Red Cell Products

Expiry

Packed Red Blood Cells (PRBC) may be stored for a maximum of 42 days from the date of collection; the expiry date is indicated on the product label.

Stored Whole Blood (SWB) may be stored for a maximum of 21 days from the date of collection; the expiry date is indicated on the product label.

PRBC and SWB must not be used past their expiry date. All PRBC and SWB that have reached their expiry date must be discarded as clinical waste.

Storage and Monitoring

PRBC and SWB should be kept at a core temperature of 4°c +/- 2°c. Variation from the core temperature of 4°c +/- 2°c must be kept to a minimum during storage and restricted to only a short period necessary for examining or issuing the product.

In order to ensure red cell products are being stored correctly it is vital that the correct equipment is used. A dedicated fridge that maintains a temperature of 4°c +/- 2°c with a max/min thermometer that is read and recorded twice daily is ideal. Temperatures should be closely monitored for fluctuations and any temperatures outside the normal range reported for action. Visual inspection is advised and any colour change reported. In addition, gentle inversion of the products several times each week to ensure additive solutions are mixed with the red cells is also advised.

If PRBC and SWB are kept outside of the recommended temperature range, exceptionally (i.e. due to equipment failure at the veterinary practice) red cell products which have been exposed to a core temperature not exceeding 10°C and not less than 1°C may be released for transfusion provided:

  • That the component has been exposed to such a temperature change on one occasion only
  • That the duration of the temperature change has not exceeded five hours
  • That a documented system is available to cover such eventualities
  • That adequate records of the incident are compiled and retained

If PRBC or SWB are removed from storage to be transfused but are then found not to be required, it is recommended that the time allowed out of controlled temperature if the product is to be returned to storage (refrigerator), be 30 minutes maximum. All products should be given within 4 hours of the product being removed from storage.

Warming

Red cell products can be adversely affected by any sudden change in temperature. A zip lock bag should be used to keep the product clean once they are removed from their storage area unless being immediately prepared for transfusion. Red cell product can be transfused immediately on removal from the fridge – as the fluid passes down the ambient temperature giving set, the blood will increase in temperature to near room temperature. Alternatively, the unit can be allowed to gradually reach ambient temperature for 30 minutes prior to initiating the transfusion. A water bath can also be used to give a gradual increase to temperature (never to exceed 37°C) for critical patients where fluid warming is deemed paramount.

 

Plasma Products

Including: Fresh Frozen Plasma (FFP), Frozen Plasma (FP), Cryo-precipitate (Cryo-P) and Cryo-supernant (Cryo-S)

Expiry

FFP has an expiry date of 12 months from the date of collection. However, after 12 months has elapsed, this product can be re-labelled and stored for a further 4 years as FP.

FP has an expiry date of 5 years from the date of collection.

Cryo-P has an expiry date of 12 months from date of collection.

Cryo-S has an expiry date of 12 months from date of collection.

All expiry dates are shown on the product label and plasma products that have reached their expiry date must be discarded in clinical waste. The only exception to this is FFP which can be re-labelled as FP and stored for another 4 years before discard will be required.

Temperature

Plasma products should be stored at a temperature of -18°C or below.

Storage and Monitoring

In order to ensure plasma products are being stored correctly, it is vital that the correct equipment is used. A dedicated freezer that maintains a temperature of -18°C or below with a max/min thermometer that is read and recorded twice daily is ideal. The freezer should not have an auto-defrost as this will significantly decrease the lifespan of the plasma product. Temperatures should be monitored closely for fluctuations and any temperatures reported outside the normal range reported for action. Visual inspection should take place prior to plasma products being placed into their storage location to ensure they are undamaged from transit. Although a storage temperature below -18°C improves the preservation of labile coagulation factors, lower temperatures increase the fragility of plastic. Particular care must be taken when handling such products.

If plasma products are kept outside of the recommended temperature range, exceptionally (i.e. due to equipment failure at the veterinary practice) plasma products which have been exposed to an increase in core temperature not exceeding 4 hours at 22°C +/- 2°C or 24 hours if stored at 4°C +/- 2°C may be refrozen provided:

  • That in the case of FFP and Cryo-P the plasma product is to be relabelled as Frozen Plasma (FP)
  • That the plasma product has been exposed to such a temperature change on one occasion only
  • That the duration of the temperature change has not exceeded four hours
  • That a documented system is available to cover such eventualities
  • That adequate records of the incident are compiled and retained

If plasma products are removed from storage to be transfused but are then found not to be required, if delay is unavoidable, the plasma product may be stored and should be used within 4 hours if maintained at 22°C +/- 2°C or 24 hours if stored at 4°C +/- 2°C, but it should be borne in mind that extended post-thaw storage will result in decline in the content of labile coagulation factors. Therefore, any plasma product to be refrozen must be relabelled as Frozen Plasma (FP) in the case of FFP and Cryo-P. 

Warming

Plasma products are brittle when frozen so care should always be taken when storing and handling them in their frozen state. A zip lock bag should be used to keep the products clean once they are removed from their storage area. Units can be allowed to gradually defrost and reach ambient temperature prior to initiating the transfusion. Alternatively, a water bath can also be used to defrost the plasma more quickly (never to exceed 37°C).