A colleague in Scotland reports that he is aware of data that show the temperature of RBCs shipped on airplanes over long distances may drop as low as 0.5C. The RBCs in question are typically transported in containers containing melting ice, with the RBCs covered by over wraps. He adds that his interpretation of AABB standards requires RBCs to be maintained between 1-10C during transportation, and accordingly one might interpret that if RBCs fall in temperature below 1C, they should not be used. He is having difficulty (other than the concern over freezing if the temperature dropped below zero centigrade) finding evidence that 0.5C is an unsafe temperature for RBCs. He wonders if others might have data or evidence to substantiate the need to discard RBC units whose temperature has fallen to 0.5C.

ADDENDA May 9, 2005

1. Editor's Note: One of more of the discussions linked below might benefit from knowing the coldest temperature at which whole blood and RBCs can be safely stored or transported:

• Transporting blood with patients
• Transporting patient-assigned blood products between hospitals
• Storage of blood for patients transported on emergency flights
• Acceptable containers for temporary storage of blood in the operating room and ICU
• Experience with using a blood storage refrigerator in the Operating Room
• Can returned platelet pheresis units be reissued?
• How best to manage plasma products that are returned unused and how to minimize wastage of plasma products
• How do hospital Transfusion Services validate the integrity of blood products transported in a Pneumatic Tube System?
• What guidelines do hospital Transfusion Services use to validate blood products transported in a Pneumatic Tube System?

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