Adjusting the anticoagulant/preservative solution volume when collecting low volume autologous units
A colleague in Ohio asks if any institution removes anticoagulant from the collection bag prior to venipuncture when collecting low volume autologous units from donors who weigh less than 110 pounds? If so, how is the volume of removed anticoagulant verified, and does removing the anticoagulant change the expiration date of the units, even if the removal is done aseptically? Their procedure states to calculate the maximum blood volume to be collected and adjust the anticoagulant volume in the collection bag accordingly. However, they have not actually done this and cannot find instructions for how to remove the anticoagulant accurately without compromising the sterility of the container. They have satellite bags attached to the primary container, but for them, measuring volume going into these bags is not easy.
The following comments have been received in response.
ADDENDA Nov. 17, 2010
- A colleague in Indiana reports that at her institution the plasma from an autologous donation is always discarded. Thus, they are able to reduce the volume of anticoagulant in the primary collection container into the container that will be used to transfer the plasma after centrifugation. Her facility uses electronic mixers with scales, so the amount of anticoagulant removed can be measured accurately. They use a table that guides their collection staff on how much anticoagulant needs to be removed from the primary bag and how much blood should be collected from the donor in order to maintain the intended WB:AC ratio (plus/minus 10%). All of the information regarding anticoagulant removed and blood collected is maintained on their paper Donor Registration/History form. They also can adjust the additive during manufacturing, for both underweight and overweight autologous collections. They have tables and forms that they use to calculate how much to add and document what was done.
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