Blood Cold Chain: Storage and Transportation

Blood Cold Chain

• The Blood Cold Chain is the system for storing and transporting blood and blood components to maintain the correct temperature from collection to administration.
• Any break in the Blood Cold Chain increases the risks for blood recipients.

Blood Cold Equipment

• Blood bank refrigerators, plasma freezers, platelet agitator cum incubators, and blood transport boxes are used to store blood and components.

Whole Blood and Red Cells

• Red cells and whole blood must be stored at a temperature between +2°C to +6°C in a blood bank refrigerator.
• The temperature range is essential to maintain the oxygen-carrying ability of blood and prevent bacterial contamination.
• Red cells become haemolysed below 2°C and must never be allowed to freeze.
• Haemolysed cells can cause renal failure and fatal bleeding problems if transfused.
• The shelf life of whole blood and red cells ranges from 35-42 days, depending on the type of blood bag used.
• Whole blood and red cells should be transported in a blood transport box or insulator carrier to maintain a temperature under 10°C if the room temperature is greater than 25°C or if transfusion is not possible within 30 minutes.
• Once issued, red blood cells should be transfused within ½ hour of release from the Blood Transfusion Service (BTS).

Fresh Frozen Plasma (FFP)

• Fresh Frozen Plasma is stored in a Blood Transfusion centre at -40°C or colder.
• FFP has a shelf life of one year.
• FFP must be thawed before transfusion in a plasma thawing bath at 30°C - 37°C, which takes about 30-45 minutes.
• Thawed FFP should be infused within 30 minutes; if not required, it can be kept at 2°C - 6°C and transfused within 24 hours.
• Once thawed, FFP cannot be refrozen and must be discarded.

Cryoprecipitate

• Cryoprecipitate is the cold insoluble portion of plasma containing Factor VIII, Von Willebrand factor, Factor XIII, and fibrinogen.
• Cryoprecipitate is prepared from plasma separated from a unit of blood within 6-8 hours of donation and rapidly frozen.
• It is stored in a Blood Transfusion centre at -40°C or colder and has a shelf life of one year.
• Cryoprecipitate needs to be thawed at 30°C - 37°C in a water bath for about 15-30 minutes.
• Once thawed, cryoprecipitate should be transfused within 30 minutes; if not immediately transfused, it can be kept at 2°C - 4°C and transfused within 4 hours of thawing.