title: Critical re-appraisal of blood component quality after overnight hold of whole blood outside current room temperature limits.
abstract: OBJECTIVE
  According to European guidelines, the temperature of whole blood (WB) has to be maintained at 20-24°C until processing within 24 h, but in blood bank practice, WB is frequently held at temperatures between 18-25°C. We aimed to assess the impact of these small temperature deviations on the quality of the blood components.
  
  
  METHODS
  After rapid cooling, 7 WB units were held overnight at 18°C and 8 units at 25°C, reflecting worst case holding conditions, and separated into a red cell concentrate (RCC), plasma and buffy coat (BC). RCCs were filtered at test temperature and stored for 42 days at 2-6°C. BCs were processed to single-BC platelet concentrates (sPC) and stored up to Day 8 at 20-24°C.
  
  
  RESULTS
  After overnight hold at 18°C, 2,3-DPG in WB decreased by 34 ± 9%, while at 25°C the decrease was 82 ± 6%. Accordingly, the 2,3-DPG levels in the RCCs in the 25°C group were significantly lower than in the 18°C group (2·2 ± 1·4 vs. 10·4 ± 2·9 μmol/g Hb). RCCs and sPCs in the 25°C group showed higher initial lactate levels and lower pH compared to the 18°C group, but these differences levelled off at the end of storage. RCCs showed small differences in ATP levels and haemolysis. Plasma in both groups showed comparable Factor VIII:C levels.
  
  
  CONCLUSIONS
  The temperature of WB during overnight hold strongly affects initial 2,3-DPG levels of RCCs and supports the maintenance of temperature limits between 20 and 24°C. Other in vitro effects of the temperature deviations were small and of no practical relevance.
authors.affiliation: Sanquin Blood Supply, Amsterdam, The Netherlands.
authors.forename: I J
authors.initials: IJ
authors.lastname: Bontekoe
authors.affiliation: Sanquin Blood Supply, Amsterdam, The Netherlands.
authors.forename: P F
authors.initials: PF
authors.lastname: van der Meer
authors.affiliation: Sanquin Blood Supply, Amsterdam, The Netherlands.
authors.forename: D
authors.initials: D
authors.lastname: de Korte
mesh_terms: D019794:2,3-Diphosphoglycerate / Q000032:analysis; D000255:Adenosine Triphosphate / Q000378:metabolism; D001792:Blood Platelets / Q000166:cytology* / Q000378:metabolism; D001793:Blood Preservation; D004912:Erythrocytes / Q000166:cytology* / Q000378:metabolism; D006461:Hemolysis; D006801:Humans; D006863:Hydrogen-Ion Concentration; D019344:Lactic Acid / Q000032:analysis; D013696:Temperature; D013997:Time Factors
chemical_list: D019794:2,3-Diphosphoglycerate; D019344:Lactic Acid; D000255:Adenosine Triphosphate
keywords: platelet quality; red cell in vitro quality