A blood banker in Asia asks how blood collection centers manage underweight (under collected) or overweight (over collected) whole blood units. She wonders what criteria are used to determine if such collections are suitable for use, since at her collection center they collect blood in commercially available 250 mL single bags, 300 mL single bags, 350 mL double bags, 450 mL triple bags and 450 mL quadruple bags.

For their 450 mL triple and quadruple bag collections, they typically collect between 405 to 495 ml blood, and process those whole blood units into components. If they under collect, and the collected volume is between 221 to 404 mL, they maintain the unit as Whole Blood for Adult use only, and the Whole Blood unit expires 14 days after collection. If they over collect, and the collected volume is between 496 to 567 mL, they prepare FFP and red cells, but the red cells expire 14 days after collection. The FFP is stored frozen for up to two years at below -30 degree celcius.

For their 350 mL double bag collections, they typically collect between 315 to 385 mL, and process those whole blood units into red cell concentrates and plasma. If they under collect, and the collected volume is between 171 to 314 mL, they maintain the unit as Whole Blood for Adult use only, and the Whole Blood unit expires 14 days after collection. If they over collect, and the collected volume is between 386 to 472 mL, they prepare FFP and red cells, but the red cells expire 14 days after collection. The FFP is stored frozen for up to two years at below -30 degree celcius.

For their 300 mL single bag collections, they typically collect between 270 to 330 mL as whole blood. If they under collect, and the collected volume is between 147 to 269 mL, they maintain the unit as Whole Blood for Adult use only, and the Whole Blood unit expires 14 days after collection. If they over collect, and the collected volume is between 331 to 378 mL, they maintain the unit as Whole Blood for Adult use only, and the Whole Blood unit expires 14 days after collection.

For their 250 mL single bag collections, they typically collect between 225 to 275 mL as whole blood. If they under collect, and the collected volume is between 122 to 224 mL, they maintain the unit as Whole Blood for Adult use only, and the Whole Blood unit expires 14 days after collection. If they over collect, and the collected volume is between 276 to 315 mL, they maintain the unit as Whole Blood for Adult use only, and the Whole Blood unit expires 14 days after collection.

The following comments have been received.

ADDENDA Sept. 18, 2006

1. A colleague affiliated with a blood collection center in San Bernardino and Riverside Counties reports that her blood center collects whole blood donations of either 450 mL or 500 mL. For the donations that are supposed to be 450 mL of whole blood, they process 'low volume' collections of between 300 and 404 mL into 'Low Volume Red Cells' and plasma. The 'Low Volume Red Cells' retain the original expiration date, and the plasma is discarded. Her blood center has not yet implemented a protocol for 'low volume' collections that were supposed by be 500 mL whole blood donations.

Overweight collections are discarded unless they are autologous units. For autologous units, they consult with a blood center medical director and follow their instructions. Usually such units are ‘filtered' with a leukocyte reduction filter to remove any clots due to over saturation of the anticoagulant.

ADDENDA Oct. 15, 2006

2. A transfusion medicine physician in Santander, Spain reports that when they collect a donation that exceeds 495 mL, the product is discarded. An exception may be made when the collected donation consists of blood that is scarce and the deviation is minimal.

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