Introduction Equipments required Harmful effects of improper storage Storage of various blood components- AABB guidelines NACO guidelines for storage Storage during transport Storage in frozen state Physical and chemical changes in stored blood

1. A seminar on-
Storage of Blood and its
Components
Presenter- Dr. Shiny
Moderator- Dr. Nidhi Bansal

2. INDEX
• Introduction
• Equipments required
• Harmful effects of improper storage
• Storage of various blood components- AABB guidelines
• NACO guidelines for storage
• Storage during transport
• Storage in frozen state
• Physical and chemical changes in stored blood

3. INTRODUCTION
• Transport and storage requirements must be followed when blood
components are transferred from the collection site to the processing facility,
from the supplier to the blood bank, or from the blood bank to the patient.
• Failure to adhere to these storage and expiration requirements can result in
decreased product potency and/or safety.
• Blood is collected at body temperature, i.e. +37°C. But in order to maintain its
vital properties, it must be cooled to below +10° C to be transported, and
stored at refrigeration temperatures of around +4°C until use.

4. • Temperature requirements during transport of blood components differ from
those during storage.
• When blood components are issued from the blood bank to the patient care
area, maintenance of appropriate temperature requirements allows for the
possibility of returning the component to inventory if it is not transfused.

5. EQUIPMENTS REQUIRED
• Refrigerators, freezers, and platelet incubators equipped with continuous-
temperature-monitoring devices to allow detection of temperature deviations
before products are affected.
Automated electronic monitoring devices include:
1)weekly pen and chart recorders
2)sets of hard-wired or radio-frequency temperature-recording devices
3)centralized temperature-monitoring systems.

6. • If an automated temperature-recording device is not used, temperatures of the
blood storage environment must be recorded manually every 4 hours.
• Because platelets must be gently agitated during storage, typically using
horizontal flatbed or elliptical rotators; alarm systems should also emit alerts
when the platelet agitator has malfunctioned.

7. Harmful effects of Improper Storage
• If blood is stored or transported outside of these temperatures for long, it loses its
ability to transport oxygen or carbon dioxide to and from tissues respectively
upon transfusion.
• Other factors of serious concern are the risk of bacterial contamination if blood is
exposed to warm temperatures.
• Conversely, blood exposed to temperatures below freezing may get hemolysed
and can lead to a fatal transfusion reaction.

8. STORAGE
OFVARIOUS
BLOOD
COMPONENTS
(AABB guidelines)

14. NACO
GUIDELINES
FOR STORAGE

15. WHOLE BLOOD AND RED CELLS

16. PLASMA

17. PLATELET CONCENTRATES

18. IMPORTANT POINTS FOR STORAGE
• Avoid fluctuations in temperature
• No food/drinks in storage refrigerators
• Blood units in upright position
• Separate areas for unprocessed blood, processed blood, cross-matched blood
• Alternative power supply in case of frequent power cuts

19. STORAGE DURINGTRANSPORTATION
• Temperature 2-8o C
• Cold boxes or insulated carrier boxes surrounded by ice packs. Eg- Blood
transport containers from Electrolux or REMI
• Measure the temperature of blood bags after arrival
• Check for any evidence of hemolysis

20. PHYSICAL CHANGES IN STORED BLOOD
• Change in shape of RBC from disc to spherical
• Loss of lipid in red cell membrane, which causes decrease in
deformability
• Decrease in critical hemolytic volume (CHV) in parallel with membrane
lipid content. Critical haemolytic volume is the largest volume to which
red cells swell before hemolysis

21. Contd..
• Increase in osmotic fragility
• Blood stored for more than 24 hours loses viable platelets and
granulocytes
• Heat labile coagulation factors i.e. Factor V and Factor VIII decreases on
storage, 50% in first 48-72 hours.
• Viable lymphocytes persist throughout the storage period.

22. BIOCHEMICAL CHANGES IN STORED BLOOD
• Dextrose level and pH levels drop as the red cells undergo
anaerobic glycolysis to generate ATP.
• Decrease in 2,3-DPG
• Decrease in cells’ ability to release oxygen to the tissues
• Loss of potassium from red cells into plasma
• Passage of sodium from plasma to red cells
• Increase in plasma ammonia levels

23. • The sum of physical & chemical lesions – STORAGE LESIONS
• But these changes have little or no significance in transfusions as
patient’s body compensates for them, except compromised
patients and neonates, in whom blood less than 7 days old is
preferred.

26. STORAGE OF BLOOD IN FROZEN STATE
• The storage of red cells can be extended upto 10 years or more by freezing cells
after adding glycerol (cryo-protective agent).
• The deglycerolized blood is comparable to freshly drawn blood in volume,
hematocrit and functioning of red cells.
HIGH GLYCEROL-SLOW
FREEZE
LOW GLYCEROL-RAPID
FREEZE
At -80 C using mechanical
freezing
At -196 C using liquid nitrogen

27. References
• AABBTechnical manual 18th edition
• Makroo Principles & Practices ofTransfusion Medicine
• NACO guidelines for Blood storage