All blood bank refrigerators should be specifically designed for blood storage.
Once issued by the blood bank, the transfusion of whole blood, red cells and thawed fresh frozen plasma should be commenced within 30 minutes of their removal from refrigeration.
If the transfusion cannot be started within this period, they must be stored in an approved blood refrigerator at a temperature of 2°C to 6°C. The temperature inside every refrigerator used for blood storage in wards and operating rooms should be monitored and recorded daily to ensure that the temperature remains between 2°C and 6°C.
If the ward or operating room does not have a refrigerator that is appropriate for storing blood, the blood should not be released from the blood bank until immediately before transfusion.
All unused blood products should be returned to the blood bank so that their return and reissue or safe disposal can be recorded.
Whole blood and red cells
• Should be issued from the blood bank in a cold box or insulated carrier which will keep the temperature between 2°C and 6°C if the ambient (room) temperature is greater than 25°C or there is a possibility that the blood will not be transfused immediately
• Should be stored in the ward or operating theatre refrigerator at 2°C to 6°C until required for transfusion
• The upper limit of 6°C is essential to minimize the growth of any bacterial contamination in the unit of blood
• The lower limit of 2°C is essential to prevent haemolysis, which can cause fatal bleeding problems or renal failure.
Whole blood and red cells should be infused within 30 minutes of removal from refrigeration.
• Should be issued from the blood bank in a cold box or insulated carrier that will keep the temperature at about 20°C to 24°C
• Platelet concentrates that are held at lower temperatures lose their blood clotting capability; they should never be placed in a refrigerator
• Platelet concentrates should be transfused as soon as possible.
Fresh frozen plasma and cryoprecipitate
• Fresh frozen plasma should be stored in the blood bank at a temperature of -25°C or colder until it is thawed before transfusion
• It should be thawed in the blood bank in accordance with approved procedures and issued in a blood transport box in which the temperature is maintained between 2°C and 6°C
• Fresh frozen plasma should be infused within 30 minutes of thawing
• If not required for immediate use, it should be stored in a refrigerator at a temperature of 2°C to 6°C and transfused within 24 hours
• As with whole blood or red cells, bacteria can proliferate in plasma that is held at ambient (room) temperature
• Most of the coagulation factors are stable at refrigerator temperatures, except for Factor V and Factor VIII:
- If plasma is not stored frozen at -25°C or colder, Factor VIII falls rapidly over 24 hours. Plasma with a reduced Factor VIII level is of no use for the treatment of haemophilia, although it can be used in other clotting problems
- Factor V declines more slowly.