Blood Storage and its Implication to Therapeutic Success

Published by Patrick Famisaran on

blood storage

Blood banking is an effective life-saving procedure. Making blood available when needed benefits patients that need a transfusion. Maximizing the delivery of blood banks from donors to patients is imperative. Such delivery accounts for safe, effective, and timely relay of needed blood supply when required.

Regulations have been outlined to assure that blood banks follow safe and effective measures. Blood storage protocols are followed for compliance and quality control. There are many steps involved in blood processing. This requires thorough standard guidelines to enforce strict compliance. From collecting blood components to preparing them correctly, such is an arduous task to maintain blood banking standards.

There are many factors affecting blood processing. It needs to have suitable anticoagulant and preservative solutions. Hence, it requires well-managed storage with conditions at optimum. Blood is fragile. Thus, proper handling is necessary. Any kind of damage can be detrimental to the blood components. Ultimately, such damage may risk saving lives in the process.

Blood Collection Preservatives

Anticoagulant

To collect blood and prepare them for transfusion, there are particular preserve its quality. Specific anticoagulant preservatives prevent clotting. It provides the proper nutrients to maintain red cells.

In principle, the anticoagulant requirement volume is directly proportional to the blood volume taken. Once blood volume is smaller, it only requires a smaller volume of anticoagulants also. 

Adenosine Triphosphate

ATP is a form of energy inside the cell. It is utilized through glycolysis from enzyme metabolism. The ATP then provides the needed energy by red blood cells. 

Red Cell Additive Solutions

Collected red cells need additive solutions to improve their shelf life. After centrifugation, the anticoagulants and nutrients are also removed. The blood is now at the stage of anticoagulation. But red cells need to survive. They need to be suspended in enough fluid. The nutrient used to achieve this is a red cell additive solution. The specific additive solutions are:

  • Saline
  • Glucose (dextrose)
  • Adenine
  • Mannitol

Like anticoagulants, the volume of additive solution is proportional to the total volume of the blood donation.

Blood Storage Concerns
Photo Credit: www.redcrossblood.org

Blood Storage Concerns

The main concern in blood banking is to make sure that physiological properties are intact. One of the primary concerns in blood storage is called storage lesion. This is primarily the change seen in the collected blood over time. During storage lesion, the blood undergoes the following:

  • deterioration of coagulation quickly
  • blood platelets lose their function and will not be feasible as a source in platelet therapy
  • red cells propensity to oxygen whereby losing its viability
  • release of leucocytes proteases
  • formation of macroaggregates
  • red cells release potassium

These changes in physiological properties will lead to blood sample deterioration. Such deterioration will negate any transfusion capacity of the collected blood.

Storage Temperature

Proper storage is imperative in a blood bank. Because of its properties, specific temperature ranges are required to preserve it. In principle, lower temperatures are conditions to which blood can maintain its quality. The many functions of low-temperature conditions to blood are:

  • slows glycolytic activity allowing extended shelf life
  • impede bacterial accumulation
  • avoiding physical damage to blood components

There are specific temperature specifications for specific blood components. Because of the nature of use and its functionality, specific blood components required particular conditions. 

  • Whole blood can be stored at refrigeration temperature. A controlled room temperature of +22°C ± 2°C can be an alternative.
  • Red cell concentrates can be placed at +4°C ± 2°C temperature. Concentrates should be prepared from whole blood refrigeration immediately after collection
  • Up to 24 hours, red cell concentrates from whole blood can be stored at ±22°C ± 2°C 
  • Platelet concentrates taken from whole blood are held at +22°C ± 2°C. 
  • When plasma is separated within 24 hours of collection, it can be stored at temperatures colder than –25°C. It has a storage period of up to 3 years. 

Blood Storage Equipment

The backbone of blood storage is blood storage refrigerators. The conditions they have at +4°C ± 2°C can maintain a variety of blood components. As such, storage refrigerators are critical requirements in blood banking.

Types of Refrigerators for Blood Storage:

  1. Upright, freestanding units
  2. Freestanding chest type refrigerators
  3. Cold rooms
  4. Solar and gas-powered storage devices

The most common refrigerator is the upright type. They sometimes come in double-door units. On the other hand, chest-type ones are used for better cold air retention. While they may not be the widely used option, their insulation features are better. Cold rooms are mainly used for blood transfusion. Depending on the capacity of the facility, cold rooms allow for bulk storage. Because there are far-flung areas with no electricity access, most health facilities in the area resort to using solar and gas-powered devices. It meets the essential controlled temperature requirement for blood storage. 

Plasma Freezer

There is also a particular type of freezers for plasma. Because plasma is much needed in blood therapy, plasma storage freezers specifically meet the need for plasma storage. It is capable of holding a consistent temperature colder than -25 0C. The freezer can undergo a ‘defrost cycle.‘ This cycle pertains to clearing the ice from the blower unit. 

Temperature-Controlled Rooms

Often blood banking is in bulk; to accommodate a more significant volume, dedicated rooms are built. These are controlled spaces with constant temperature to take insufficient blood components. Specific features of a temperature-controlled room are:

  • insulated walls
  • automatic doors
  • sealed window
  • proper lighting
  • high-quality air conditioner
  • preset alarm points
  • battery-powered alarm
  • temperature reading display

Blood Transport 

Blood like drugs and vaccines are commodities that are relayed from one place to another. They are highly-valued commodities that securing them in proper temperature conditions is a must. While refrigerators and freezers are present at blood banks, the transport of blood requires a different container. The transport container should ensure the temperature is controlled.

Features of a Blood Transport Container

  • Adequate insulation material
  • Containers should be made of solid materials capable of withstanding rough handling.
  • The container should be made of anti-leak material to contain any leaks
  • Practical design for easy loading and unloading
  • Easy to clean
  • Sealed and tamper-proof
  • The container should have a unique ID number
  • Embossed names and logos for easy identification
  • Provision for attachments for easy labeling

There are also specific transportation requirements for particular blood components. Containers and coolant packs are structured to maintain the specific temperature conditions of every blood component. Designing a transportation system for blood components should derive from the provision to safety transporting upholding the necessary environmental requirements. As such, the selection of quality coolant is critical. 

There are also validation procedures for containers and coolants. This is evidence that the used equipment complies with the standard. These standards may pertain to:

  • preset temperature
  • transport time requirements
  • number of units
  • the specific volume of coolant

When storage containers comply with such standards, it is proof that blood transport is also performed at the standard level. 

Blood Storage Temperature Monitoring

Like any other transit activity, conditions are maintained at a constant. The cold chain system for blood transport is within the same pre-conditions. Temperature monitoring is one way of accounting evidence that logistic operations are sustained in a set temperature guideline. This monitoring data is critical to ensure the quality of the blood.

As monitoring is an iterative task, some technologies are integrated to perform a quality reading. Temperature monitoring devices are convenient for remote monitoring. While manual recording may still be used, the data from monitoring devices provide better accuracy and precision. 

A variety of measuring devices can record blood transport temperature. They can come in the form of:

  • Manual reading through thermometers
  • Semi-automated
  • Automated

Semi-automated monitoring activity requires a combination of chart records and electronic data loggers. This can be streamlined by automating the process through a linked software. In essence, the software generally links the data loggers to graph charts and record data. 

Central management software is a competitive edge that limits the risk of temperature fluctuation on your blood delivery. AKCP Pharma-mon Server is an example of a single interface capable of tracking blood logistics. With the use of calibrated, wireless sensors, remote monitoring has never been easier. While gaining granular visibility, data are all tracked and recorded in the background. 

AKCP Wireless Temperature Sensor

AKCP Wireless Temperature Sensor is calibrated and has precise temperature measurement and documentation of data values blood storing preparations. The wireless temperature sensor design is perfect for monitoring blood bank temperature. It is important to monitor the temperature of the blood bank to ensure the blood is stored properly to avoid wastage and shortage of blood supply. Sensors transmit data collected to the nearest gateway. The gateway sends the data to the AKCPro Pharma Server for easily viewing monitoring access of data.

Wireless Temperature Sensors feature 2x NIST traceable, calibrated temperature sensors in a single stainless steel tube. Working as a pair they check each other’s values once a second for accuracy. If we detect the sensors are out of acceptable tolerances an alert is sent warning that the sensor requires re-calibration. NIST4 sensors come with 3x NIST traceable, calibrated temperature sensors in a single stainless steel tube. They work in pairs, with the averages of each pair averaged to give an overall reading. Improved accuracy and calibration checks with failover. Should any pair be out of calibration that value is ignored and an alert generated to warn that a pair is out of calibration?

Sensor Features
  • 4x AA Battery powered, with 10-year life*
  • USB 5VDC external power.
  • 12VDC external power.
  • Custom sensor cable length up to 15ft to position sensor in an optimal location.
  • NIST2 dual-sensor calibration integrity check.
  • NIST3 triple sensor calibration integrity checks with failover.

The Blood “Cold Chain”

It is established that cold facilities are needed in blood banking. But while the focus is on the blood, transit, the cold chain starts from the collection first. From the collection alone, particular cold containers are already required. Maintaining conditions from the get-go will save a lot of salvage procedures in the process. When blood is conditioned at optimum temperatures as it relays to processing and storage, quality is maintained. 

Thus, all facets of the blood “cold chain” are feasible for monitoring. Deploying applicable monitoring devices from root to finish is a comprehensive monitoring system. In the end, we want to supply as much blood as needed. Taking control of logistics conditions is the best way to make sure the blood meets its intended recipient. Only then do we know that our efforts are worthy and can save lives. 

Reference Links:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2897192/

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1751-2824.2008.00196.x


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