total reaches an average volume of 300 ml. The hematocrit rate is in the range of 65-75%.
Blood storage depots are essential for blood units containing erythrocytes. The blood storage conditions for them are in the range of 2-6 degrees Celsius. In cases where there is an uneven distribution or variability of temperature, hemolysis is experienced. From this point of view, erythrocyte storage or storage cannot be done anywhere other than the blood storage cabinet.
Storage times vary for blood units containing erythrocytes. The main variable for this is the anticoagulant/preservative fluids used. According to the liquids used, the blood storage conditions and times are as follows:
- 21 days for Acid-Citrate-Dextrose (ACD) and Citrate Phosphate-Dextrose (CPD),
- 35 days for CPD-Adenine (CPDA-1),
- 42 days for Saline-sodium chloride, Adenine, Glucose, Mannitol (SAG-M).
Transfusion and infusion rate also vary for erythrocyte suspension. While the maximum foreseen for 1 unit is 4 hours, the actual transfer should be done within 2-3 hours on average.
In an adult, 1 unit of erythrocyte suspension transfer increases hemoglobin about 1-1.5 g/dl and Htc by 3-5%.
Platelets are prepared by manual and automated methods and then stored at 22°C -24°C in a platelet agitator cum incubator to maintain platelet function to prevent or stop spontaneous bleeding in patients with thrombocytopenia or hypoplastic anemia or bone marrow. For separation of platelets, as lower temperatures affect platelet function and separation, whole blood should be kept at 20-24 degrees Celsius before the procedure. Platelets should be prepared 8 hours after phlebotomy and stored at 20-24 degrees Celsius with constant shaking.
The platelet suspension prevents clumping, which can cause loss of viability. Platelets have a shelf-life of 3-5 days, depending on the type of blood bag used. There is a risk of bacterial contamination as they are stored at room temperature, so the temperature in the platelet storage area should be kept at ambient temperature below + +.
Platelet stocks are not kept at the hospital Blood Bank but are ordered from the National Blood Service (NBS) for certain patients as needed. Due to the risk of bacterial contamination, they are kept in the Blood Transfusion laboratory under special storage conditions that maintain their clinical effectiveness and have a shelf-life of only 5 days from a donation.
Platelets should not be refrigerated. They are given as an adult or pediatric “therapeutic dose” and must be transfused immediately after collection from the Blood Donation Room. Rh-Negative premenopausal women should receive Rh(D) Negative platelets whenever possible.
Blood Storage Conditions and Patients
Blood should not remain outside of designated temperature-controlled storage areas for more than 30 minutes. Blood is an excellent culture medium for bacterial growth; therefore, it is stored in approved refrigerators at 2-6°C and has a shelf-life of 35 days from a donation. There are legal requirements for temperature regulation and alarm systems to store blood. The hospital has approved Blood Bank refrigerators in the Blood Problem room in the Pathology department and in the Pantry room in Theaters.
Blood should never be stored at home or in any other refrigerators. Blood should be removed from the Blood Bank refrigerator one unit at a time only when a transfusion needs to begin within 30 minutes. Transfusion should be completed within 4 hours of removing the package from the blood bank refrigerator to avoid the risk of bacterial growth.
Bacterial contamination of blood products may be the largest cause of death from transfusion accidents. If a unit of blood has been removed from the refrigerator for more than 30 minutes and there is no possibility of imminent transfusion, the Blood Bank should be notified and the unit marked “Unsafe to Transfuse”. The unit will then be taken directly to a staff member at the Blood Bank for safe disposal.
Blood Storage Conditions and Recommendations
As we mentioned above, blood storage conditions vary according to the elements in it and the state of the blood. Therefore, it should be confirmed by authorized persons that the correct temperatures and blood storage conditions are applied. These blood storage conditions must be strictly enforced to prevent contamination and prevent potentially fatal bleeding. Ultra-deep freezers, blood cabinets, freezer cabinets, and outdoor coolers are used to provide blood storage conditions. Coolermed, one of the domestic productions, also meets this need with various medical coolers. With systems that can control temperature fluctuations and advanced technology blood storage units, it is possible to apply storage conditions with health, with products such as Coolermed, which are pioneers in health and value people.
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