Increasing the time-to-freezing for clinical apheresis plasma meets quality specifications.

BACKGROUND AND OBJECTIVES: In Australia, the vast distances between blood collection centres and processing facilities make it challenging to align supply with demand. Increasing the time to freezing for clinical plasma beyond 6 h would alleviate supply issues. This study aimed to determine the quality of clinical apheresis plasma frozen within 12 h of collection. MATERIALS AND METHODS: Apheresis plasma (n = 20) collected at donor centres was immediately transported to a blood processing facility, stored at 26°C and sampled aseptically at 6, 8 and 12 h post collection. Frozen samples were thawed, and coagulation factors (F) II, V, VII, VIII and XIII, von Willebrand factor (vWF) and fibrinogen were measured using a coagulation analyser. RESULTS: FVIII concentrations declined in plasma frozen at 6, 8 and 12 h post collection (1.22 ± 0.27, 1.21 ± 0.25 and 1.16 ± 0.24 IU/mL, respectively) but not significantly (p = 0.3338). Importantly, all components met the FVIII specification (>0.7 IU/mL) for clinical plasma. Fibrinogen concentrations were stable from 6 to 12 h (p = 0.3100), as were vWF concentrations (p = 0.1281). Coagulation factors II, V, VII and XIII were not significantly different (p > 0.05 for all factors). CONCLUSION: Clinical apheresis plasma can be frozen within 12 h of collection, allowing collections from donor centres further from processing centres and increasing supply.

Evaluation of two temperature storage conditions for full blood count samples from Lifeblood's donors.

BACKGROUND AND OBJECTIVES: Lifeblood completes full blood count samples for selected donors to assess their suitability for future donations. Removing the current practice for refrigerated (2-8°C) storage and aligning with room temperature (20-24°C) storage of other donor blood samples would produce significant efficiencies in blood donor centres. This study aimed to compare full blood count results under two temperature conditions. MATERIALS AND METHODS: Paired full blood count samples were collected from 250 whole blood or plasma donors. These were stored either refrigerated or room temperature for testing on arrival at the processing centre and the following day. The primary outcomes of interest included differences between mean cell volume, haematocrit, platelet count, white cell and differential counts, and the need to produce blood films, based on existing Lifeblood criteria. RESULTS: A statistically significant (p < 0.05) difference for most full blood count parameters results was found between the two temperature conditions. The number of blood films required was similar under each temperature condition. CONCLUSION: The clinical significance of the small numerical differences in results is considered minimal. Furthermore, the number of blood films required remained similar under either temperature condition. Given the significant reductions in time, processing and costs associated with room temperature over refrigerated processing, we recommend a further pilot study to monitor the broader impacts, with the intent to implement national storage of full blood count samples at room temperature within Lifeblood.

Routine donor red cell antibody screening: Considering the alternate strategy.

BACKGROUND AND OBJECTIVES: Australian Red Cross Lifeblood (Lifeblood) performs red blood cell (RBC) antibody screening on every whole blood donation. An alternate strategy has been proposed whereby an antibody screen is performed on the first donation and only repeated following pregnancy, transfusion or a significant break between donations (>2 years). We assess the blood safety risks associated with removing antibody screening for every whole blood donation. MATERIALS AND METHODS: A retrospective desktop analysis included all whole blood donations collected by Lifeblood between 01 May 2018 and 30 April 2019 to quantify the antibodies that would have been undetected with the alternate strategy. The strategy was further assessed using the Alliance of Blood Operators Risk-Based Decision-Making framework. RESULTS: One hundred and seventy-one routine donors had antibodies for the first time, but reported no sensitizing event since their last donation. Forty-seven of these had antibodies of a clinically significant specificity and titre that have the potential to cause a haemolytic transfusion reaction (HTR). The calculated risk of undetected antibodies being transfused to an incompatible recipient is 1 in 82,200. CONCLUSION: The estimated risk of HTRs with the alternate strategy results in an increased risk. While the alternate strategy is identified as the most cost-effective option within the Australian setting, this additional residual risk was not deemed to be acceptable. Blood services would need to determine whether the increase in residual risk stemming from implementation of such a strategy is tolerable.

Cytomegalovirus in Australian blood donors: seroepidemiology and seronegative red blood cell component inventories.

BACKGROUND: Cytomegalovirus (CMV) can lead to severe disease in high-risk subpopulations. To prevent transfusion-transmitted CMV in these patient groups, the Australian Red Cross Blood Service maintains inventories of CMV-seronegative fresh blood components. STUDY DESIGN AND METHODS: Donor demographic data and CMV seroscreening results for all blood donations and blood components issued in Australia between financial years (FYs) 2008/09 to 2012/13 inclusive were obtained. Population estimates were also extracted for the calculation of age-weighted seroprevalence estimates. Linear regression was used to model trends in red blood cell (RBC) component acquisition and demand. RESULTS: The estimated age-weighted seroprevalence of CMV in 20- to 69-year old Australians was 76.12 ± 0.13%, with higher seroprevalence in females and older age groups. Seroprevalence decreased over the study period, while the demand for CMV-seronegative RBC components increased. It was predicted that component acquisition may be insufficient by FY 2017/18 if current trends persist. CONCLUSION: These findings represent an evaluation of CMV seroepidemiology in Australia and form a basis to predict the future status of CMV-seronegative RBC component inventories. The results will serve to guide Blood Service operations and inform current international debate on CMV-safe blood components.