A cost effective model for appropriate administration of red cell units and salvaging un-transfused red cell units by using temperature sensitive indicators for blood component transportation in a hospital setting.
BACKGROUND
A rule called "30-min rule" defines that red cell unit cannot be used if it has been out of blood bank refrigerator for over 30 min. This rule is useful to guide initiation of transfusion, but is inadequate for deciding whether to reuse or discard units received-back at blood transfusion services (BTS). A simple cost-effective temperature-sensitive indicator was evaluated to decide upon reuse (cold chain was uninterrupted) or discard (where cold chain was interrupted) in a simulation exercise.


METHODS
Temperature-sensitive indicators TH-F™ that irreversibly changed color from white to red demonstrated that heat excursion has occurred and the cumulative temperature has exceeded 10°C for over 30 min, were used in outdated red cells for simulating units, which are not used and received-back. These units were also tagged with a standard temperature monitoring device, which was a re-usable credit card sized device, which would log the actual time and temperature. In few units percent hemolysis was also calculated.


RESULTS
Statistically insignificant elevation in average temperature was noted in 102 simulated units at the time of return to BTS (Δ 0.04°C), despite the fact that these units were in the transport box for over 4 h. The average supernatant hemoglobin in these units was 0.24%, much below the prescribed threshold.


CONCLUSIONS
Transportation of blood in controlled conditions with temperature-sensitive indicator is a cost-effective model to save blood, a precious human resource.
Department of Transfusion Medicine, Medanta-The Medicity, Gurgaon, Haryana, India.
Aseem K
AK
Tiwari
Medanta Institute of Education and Research, Medanta-The Medicity, Gurgaon, Haryana, India.
Pooja
P
Sharma
Department of Transfusion Medicine, Medanta-The Medicity, Gurgaon, Haryana, India.
Prashant K
PK
Pandey
Department of Transfusion Medicine, Medanta-The Medicity, Gurgaon, Haryana, India.
Ganesh S
GS
Rawat
Department of Transfusion Medicine, Medanta-The Medicity, Gurgaon, Haryana, India.
Surbhi
S
Dixit
Department of Transfusion Medicine, Laboratory Services and Transfusion Medicine, Medanta-The Medicity, Gurgaon, Haryana, India.
Vimarsh
V
Raina
Department of Gastroenterology, Medanta-The Medicity, Gurgaon, Haryana, India.
Richa
R
Bhargava
Blood transfusion services; red cells; temperature-sensitive indicators