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A blood bank is a center where
blood Blood is a body fluid in the circulatory system of humans and other vertebrates that delivers necessary substances such as nutrients and oxygen to the cells, and transports metabolic waste products away from those same cells. Blood in the cir ...
gathered as a result of
blood donation A blood donation occurs when a person voluntarily has blood drawn and used for transfusions and/or made into biopharmaceutical medications by a process called fractionation (separation of whole blood components). Donation may be of whole bl ...
is stored and preserved for later use in
blood transfusion Blood transfusion is the process of transferring blood products into a person's circulation intravenously. Transfusions are used for various medical conditions to replace lost components of the blood. Early transfusions used whole blood, but mo ...
. The term "blood bank" typically refers to a department of a hospital usually within a
Clinical Pathology Clinical pathology is a medical specialty that is concerned with the diagnosis of disease based on the laboratory analysis of bodily fluids, such as blood, urine, and tissue homogenates or extracts using the tools of chemistry, microbiology, h ...
laboratory where the storage of blood product occurs and where pre-transfusion and Blood compatibility testing is performed. However, it sometimes refers to a collection center, and some hospitals also perform collection. Blood banking includes tasks related to blood collection, processing, testing, separation, and storage. For blood donation agencies in various countries, see list of blood donation agencies and
list of blood donation agencies in the United States Nearly every hospital in the United States has a blood bank and transfusion service. The following is a list of groups that collect blood for transfusion and not a complete list of blood banks. National organizations * American Red Cross (ARC), ...
.


Types of blood transfused

Several types of blood transfusion exist: * Whole blood, which is blood transfused without separation. Red blood cells or packed cells is transfused to patients with anemia/iron deficiency. It also helps to improve the oxygen saturation in blood. It can be stored at 2.0 °C-6.0 °C for 35–45 days. *
Platelet transfusion Platelet transfusion, also known as platelet concentrate, is used to prevent or treat bleeding in people with either a low platelet count or poor platelet function. Often this occurs in people receiving cancer chemotherapy. Preventive transfus ...
is transfused to those with low platelet count. Platelets can be stored at room temperature for up to 5–7 days. Single donor platelets, which have a more platelet count but it is bit expensive than regular. * Plasma transfusion is indicated to patients with liver failure, severe infections or serious burns. Fresh frozen plasma can be stored at a very low temperature of -30 °C for up to 12 months. The separation of plasma from a donor's blood is called plasmapheresis.


History

While the first
blood transfusion Blood transfusion is the process of transferring blood products into a person's circulation intravenously. Transfusions are used for various medical conditions to replace lost components of the blood. Early transfusions used whole blood, but mo ...
s were made directly from donor to receiver before
coagulation Coagulation, also known as clotting, is the process by which blood changes from a liquid to a gel, forming a blood clot. It potentially results in hemostasis, the cessation of blood loss from a damaged vessel, followed by repair. The mechanism ...
, it was discovered that by adding
anticoagulant Anticoagulants, commonly known as blood thinners, are chemical substances that prevent or reduce coagulation of blood, prolonging the clotting time. Some of them occur naturally in blood-eating animals such as leeches and mosquitoes, where t ...
and refrigerating the blood it was possible to store it for some days, thus opening the way for the development of blood banks. John Braxton Hicks was the first to experiment with chemical methods to prevent the coagulation of blood at
St Mary's Hospital, London St Mary's Hospital is an NHS hospital in Paddington, in the City of Westminster, London, founded in 1845. Since the UK's first academic health science centre was created in 2008, it has been operated by Imperial College Healthcare NHS Tru ...
, in the late 19th century. His attempts, using phosphate of soda, however, were unsuccessful. The first non-direct transfusion was performed on March 27, 1914, by the Belgian doctor
Albert Hustin Albert Hustin (1882–1967) was a Belgian medical doctor. Hustin was born in Ethe and died in Uccle (Uccle Brussels – Belgium). In 1914, he was the first person to successfully practice non-direct blood transfusions with sodium citrate used ...
, though this was a diluted solution of blood. The
Argentine Argentines (mistakenly translated Argentineans in the past; in Spanish (masculine) or (feminine)) are people identified with the country of Argentina. This connection may be residential, legal, historical or cultural. For most Argentines, ...
doctor Luis Agote used a much less diluted solution in November of the same year. Both used
sodium citrate Sodium citrate may refer to any of the sodium salts of citric acid (though most commonly the third): * Monosodium citrate * Disodium citrate * Trisodium citrate The three forms of salt are collectively known by the E number E331. Applications ...
as an anticoagulant.


First World War

The
First World War World War I (28 July 1914 11 November 1918), often abbreviated as WWI, was List of wars and anthropogenic disasters by death toll, one of the deadliest global conflicts in history. Belligerents included much of Europe, the Russian Empire, ...
acted as a catalyst for the rapid development of blood banks and transfusion techniques. Canadian Lieutenant
Lawrence Bruce Robertson Lawrence Bruce Robertson was a Canadian surgeon who developed methods for and promoted the use of blood transfusions in battlefield surgery during World War I. Early life and education Robertson studied medicine at the University of Toronto, grad ...
was instrumental in persuading the
Royal Army Medical Corps The Royal Army Medical Corps (RAMC) is a specialist corps in the British Army which provides medical services to all Army personnel and their families, in war and in peace. The RAMC, the Royal Army Veterinary Corps, the Royal Army Dental Corps ...
(RAMC) to adopt the use of blood transfusion at the
Casualty Clearing Station In the British Army and other Commonwealth militaries, a Casualty Clearing Station (CCS) is a military medical facility behind the front lines that is used to treat wounded soldiers. A CCS would usually be located just beyond the range of enemy ...
s for the wounded. In October 1915, Robertson performed his first wartime transfusion with a syringe to a patient who had multiple shrapnel wounds. He followed this up with four subsequent transfusions in the following months, and his success was reported to Sir Walter Morley Fletcher, director of the Medical Research Committee. Robertson published his findings in the ''
British Medical Journal ''The BMJ'' is a weekly peer-reviewed medical trade journal, published by the trade union the British Medical Association (BMA). ''The BMJ'' has editorial freedom from the BMA. It is one of the world's oldest general medical journals. Origi ...
'' in 1916, and—with the help of a few like minded individuals (including the eminent physician Edward William Archibald who introduced the citrate anticoagulant method)—was able to persuade the British authorities of the merits of blood transfusion. Robertson went on to establish the first blood transfusion apparatus at a Casualty Clearing Station on the
Western Front Western Front or West Front may refer to: Military frontiers * Western Front (World War I), a military frontier to the west of Germany *Western Front (World War II), a military frontier to the west of Germany *Western Front (Russian Empire), a maj ...
in the spring of 1917. Oswald Hope Robertson, a medical researcher and officer was attached to the RAMC in 1917, where he was instrumental in establishing the first blood banks, with soldiers as donors, in preparation for the anticipated
Third Battle of Ypres The Third Battle of Ypres (german: link=no, Dritte Flandernschlacht; french: link=no, Troisième Bataille des Flandres; nl, Derde Slag om Ieper), also known as the Battle of Passchendaele (), was a campaign of the First World War, fought by ...
. He used
sodium citrate Sodium citrate may refer to any of the sodium salts of citric acid (though most commonly the third): * Monosodium citrate * Disodium citrate * Trisodium citrate The three forms of salt are collectively known by the E number E331. Applications ...
as the anticoagulant, and the blood was extracted from punctures in the vein, and was stored in bottles at British and American Casualty Clearing Stations along the Front. He also experimented with preserving separated
red blood cell Red blood cells (RBCs), also referred to as red cells, red blood corpuscles (in humans or other animals not having nucleus in red blood cells), haematids, erythroid cells or erythrocytes (from Greek ''erythros'' for "red" and ''kytos'' for "hol ...
s in iced bottles.
Geoffrey Keynes Sir Geoffrey Langdon Keynes ( ; 25 March 1887, Cambridge – 5 July 1982, Cambridge) was a British surgeon and author. He began his career as a physician in World War I, before becoming a doctor at St Bartholomew's Hospital in London, where h ...
, a British surgeon, developed a portable machine that could store blood to enable transfusions to be carried out more easily.


Expansion

The world's first blood donor service was established in 1921 by the secretary of the
British Red Cross The British Red Cross Society is the United Kingdom body of the worldwide neutral and impartial humanitarian network the International Red Cross and Red Crescent Movement. The society was formed in 1870, and is a registered charity with mor ...
, Percy Oliver. Volunteers were subjected to a series of physical tests to establish their blood group. The London Blood Transfusion Service was free of charge and expanded rapidly. By 1925, it was providing services for almost 500 patients and it was incorporated into the structure of the British Red Cross in 1926. Similar systems were established in other cities including
Sheffield Sheffield is a city in South Yorkshire, England, whose name derives from the River Sheaf which runs through it. The city serves as the administrative centre of the City of Sheffield. It is historically part of the West Riding of Yorkshire ...
,
Manchester Manchester () is a city in Greater Manchester, England. It had a population of 552,000 in 2021. It is bordered by the Cheshire Plain to the south, the Pennines to the north and east, and the neighbouring city of Salford to the west. The ...
and
Norwich Norwich () is a cathedral city and district of Norfolk, England, of which it is the county town. Norwich is by the River Wensum, about north-east of London, north of Ipswich and east of Peterborough. As the seat of the Episcopal see, See of ...
, and the service's work began to attract international attention. Similar services were established in France, Germany, Austria, Belgium, Australia and Japan. Vladimir Shamov and Sergei Yudin in the
Soviet Union The Soviet Union,. officially the Union of Soviet Socialist Republics. (USSR),. was a transcontinental country that spanned much of Eurasia from 1922 to 1991. A flagship communist state, it was nominally a federal union of fifteen nationa ...
pioneered the transfusion of cadaveric blood from recently deceased donors. Yudin performed such a transfusion successfully for the first time on March 23, 1930, and reported his first seven
clinic A clinic (or outpatient clinic or ambulatory care clinic) is a health facility that is primarily focused on the care of outpatients. Clinics can be privately operated or publicly managed and funded. They typically cover the primary care needs ...
al transfusions with cadaveric blood at the Fourth Congress of
Ukrainian Ukrainian may refer to: * Something of, from, or related to Ukraine * Something relating to Ukrainians, an East Slavic people from Eastern Europe * Something relating to demographics of Ukraine in terms of demography and population of Ukraine * So ...
Surgeons at Kharkiv in September. Also in 1930, Yudin organized the world's first blood bank at the Nikolay Sklifosovsky Institute, which set an example for the establishment of further blood banks in different regions of the Soviet Union and in other countries. By the mid-1930s the Soviet Union had set up a system of at least 65 large blood centers and more than 500 subsidiary ones, all storing "canned" blood and shipping it to all corners of the country. One of the earliest blood banks was established by Frederic Durán-Jordà during the
Spanish Civil War The Spanish Civil War ( es, Guerra Civil Española)) or The Revolution ( es, La Revolución, link=no) among Nationalists, the Fourth Carlist War ( es, Cuarta Guerra Carlista, link=no) among Carlism, Carlists, and The Rebellion ( es, La Rebeli ...
in 1936. Duran joined the Transfusion Service at the Barcelona Hospital at the start of the conflict, but the hospital was soon overwhelmed by the demand for blood and the paucity of available donors. With support from the Department of Health of the
Spanish Republican Army The Spanish Republican Army ( es, Ejército de la República Española) was the main branch of the Armed Forces of the Second Spanish Republic between 1931 and 1939. It became known as People's Army of the Republic (''Ejército Popular de la Rep� ...
, Duran established a blood bank for the use of wounded soldiers and civilians. The 300–400 ml of extracted blood was mixed with 10% citrate solution in a modified Duran Erlenmeyer flask. The blood was stored in a sterile glass enclosed under pressure at 2 °C. During 30 months of work, the Transfusion Service of Barcelona registered almost 30,000 donors, and processed 9,000 liters of blood. In 1937
Bernard Fantus Bernard Fantus (September 1, 1874 – April 14, 1940) was a Hungarian Jewish-American physician. He established the first hospital blood bank in the United States in 1937 at Cook County Hospital, Chicago while he served there as director of the p ...
, director of therapeutics at the Cook County Hospital in
Chicago (''City in a Garden''); I Will , image_map = , map_caption = Interactive Map of Chicago , coordinates = , coordinates_footnotes = , subdivision_type = List of sovereign states, Count ...
, established one of the first hospital blood banks in the
United States The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country Continental United States, primarily located in North America. It consists of 50 U.S. state, states, a Washington, D.C., ...
. In creating a hospital laboratory that preserved, refrigerated and stored donor blood, Fantus originated the term "blood bank". Within a few years, hospital and community blood banks were established across the United States. Frederic Durán-Jordà fled to Britain in 1938, and worked with
Janet Vaughan Dame Janet Maria Vaughan, Mrs Gourlay (18 October 1899 – 9 January 1993), was a British physiologist, academic, and academic administrator.Evelyn IronsObituary: Dame Janet Vaughan ''The Independent'', 12 January 1993. She researched in haema ...
at the
Royal Postgraduate Medical School The Royal Postgraduate Medical School (RPMS) was an independent medical school, based primarily at Hammersmith Hospital in west London. In 1988, the school merged with the Institute of Obstetrics & Gynaecology, and in 1997 became part of Imperial ...
at Hammersmith Hospital to create a system of national blood banks in London. With the outbreak of war looking imminent in 1938, the
War Office The War Office was a department of the British Government responsible for the administration of the British Army between 1857 and 1964, when its functions were transferred to the new Ministry of Defence (MoD). This article contains text from ...
created the Army Blood Supply Depot (ABSD) in Bristol headed by
Lionel Whitby Brigadier Sir Lionel Ernest Howard Whitby, CVO, MC (8 May 1895 – 24 November 1956) was a British haematologist, British Army officer and academic. He served as Regius Professor of Physic at the University of Cambridge from 1945 to 1956, Mas ...
and in control of four large blood depots around the country. British policy through the war was to supply military personnel with blood from centralized depots, in contrast to the approach taken by the Americans and Germans where troops at the front were bled to provide required blood. The British method proved to be more successful at adequately meeting all requirements and over 700,000 donors were bled over the course of the war. This system evolved into the National Blood Transfusion Service established in 1946, the first national service to be implemented.


Medical advances

A blood collection program was initiated in the US in 1940 and
Edwin Cohn Edwin Joseph Cohn (December 17, 1892 – October 1, 1953) was a protein scientist. A graduate of Phillips Academy, Andover 911 and the University of Chicago 914, PhD 1917 he made important advances in the physical chemistry of proteins, and was ...
pioneered the process of
blood fractionation Blood fractionation is the process of fractionating whole blood, or separating it into its component parts. This is typically done by centrifuging the blood. The resulting components are: * a clear solution of blood plasma in the upper p ...
. He worked out the techniques for isolating the serum albumin fraction of
blood plasma Blood plasma is a light amber-colored liquid component of blood in which blood cells are absent, but contains proteins and other constituents of whole blood in suspension. It makes up about 55% of the body's total blood volume. It is the int ...
, which is essential for maintaining the
osmotic pressure Osmotic pressure is the minimum pressure which needs to be applied to a solution to prevent the inward flow of its pure solvent across a semipermeable membrane. It is also defined as the measure of the tendency of a solution to take in a pure ...
in the
blood vessel The blood vessels are the components of the circulatory system that transport blood throughout the human body. These vessels transport blood cells, nutrients, and oxygen to the tissues of the body. They also take waste and carbon dioxide awa ...
s, preventing their collapse. The use of blood plasma as a substitute for whole blood and for transfusion purposes was proposed as early as 1918, in the correspondence columns of the ''
British Medical Journal ''The BMJ'' is a weekly peer-reviewed medical trade journal, published by the trade union the British Medical Association (BMA). ''The BMJ'' has editorial freedom from the BMA. It is one of the world's oldest general medical journals. Origi ...
'', by Gordon R. Ward. At the onset of
World War II World War II or the Second World War, often abbreviated as WWII or WW2, was a world war that lasted from 1939 to 1945. It involved the World War II by country, vast majority of the world's countries—including all of the great power ...
, liquid plasma was used in Britain. A large project, known as 'Blood for Britain' began in August 1940 to collect blood in
New York City New York, often called New York City or NYC, is the List of United States cities by population, most populous city in the United States. With a 2020 population of 8,804,190 distributed over , New York City is also the L ...
hospitals for the export of plasma to Britain. A dried plasma package was developed, which reduced breakage and made the transportation, packaging, and storage much simpler. The resulting dried plasma package came in two tin cans containing 400 cc bottles. One bottle contained enough distilled water to reconstitute the dried plasma contained within the other bottle. In about three minutes, the plasma would be ready to use and could stay fresh for around four hours.
Charles R. Drew Charles Richard Drew (June 3, 1904 – April 1, 1950) was an American surgeon and medical researcher. He researched in the field of blood transfusions, developing improved techniques for blood storage, and applied his expert knowledge to devel ...
was appointed medical supervisor, and he was able to transform the test tube methods into the first successful mass production technique. Another important breakthrough came in 1939–40 when
Karl Landsteiner Karl Landsteiner (; 14 June 1868 – 26 June 1943) was an Austrian-born American biologist, physician, and immunologist. He distinguished the main blood groups in 1900, having developed the modern system of classification of blood groups from ...
, Alex Wiener, Philip Levine, and R.E. Stetson discovered the Rhesus blood group system, which was found to be the cause of the majority of
transfusion reaction Blood transfusion is the process of transferring blood products into a person's circulation intravenously. Transfusions are used for various medical conditions to replace lost components of the blood. Early transfusions used whole blood, but mod ...
s up to that time. Three years later, the introduction by J.F. Loutit and Patrick L. Mollison of
acid-citrate-dextrose Acid-citrate-dextrose or acid-citrate-dextrose solution, also known as anticoagulant-citrate-dextrose or anticoagulant-citrate-dextrose solution (and often styled without the hyphens between the coordinate terms, thus acid citrate dextrose or ACD) ...
(ACD) solution, which reduced the volume of anticoagulant, permitted transfusions of greater volumes of blood and allowed longer-term storage. Carl Walter and W.P. Murphy Jr. introduced the
plastic bag A plastic bag, poly bag, or pouch is a type of container made of thin, flexible, plastic film, nonwoven fabric, or plastic textile. Plastic bags are used for containing and transporting goods such as foods, produce, powders, ice, magazine ...
for blood collection in 1950. Replacing breakable
glass Glass is a non- crystalline, often transparent, amorphous solid that has widespread practical, technological, and decorative use in, for example, window panes, tableware, and optics. Glass is most often formed by rapid cooling (quenchin ...
bottles with durable plastic bags allowed for the evolution of a collection system capable of safe and easy preparation of multiple blood components from a single unit of whole blood. Further extending the shelf life of stored blood up to 42 days was an anticoagulant preservative, CPDA-1, introduced in 1979, which increased the blood supply and facilitated resource-sharing among blood banks.


Collection and processing

In the U.S., certain standards are set for the collection and processing of each blood product. "Whole blood" (WB) is the proper name for one defined product, specifically unseparated venous blood with an approved preservative added. Most blood for transfusion is collected as whole blood. Autologous donations are sometimes transfused without further modification, however whole blood is typically separated (via centrifugation) into its components, with
red blood cell Red blood cells (RBCs), also referred to as red cells, red blood corpuscles (in humans or other animals not having nucleus in red blood cells), haematids, erythroid cells or erythrocytes (from Greek ''erythros'' for "red" and ''kytos'' for "hol ...
s (RBC) in solution being the most commonly used product. Units of WB and RBC are both kept refrigerated at , with maximum permitted storage periods ( shelf lives) of 35 and 42 days respectively. RBC units can also be frozen when buffered with glycerol, but this is an expensive and time-consuming process, and is rarely done. Frozen red cells are given an expiration date of up to ten years and are stored at . The less-dense
blood plasma Blood plasma is a light amber-colored liquid component of blood in which blood cells are absent, but contains proteins and other constituents of whole blood in suspension. It makes up about 55% of the body's total blood volume. It is the int ...
is made into a variety of frozen components, and is labeled differently based on when it was frozen and what the intended use of the product is. If the plasma is frozen promptly and is intended for transfusion, it is typically labeled as fresh frozen plasma. If it is intended to be made into other products, it is typically labeled as recovered plasma or plasma for fractionation.
Cryoprecipitate Cryoprecipitate, also called cryo for short, is a frozen blood product prepared from blood plasma. To create cryoprecipitate, fresh frozen plasma thawed to 1–6 °C is then centrifuged and the precipitate is collected. The precipitate is re ...
can be made from other plasma components. These components must be stored at or colder, but are typically stored at . The layer between the red cells and the plasma is referred to as the buffy coat and is sometimes removed to make
platelets Platelets, also called thrombocytes (from Greek θρόμβος, "clot" and κύτος, "cell"), are a component of blood whose function (along with the coagulation factors) is to react to bleeding from blood vessel injury by clumping, thereby ...
for transfusion. Platelets are typically pooled before transfusion and have a shelf life of 5 to 7 days, or 3 days once the facility that collected them has completed their tests. Platelets are stored at room temperature () and must be rocked/agitated. Since they are stored at room temperature in nutritive solutions, they are at relatively high risk for growing
bacteria Bacteria (; singular: bacterium) are ubiquitous, mostly free-living organisms often consisting of one biological cell. They constitute a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria were am ...
. Some blood banks also collect products by apheresis. The most common component collected is plasma via plasmapheresis, but red blood cells and platelets can be collected by similar methods. These products generally have the same shelf life and storage conditions as their conventionally-produced counterparts. Donors are sometimes paid; in the U.S. and Europe, most blood ''for transfusion'' is collected from volunteers while plasma for other purposes may be from paid donors. Most collection facilities as well as hospital blood banks also perform testing to determine the
blood type A blood type (also known as a blood group) is a classification of blood, based on the presence and absence of antibodies and inherited antigenic substances on the surface of red blood cells (RBCs). These antigens may be proteins, carbohydrates ...
of patients and to identify compatible blood products, along with a battery of tests (e.g. disease) and treatments (e.g. leukocyte filtration) to ensure or enhance quality. The increasingly recognized problem of inadequate efficacy of transfusion is also raising the profile of RBC viability and quality. Notably, U.S. hospitals spend more on dealing with the consequences of transfusion-related complications than on the combined costs of buying, testing/treating, and transfusing their blood.


Storage and management

Routine blood storage is 42 days or 6 weeks for stored packed ''red blood cells'' (also called "StRBC" or "pRBC"), by far the most commonly transfused blood product, and involves refrigeration but usually not freezing. There has been increasing controversy about whether a given product unit's age is a factor in transfusion efficacy, specifically on whether "older" blood directly or indirectly increases risks of complications. Studies have not been consistent on answering this question, with some showing that older blood is indeed less effective but with others showing no such difference; nevertheless, as storage time remains the only available way to estimate quality status or loss, a ''first-in-first-out'' inventory management approach is standard presently. It is also important to consider that there is large ''variability'' in storage results for different donors, which combined with limited available quality testing, poses challenges to clinicians and regulators seeking reliable indicators of quality for blood products and storage systems. Transfusions of ''platelets'' are comparatively far less numerous, but they present unique storage/management issues. Platelets may only be stored for 7 days, due largely to their greater potential for contamination, which is in turn due largely to a higher storage temperature.


RBC storage lesion

Insufficient transfusion efficacy can result from red blood cell (RBC) blood product units damaged by so-called ''storage lesion''—a set of biochemical and biomechanical changes which occur during storage. With red cells, this can decrease viability and ability for tissue oxygenation. Although some of the biochemical changes are reversible after the blood is transfused, the biomechanical changes are less so, and rejuvenation products are not yet able to adequately reverse this phenomenon. Current regulatory measures are in place to minimize RBC storage lesion—including a maximum shelf life (currently 42 days), a maximum auto-hemolysis threshold (currently 1% in the US), and a minimum level of post-transfusion RBC survival ''in vivo'' (currently 75% after 24 hours). However, all of these criteria are applied in a universal manner that does not account for differences among units of product; for example, testing for the post-transfusion RBC survival ''in vivo'' is done on a sample of healthy volunteers, and then compliance is presumed for all RBC units based on universal (GMP) processing standards. RBC survival does not guarantee efficacy, but it is a necessary prerequisite for cell function, and hence serves as a regulatory proxy. Opinions vary as to the best way to determine transfusion efficacy in a patient ''in vivo''. In general, there are not yet any ''in vitro'' tests to assess quality deterioration or preservation for specific units of RBC blood product prior to their transfusion, though there is exploration of potentially relevant tests based on RBC membrane properties such as erythrocyte deformability and erythrocyte fragility (mechanical). Many physicians have adopted a so-called "restrictive protocol"—whereby transfusion is held to a minimum—due in part to the noted uncertainties surrounding storage lesion, in addition to the very high direct and indirect costs of transfusions, along with the increasing view that many transfusions are inappropriate or use too many RBC units.


Platelet storage lesion

Platelet storage lesion is a very different phenomenon from RBC storage lesion, due largely to the different functions of the products and purposes of the respective transfusions, along with different processing issues and inventory management considerations.


Alternative inventory and release practices

Although as noted the primary inventory-management approach is first in, first out (FIFO) to minimize product expiration, there are some deviations from this policy—both in current practice as well as under research. For example, exchange transfusion of RBC in neonates calls for use of blood product that is five days old or less, to "ensure" optimal cell function. Also, some hospital blood banks will attempt to accommodate physicians' requests to provide low-aged RBC product for certain kinds of patients (e.g. cardiac surgery). More recently, novel approaches are being explored to complement or replace FIFO. One is to balance the desire to reduce average product age (at transfusion) with the need to maintain sufficient availability of non-outdated product, leading to a strategic blend of FIFO with last in, first out (LIFO).


Long-term storage

"Long-term" storage for all blood products is relatively uncommon, compared to routine/short-term storage.
Cryopreservation Cryo-preservation or cryo-conservation is a process where organisms, organelles, cells, tissues, extracellular matrix, organs, or any other biological constructs susceptible to damage caused by unregulated chemical kinetics are preserved by co ...
of red blood cells is done to store rare units for up to ten years. The cells are incubated in a
glycerol Glycerol (), also called glycerine in British English and glycerin in American English, is a simple triol compound. It is a colorless, odorless, viscous liquid that is sweet-tasting and non-toxic. The glycerol backbone is found in lipids known ...
solution which acts as a
cryoprotectant A cryoprotectant is a substance used to protect biological tissue from freezing damage (i.e. that due to ice formation). Arctic and Antarctic insects, fish and amphibians create cryoprotectants ( antifreeze compounds and antifreeze proteins) in ...
("antifreeze") within the cells. The units are then placed in special sterile containers in a freezer at very low temperatures. The exact temperature depends on the glycerol concentration.


See also

*
Medical technologist A medical laboratory scientist (MLS) or clinical laboratory scientist (CLS) or medical technologist (MT) performs diagnostic testing of blood and body fluids in clinical laboratories. The scope of a medical laboratory scientist's work begins wit ...
* Phlebotomist *
Blood transfusion Blood transfusion is the process of transferring blood products into a person's circulation intravenously. Transfusions are used for various medical conditions to replace lost components of the blood. Early transfusions used whole blood, but mo ...


References


Further reading

* Kara W. Swanson, ''Banking on the Body: The Market in Blood, Milk, and Sperm in Modern America.'' Cambridge, MA: Harvard University Press, 2014.


External links


Animated Venipuncture tutorial
{{DEFAULTSORT:Blood Bank Transfusion medicine Blood donation