Pre Transfusion sample timings

[Matt]

HI Rashmi Happy new year to you.
Thanks for the reply. You have raised some very good. If people are wanting to progress this I I will suggest contacting the BSH writing group, I don't really want to start a practice outside the norm.

Thanks
Matt

[Chris Robbie]

Hi Matt and Rashmi

Thanks for the considered points Rashmi and I agree a change control would help to ensure the correct decision is made according to good practice.

It is not for MHRA to consider the rights or wrongs in clinical decisions like this, but my only comment would be that in my experience, a 72 hour limit would not be outside of the norm. When assessing SABRE reports I assess them as errors against the local QMS, not the BSH guidelines. I have seen a variety of sample validity timings including 72 hours for all, and even 48 hrs across the board to ensure that issued blood is identified and removed from the supply chain in good time. I couldn't tell you how many labs do what, just that I have seen it through SABRE reports.

Does anyone else who practices 48 hr or 72 hour validity have any comments?

[Matt]

Hi Chris
this is a bit of a surprise to me I would have thought that the vast majority of people were sticking to the BSH guidelines. When you say that a 72 hr limit for all is not outside the norm, do you mean there are a lot of people doing this? One of the reasons I was concerned about this was because I didn't know of anyone else using this practice. I would be very keen to get a bit of feed back form anyone using such a practice.

[Chris Robbie]

Hi Matt

I'm afraid it is up to others to come forward. I can't give you exact figures, but all I can say is that looking at SABRE reports, there are some reporters that operate a policy of less than 72 hours so that they are not caught out by samples that expire after 72 hours. For example, they will collect all the units that have reached 48 hours in the morning in case there are some that go beyond 72 hours over night before the next reclaim. Other hospitals may have several reclaims during the day depending on staffing and location of fridges for example, or may bring units back to the lab after 48 hours so they can then control the release of the blood from the lab within the period between the 48 and 72 hours.

It is for local trusts to decide how to ensure expired or unsuitable units are removed from the supply chain, and there is no "right" or "wrong" answer.

[Chris Robbie]

Hi Matt

It's been pointed out to me I may have got the wrong end of the stick! (Not unusual and serves me right for logging on while still on Christmas leave)

My comments were regarding sample validity and when to re-stock issued components and not sample timings in the way you describe.

Sorry for the confusion

Chris

[Matt]

Hi Chris
I was a little confused by your post which is why I wanted to clarify. After some discussion I think we will be sticking with the timings as in the BSH guidelines. Hooray.
As for getting the wrong end of the stick, I may have made a similar non conformance myself a few times LOL.

Regards
Matt

[maryslarson1]

Looks like detailed clinical advice can be found in the 4th edition of the Handbook of Transfusion Medicine in this case if I remember correctly (there are well-described guideline designed to deal with the cases).