A blood banker reports that when neonatal patients are transferred to other facilities her hospital occasionally receives requests to ship partially used red blood cell units along with the patient in order to keep the neonate's donor exposure to a minimum. These units have been irradiated and sterile docked at the inquiring blood banker's facility, which is registered with the FDA for irradiation, but not for shipment to other facilities. The inquiring blood banker is not comfortable with the thought of shipping units that have been manipulated by her transfusion service to another facility, nor is she comfortable receiving such units from another facility that is not a licensed blood supplier. She believes that it would NOT be appropriate to ship these units unless they revised their registration and performed a validation of the shipping containers that would be utilized, and vice versa, if another hospital wished to ship a unit to her facility. The inquiring blood banker would like to hear what other hospitals are doing in this situation.

The following replies were submitted in response to the above.

1. Editor's note: For a related discussion, please review the July 3, 2000 issue.

2. An East Coast blood bank physician suggests that it is worth establishing a protocol that defines the transfer methodology and includes a form letter that defines the circumstances of the blood product transfer. She adds that this letter should be signed by the two blood bank directors who oversee operations at the sending and the receiving side. The responding blood banker reported that at her facility, they accept such units, as her center is a tertiary referral center. She concludes saying that they have the parents sign a separate consent for the transferred blood product unit, so that the parents understand the product was collected and stored elsewhere before being accepted at the facility.

3. A Texan wrote that her facility gets its blood from the American Red Cross, but that they also have an SOP in place to 'send' blood with a patient who is being transferred to another hospital. The Texan believes that it takes very little time (1 day) to test (validate) a blood transfer container, and that there are temperature indicators that cost $1.00 each which can be affixed to the blood bag to assure that proper temperature has not been exceeded. The Texan concludes that she does not think transporting blood with a patient who has already received a portion of that unit would violate FDA rules. (Editor's query: perhaps one of the FDA e-Networkers would comment on FDA oversight of interhospital transfer of blood products that have already been partially used by a patient).

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Ira A. Shulman, MD
CBBS e-Network Forum Editor & Moderator

W. Tait Stevens, MD
CBBS e-Network Forum Assistant Editor & Moderator