Blood Bank and Pre-Transfusion Testing

OVERVIEW

  • blood products undergo a meticulous collection, preparation and testing process to minimise the risks of blood transfusion

COLLECTION

  • donor selection
  • testing of donor blood: groups (ABO, Rh), red cell antibodies and extended red cell antigen typing, infectious diseases, HLA typing, direct antiglobulin test
  • processing into components and plasma derivatives

PREPARATION

  • viral testing
  • sterile handling
  • leukodepletion
  • blood component labeling
  • compatibility labeling
  • irradiation if required (against donor lymphocytes)

STORAGE

  • RBC: 2-6°C for up to 42 days (35 days for pediatrics)
  • Platelets: 20-24°C for up to 5 days with continuous gentle agitation
  • FFP/Cryo: <-25°C for 12 months

PRE-TRANSFUSION TESTING

  • meticulous attention to request form – request invalidated if any discrepancy
  • group and hold/ type and screen: takes 45 min total

group or type

  • ABO and Rh groups (forward and reverse typing tests) – takes 15 min

screen

  • antibody screen (for non-ABO Abs) – if found takes hours to resolve
  • checking for duplicate records of patient and comparing historic results with new
  • valid for 3 days if previous transfusion or pregnant in past 3 months

Cross match (total 1-2 hours)

  • electronic cross match only if negative Ab screen (takes 1 hour total, including G&H)
  • serological cross match of patients plasma with donor cells if positive Ab screen (takes 2 hours total)

POST-REACTION TESTING

  • haemovigilance activities
  • notification and investigation of an adverse transfusion reaction

OTHER

  • advice and information

References and Links

  • Yazer MH. The blood bank “black box” debunked: pretransfusion testing explained. CMAJ. 2006 Jan 3;174(1):29-32. PMC1319340.

CCC 700 6

Critical Care

Compendium

Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also the Innovation Lead for the Australian Centre for Health Innovation at Alfred Health and Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.

After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.

He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE.  He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.

His one great achievement is being the father of two amazing children.

On Twitter, he is @precordialthump.

| INTENSIVE | RAGE | Resuscitology | SMACC

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