Topics include:
Quality Management, Regulatory Compliance, Blood Banking Basics, Current Issues in Transfusion Medicine and more!

You will receive automated printing of CEUs, personalized course history of your participation in all learning modules, technical support online at the website and via a toll free number.

*PACE® Statement: Blood Systems, Inc. is approved as a provider of continuing education programs in the clinical laboratory sciences by the ASCLS PACE® Program.

Licensing and Accreditation

Blood Centers of the Pacific and our Blood Systems Laboratories are licensed by the US Food & Drug Administration and accredited by AABB. Additionally, Blood Centers of the Pacific is licensed by the US Department of Public Health, the Centers for Medicare and Medicaid and the California Department of Public Health. 

Blood Systems Laboratories holds current certifications for the Clinical Laboratory Improvement Act (CLIA), and licensure with the New York State Department of Health and California Department of Health Services.

• Licenses
  

Quality Initiatives:

• Comprehensive Quality Manual
• Internal Quality Audits (approximately 30 per center and laboratory each year)
• All blood products traceable and trackable by 510k approved computer system (cleared by the US FDA)
• Formal Change Control Process
• Annual training in current Good Manufacturing Practices
• Task-based training and competency testing
• Equipment satisfies safety requirements
• Shipping containers manufactured and labeled in compliance with Department of Transportation regulations 49 CFR 178.609
• Quality control testing on all shipping containers including:
  temperature range of container, duration time temperature, water immersion testing and drop testing
• Customers informed of regulatory inspection status
• Annual customer satisfaction survey

Quality Source

Blood Systems’ innovative Quality Source offers a diverse portfolio of quality-focused programs and services designed to help others. Our program includes highly skilled quality professionals with experience in blood center operations, blood banks and transfusion medicine, and regulatory affairs (FDA, GMPs, GTPs, AABB, JCAHO).

Targeted expertise, extensive resources, proven quality programs, problem-solving skills and process improvement methods enable Quality Source to deliver a broad range of flexible, customizable solutions to improve quality.

We are able to offer quality-focused programs at a variety of levels of service that include:

• quality awareness and in-service education and training
• quality assessments (audits, gap assessments)
• procedure development
• quality support services

Our clients have benefited from programs such as tailored cGMP training, deviation management/problem solving training, audits and gap assessments (preparation for external inspections), procedure development, regulatory support and quality leadership.

For more information, contact Quality Source at 1-800-288-2199, extension 5804 or by e-mail at .(JavaScript must be enabled to view this email address).

Facility Inspection & Shipping Quality Control

Upon request by the FDA, CAP, AABB or BCP, its agents and employees, the transfusion facility shall allow reasonable on-site inspection of blood storage facilities during normal business hours. They shall also allow the review and copying of the storage facility’s SOP for blood component storage and quality assurance records relating to blood component storage and handling.

Inspection of storage records is performed by BCP on an annual basis, unless the facility has current AABB certification and two consecutive years of satisfactory inspections. In these cases, the inspection is performed every two years. Results of the inspection are shared with the transfusion facility.

During the inspection, BCP employees will complete an inspection checklist when observing storage devices. There is one checklist for each temperature range:

• Storage at 20-24C: BS 983A
• Storage at 1-6C: BS 983B
• Storage at or colder than -18C: BS 983C

Twice a year (summer and winter), BCP staff perform temperature quality control on units shipped to selected facilities. The facility should follow instructions on the Datalogger Envelope, BS 334G, and return the shipment to BCP by overnight delivery as soon as possible if delivered by a non- BCP courier. (Contact Hospital Services for a Datalogger Envelope BS 334G.)

Billing Processes

Blood center component service (processing) fees should be listed on patients’ bills separately from hospital blood related charges.

Derivatives and Reagents

Available from BioCare:

• Albumin
• Coagulants
• Fibrin Sealant
• Hyper Immune Globulin
• IM Immune Globulin
• IV Immune Globulin
• Rh Immune Globulin
• Blood Banking Reagents

Contact BioCare representative Andrew Lefevre for additional information. Call (714) 743-0749 or email .(JavaScript must be enabled to view this email address).

Blood Component Storage & Handling

Requirements

As stated in the Agreement , the Transfusion Facility furnishes specific storage units, restricted to storage of blood and other biologicals, capable of maintaining required storage temperatures as specified in Title 21 of the Code of Federal Regulations, Standards of the AABB and BSI policies and procedures.

Normal Storage and Temperature Monitoring

Storage units must be equipped with a continuous temperature monitoring system that records temperatures at least once every four hours and an alarm that sounds if temperature limits are reached. The facility verifies continuous blood storage temperature of the storage units and maintains such documentation. The facility notifies Blood Centers of the Pacific of any temperature deficiencies in the storage of blood and blood components within 24 hours of the occurrence and agrees not to return units subjected to temperatures outside the required ranges unless approved for return by BCP. Documentation of storage temperatures may be required during inspections by regulatory agencies, and the facility agrees to provide records to BCP upon request.

Requirements for blood storage units are:

Component	Storage Temperature
Whole Blood, Red Blood Cells	1-6C
Plasma, Cryoprecipitated AHF	-18C or colder
Platelets	20-24C, with gentle agitation
Granulocytes	20-24C, without agitation

Additional criteria for storage and handling:

• Blood and blood products must be stored in labeled designated storage areas/units.
• Alarm checks of storage units must be performed and adequate corrective action taken when indicated.
• When released to another department, blood components must be maintained within appropriate storage temperatures or returned to proper storage within a specified time if storage is not available and the component is not transfused.
• Store in an orderly fashion to prevent crowding and allow air circulation.
• Do not store quarantined components above other components.
• Do not store reagents above blood components.
• Segregate autologous components from allogeneic components, and biohazard labeled autologous components from other autologous components.
• Do not overlap platelet bags during storage, and place face down to optimize oxygen exchange.

Storage Unit Failures

In the event of a storage unit failure, components must be moved to appropriate alternative storage. If alternative storage is not available with a temperature monitoring system, temperatures must be manually checked and recorded a minimum of every 4 hours. Alternative storage may be temporary storage of components in BCP shipping containers. Contact Hospital Services to discuss alternative storage at BCP or using BCP shipping containers.

Return of Components

Return Privileges for Credit

Returning short-dated units for use by another facility benefits everyone; ensuring an adequate blood supply is everyone’s responsibility. Return privileges are defined in the Agreement, Units must be properly packed in appropriate shipping containers for return, and red cells must have a minimum of 2 segments remaining on the unit. Units must have been stored at the Transfusion Facility following required storage conditions, and monitored during the storage period. Your BCP center will conduct visits to your facility to ensure acceptable storage is maintained (see section on Facility Inspection and Shipping Quality Control).

Units Returned for Quality Issues

Units that are returned for quality issues or at the request of BCP are automatically credited.

Hospital Services may request return of a component for several reasons (e.g., recall, market withdrawal, positive bacterial detection of a platelet, shortage of a particular blood type at another facility). In some cases, BCP will request destruction of the unit on site if not transfused, and will provide credit if this is done.

Units of questionable quality identified at the transfusion facility are returned to BCP for evaluation. Contact Hospital Services’ Richard Harveston to report the specific situation. Call (415) 749-6630 or email .(JavaScript must be enabled to view this email address).

Required Documentation

Complete applicable sections of the Return Document form for a unit returned to BCP. This form is also completed when transferring a unit to another Transfusion Facility.

Complete applicable sections of the Return form for requesting credit for a unit disposed of at the Transfusion Facility.

Contact Hospital Services’ Richard Harveston for return forms. Call (415) 749-6630 or email .(JavaScript must be enabled to view this email address).

Delivery of Components

Packing Configurations

There are several shipping containers configurations used for each required shipping temperature and container design. Centers may use all or only certain types of containers for transport. Containers have been validated for the transport times listed in the following table.

Temperature	Component Type	Coolant	Container Designation	Transport Time
1-10C	Red Cells/ Whole Blood	BSI Blue Ice	CF45 /CF89/ Igloo Coolers	< 48 hours/< 3 hours
20-24C	Platelets/ Granulocytes	Gel Coolant	Igloo Coolers/ EU-38	< 3 hours/< 24 hours
< -20C	Plasma/Cryoprecipitate	Dry Ice	CF45/CF89	Dependent on amount of dry ice. Shipment is acceptable if dry ice is still present.

A packing slip will accompany each shipment.

To return components to BCP, they must be packed in the shipping container with appropriate coolant determined for the type of product. If you have any questions concerning packing units for return, contact the Hospital Services department at you blood center.

The CF-45 and CF-89 shipping containers may be used for temporary storage of blood products in the case of a storage unit failure. Proper packing and temperature measurement and recording every 4 hours is required. Contact Hospital Services to arrange to return units, when applicable, or provide adequate shipping containers and packing materials for short term storage.

Packing Supplies and Configuration for Returning Red Cells to BCP

Packing supplies are available from BCP RBCs may be returned to BCP when the following packing configuration is followed:

• BSI Blue Ice: Do not store at temperatures colder than -35C. If stored at <-20C, leave ice at ambient room temperature for at least 15 minutes prior to packing. Ensure BSI Blue Ice is frozen solid prior to packing shipping container.
• Polar Packs (8 oz): Equilibrate to a temperature of 1-6C for red cells/whole blood.
• Plastic Bags (4 mil)
• Absorbent Pads
• CF-45/CF-89 Shipping Container with polyurethane liners
  
1. Place plastic bag inside inner box.
   • The CF-45 holds one inner box, the CF-89 holds two.
   • If the CF-89 container is used, ensure both inner boxes are packed appropriately.
2. Place one frozen solid BSI Blue Ice on each end of the cardboard sleeve, positioned between the sleeve and the inner box wall.
3. Place one absorbent pad flat inside plastic bag.
4. Place 2 units on top of the absorbent pad.
5. Repeat layering of absorbent pads and units until the box is full, ending with absorbent pad.
   • Caution: Minimum component load is 1200 mL. Add refrigerated Polar Packs to bring the total component load to at least 1200mL.
   • If Polar Packs are used to add volume, treat them as units and layer as described above.
6. Close and secure plastic bag.
7. Insert top polyurethane panel.
8. Close and seal container.
9. Ship to BCP to ensure container is received within 48 hours.

Packing Supplies and Configuration for Returning Platelets to BCP

Packing supplies are available from BCP Platelets may be returned to BCP when allowed by the Service Agreement and the following packing configuration is followed:

• Polar Packs (48oz): Equilibrate to a temperature of 20-24C for platelets.
• Plastic Bags (4 mil)
• Absorbent Pads
• E-38UB Shipping Container with polyurethane liners
  
1. Place plastic bag inside inner box.
2. Place two polar packs (flat) inside the plastic bag.
3. Place two absorbent pads flat on top of polar packs.
4. Place unit(s) on top of the absorbent pads.
5. Repeat layering of absorbent pads and units until the box is full, ending with absorbent pad.
6. Close and secure plastic bag.
7. Insert top foam panel.
8. Close and seal container.
9. Ship to BCP to ensure container is received within 24 hours.

Couriers

BCP supplies couriers for transfusion facilities within driving distance (determined by blood center distribution locations).

Schedule of routine runs is dependent on the Transfusion Facility. Other couriers not currently in contract may be used in certain situations.

Discuss these options with your blood center.

Couriers may facilitate transfer of components between Transfusion Facilities.

Other Delivery Mechanisms

Out of town delivery depends on the location of the Transfusion Facility. Contact Hospital Services for specific details.

Receipt of Shipments Using non-BCP Couriers

When a shipment is delivered by a non-BCP courier, evaluate appropriate packing configuration and temperature for type of component. Contact the Hospital Services department at your blood center if you have any questions concerning deviations or questionable storage conditions.

Ordering Components From Blood Centers of the Pacific

Stock Orders

It is the goal of Blood Centers of the Pacific to maintain a minimum inventory of red blood cells equivalent to a 5-day supply. Relative to the distance from the blood center and the type of patients each hospital should maintain a 2 1/2 to 5 day red blood cell supply.

The following guidelines are used by BCP for time frames to ship regular orders. Stated time is from the order time to when the shipment leaves the center.

• STAT: Not more than 1 hour from the time an order is taken to the time it is shipped.
• ASAP: Not more than 2 hours from the time an order is taken to the time it is shipped.
• Stock (standing orders/routines): Order is shipped as workload and product availability permit, but not later than 8 hours from the time the order is taken.

Whenever possible, BCP requests the use of shorter dated units first, and the timely release of untransfused, crossmatched blood for other patient use or return to the blood center.

When placing an order, indicate type(s) of blood component(s), quantity and time frame for delivery.

Special Orders

Special Orders are for components that require special handling, testing, or components not available in stock at BCP. Not all blood centers may provide the complete list of options.

Pediatric Components
Units requested for pediatric use may be aliquoted by BCP or supplied with a satellite bag (or bags) attached to the primary unit for aliquoting at the Transfusion Facility.

Washed
Red Cells or Platelets requested as washed have a reduced outdate (24 hours and 4 hours respectively).

Irradiated
Cellular components can be requested as irradiated. Directed Donor units from blood relatives require irradiation.

Directed Donor / Autologous
These reserved units must be ordered to be drawn prior to transfusion need by the patient’s attending physician. (See Special Collections.)

Antigen Negative
Red cell units can be supplied as confirmed or unconfirmed depending on transfusion facility request and blood center policy. Rare units may be available as liquid or frozen, but may need to be imported from another center. If frozen, BCP will deglycerolize the unit prior to delivery; this shortens the shelf life of the units to 24 hours.

CMV Seronegative
Cellular components can be requested as CMV seronegative.

HGB S Nefative
Red cell components can be requested as Hgb S negative.

Granulocytes
Collected only after discussion with the BCP Medical Director.

Whole Blood
Available at special request.

Special platelet considerations:

Reduced Volume
Platelet pheresis components can be prepared to remove plasma volume. This process shortens the shelf life to 4 hours from the time the process starts, and allows only a very short time for administration at the Transfusion Facility.

Emergency Release Process

A discussion with Hospital Services and/or the Blood Centers of the Pacific Medical Director may facilitate the process for delivery of these special units.

Units that are not yet completely tested require release following the Blood Centers of the Pacific Emergency Release Process. Whole blood and blood components may be issued only when such issue is essential to allow time for transportation to ensure arrival of the blood by the time it is needed for transfusion. Contact the Special Donations department for the proper documentation for Emergency Release.

Certain components that cannot be completely tested may also be released upon approval by the attending physician (and our receipt of a signed Emergency Releasae Document available from your blood center representative). Rare, unlicensed frozen units fall into this category.

Process for Issuing Unlicensed Components

Certain components are only available as unlicensed by FDA. The requesting physician must supply a medical need statement for delivery of these products.

Designated Donation

General Information

Blood Centers of the Pacific offers a comprehensive designated donation program. A designated blood donation is one by which a patient selects his/her own blood donor(s) for an anticipated, non-emergency transfusion. The donor is typically a friend or relative to the patient but can be a donor unknown to the patient who has attributes that benefit the patient. Designated donations are tagged specifically for the recipient.

Although the data does not support it, the patient may feel that blood they receive from people they know is safer than the community blood supply. In some cases, it may be less safe because donors known to the patient may be hesitant to reveal information about their personal or medical history.

Directed donors are qualified in the same manner as community blood donors. This allows transfusing facilities to release designated blood to other patients if the intended patient does not receive it. Units with abnormal test results will not be distributed for transfusion.

Male spouses do not usually make the most appropriate directed donors. Previously pregnant women can become sensitized against red cell antigens from their children’s father(s), causing adverse reactions in the transfusion recipient.

Optimal time of 5-7 days should be given from time of donation to time of anticipated need.

Units that are ABO/Rh incompatible with the recipient will not be distributed for the intended recipient or charged to the transfusion facility.

How to Schedule a Directed Donation

Advance notice to the blood center is always required prior to making a directed donation.

The patient and physician:

• Identifies candidate for designated donation.
• Requests designated donation and determines number and types of components to be collected.
• Completes applicable section of the Special Donations Order Form.
• Faxes or mails the Special Collections Order Form to the blood center.

The donor or patient or physicians office can contact the blood center to schedule an appointment.

Blood Centers of the Pacific:

• Reviews the order for completeness.
• Contacts donor-patient for any additional information.
• Collects special donations fees.
• Collects, processes, tests and stores the blood.
• Ships units to hospital blood bank before transfusion.
• Notifies hospital of units that will not be shipped due to unexpected test results.

Autologous Donation

Introduction

Your own blood is the safest for you. Patients planning elective surgery requiring blood transfusion may be able to donate blood for themselves prior to surgery. This is called autologous donation or pre-donation. A patient’s health status and red blood count (hemoglobin or hematocrit) determine whether they can donate; final approval rests with BCP’s medical director. The patient’s doctor decides how much blood is needed. Blood Centers of the Pacific collects, processes and tests the blood and delivers it to the transfusing facility.

Blood may be collected up to 42 days before the date of use, but no later than six working days prior to date of anticipated use. A special processing fee is charged for this service because additional recordkeeping and handling are required, even if the blood is not used by the donor. Autologous blood cannot be used for other patients.

Advantages of Autologous Blood Donation

• Prevents transfusion-transmitted disease.
• Prevent red cell alloimmunization.
• Decreases the number of banked allogeneic units needed.
• Provides compatible blood for patients with alloantibodies.
• Prevents some adverse transfusion reactions.
• Provides reassurance to patients concerned about blood risks.

Disadvantages of Autologous Blood Donation

• Does not eliminate risk of bacterial contamination.
• Does not eliminate risk of ABO incompatibility error.
• Is more costly than allogeneic blood.
• Results in wastage of blood that is not transfused.
• Increased incidence of adverse reactions by the donor to autologous donation.
• May subject patients to perioperative anemia, increased likelihood of transfusion, and delayed recovery.

Candidates for Pre-Operative Autologous Donation

Candidates for pre-operative collection are stable patients scheduled for procedures in which blood transfusion is likely. Autologous collections should be considered for patients likely to undergo:

• Major orthopedic procedures, most commonly total joint replacement.
• Vascular surgery.
• Cardiac or thoracic surgery.

Autologous blood should not be collected for procedures that seldom require transfusion such as:

• Cholecystectomy.
• Herniorrhaphy.
• Vaginal hysterectomy.
• Uncomplicated obstetric delivery.

Donor-Patients Who Are Not Good Candidates for Autologous Donation

There some contraindications to participation in the autologous blood donation program. Donor-patients considered not to be candidates are those with:

• Evidence of infection and risk of bacteremia.
• Scheduled surgery to correct aortic stenosis.
• Unstable angina.
• Uncontrolled seizure disorder.
• Myocardial infarction or cerebrovascular accident within 6 months of donation.
• Significant cardiac or pulmonary disease who have not yet been cleared for surgery by their treating physician.
• High-grade left main coronary artery disease.
• Cyanotic heart disease.
• Uncontrolled hypertension.

Requirements

Because of the special circumstances related to autologous blood transfusion, rigid criteria for donor selection are not required. However, the following requirements do apply:

• An order from the donor-patient’s physician.
• The hemoglobin concentration of the donor-patient’s blood shall be >11g/dL or the hematocrit, if used, shall be >33%.
• Both the transfusion service and the requesting physician will be notified of abnormal test results. The transfusion service should have a written policy identifying how autologous units with abnormal test results will be handled.

Donation Frequency

Typically, a donor-patient should donate one unit per week and no more than one unit every three days. For orders of four units or less, donation should start three to four weeks prior to surgery. If more than four units are requested, donation should occur over several months. It is suggested that physicians or donor-patients contact the blood center to determine if freezing red blood cells is available. The donor-patient should also consider using banked allogeneic blood in cases where large volume transfusion is a possibility.

Other Considerations

There are times when surgery is cancelled or postponed. This may require freezing and storing the autologous units. Since freezing of red cells is not routine and is expensive, the hospital must contact BCP to discuss its feasibility.

To Schedule

The patient’s physician:

• Identifies candidate for autologous donation.
• Requests autologous donation and determines number and types of components to be collected.
• Completes applicable section of the Special Donations Order Form.

The donor-patient/physicians office:

• Contacts the blood center to schedule the appointment(s)
  Bay Area (including the North Bay): Call 1-800-215-6225 Shasta Region: Call 1-530-246-2000.
• Faxes or mails the Special Donations Order Form as directed.

Blood Centers of the Pacific:

• Reviews the order for completeness.
• Contacts donor-patient for any additional information.
• Collects special donations processing fees when applicable.
• Collects, processes and tests the donor-patient’s blood.
• Ships units to hospital blood bank before surgery.
• Notifies hospital when units will not be available.
• Notifies hospital of special labeling in cases of abnormal test results. In these situations Blood Centers of the Pacific will notify the requesting physician. The physician and the transfusing facility policy will determine if the unit will be used for transfusion or be discarded.

Component List of Commonality Codes

Label Component List:

• Words in italics are not part of the label text. They are for identification assistance.
• “Bag” refers to an RBC component from an apheresis collection.
• “Part” refers to a component containing divided in the title.
• “Split” refers to a platelet pheresis split component.
• If a version of this table with barcodes added is desired, contact your blood center.

Commonality Code	Title
00150	CPD WHOLE BLOOD
00160	CPDA-1 WHOLE BLOOD
00250	CPD WHOLE BLOOD IRRADIATED
00260	CPDA-1 WHOLE BLOOD IRRADIATED
01450	CPD WHOLE BLOOD LEUKOCYTES REDUCED
01460	CPDA-1 WHOLE BLOOD LEUKOCYTES REDUCED
02450	CPD WHOLE BLOOD LEUKOCYTES REDUCED IRRADIATED
03311	AS-1 RED BLOOD CELLS ADENINE SALINE ADDED LEUKOCYTES REDUCE (ACD-A) (BAG-2)
03320	AS-1 RED BLOOD CELLS ADENINE-SALINE ADDED LEUKOCYTES REDUCED IRRADIATED (ACD-A) (BAG 1)
03330	AS-1 RED BLOOD CELLS ADENINE-SALINE ADDED LEUKOCYTES REDUCED IRRADIATED (ACD-A) (BAG 2)
03820	AS-1 RED BLOOD CELLS ADENINE-SALINE ADDED LEUKOCYTES REDUCED (ACD-A) (BAG 1)
04050	CPD RED BLOOD CELLS
04060	CDPA-1 RED BLOOD CELLS
04080	CP2D RED BLOOD CELLS
04210	AS-1 RED BLOOD CELLS
04230	AS-3 RED BLOOD CELLS
04241	AS-3 RED BLOOD CELLS (CP2D) (PHERESIS) (BAG 1)
04250	AS-5 RED BLOOD CELLS
04261	AS-3 RED BLOOD CELLS (CP2D) (PHERESIS) (BAG 2)
04271	AS-3 RED BLOOD CELLS (ACD-A) (PHERESIS) (BAG 1)
04281	AS-3 RED BLOOD CELLS (ACD-A) (PHERESIS) (BAG 2)
04350	CPD RED BLOOD CELLS LEUKOCYTES REDUCED
04360	CPDA-1 RED BLOOD CELLS LEUKOCYTES REDUCED
04380	CP2D RED BLOOD CELLS LEUKOCYTES REDUCED
04710	AS-1 RED BLOOD CELLS LEUKOCYTES REDUCED
04730	AS-3 RED BLOOD CELLS LEUKOCYTES REDUCED
04741	AS-3 RED BLOOD CELLS LEUKOCYTES REDUCED (CP2D) (PHERESIS) (BAG 1)
04750	AS-5 RED BLOOD CELLS LEUKOCYTES REDUCED
04761	AS-3 RED BLOOD CELLS LEUKOCYTES REDUCED (CP2D) (PHERESIS) (BAG 2)
04771	AS-3 RED BLOOD CELLS LEUKOCYTES REDUCED (ACD-A) (PHERESIS) (BAG 1)
04791	AS-3 RED BLOOD CELLS LEUKOCYTES REDUCED (ACD-A) (PHERESIS) (BAG 2)
04900	RED BLOOD CELLS WASHED
04941	RED BLOOD CELLS WASHED (PHERESIS) (BAG 1)
04961	RED BLOOD CELLS WASHED (PHERESIS) (BAG 2)
05050	CPD RED BLOOD CELLS IRRADIATED
05060	CPDA-1 RED BLOOD CELLS IRRADIATED
05210	AS-1 RED BLOOD CELLS IRRADIATED
05230	AS-3 RED BLOOD CELLS IRRADIATED
05241	AS-3 RED BLOOD CELLS IRRADIATED (CP2D) (PHERESIS) (BAG 1)
05250	AS-5 RED BLOOD CELLS IRRADIATED
05261	AS-3 RED BLOOD CELLS IRRADIATED (CP2D) (PHERESIS) (BAG 2)
05271	RED BLOOD CELLS IRRADIATED (PHERESIS) (BAG 1)
05281	RED BLOOD CELLS IRRADIATED (PHERESIS) (BAG 2)
05350	CPD RED BLOOD CELLS LEUKOCYTES REDUCED IRRADIATED
05360	CPDA-1 RED BLOOD CELLS LEUKOCYTES REDUCED IRRADIATED
05380	CP2D RED BLOOD CELLS LEUKOCYTES REDUCED IRRADIATED
05710	AS-1 RED BLOOD CELLS LEUKOCYTES REDUCED IRRADIATED
05730	AS-3 RED BLOOD CELLS LEUKOCYTES REDUCED IRRADIATED
05741	AS-3 RED BLOOD CELLS LEUKOCYTES REDUCED IRRADIATED (CP2D) (PHERESIS) (BAG 1)
05750	AS-5 RED BLOOD CELLS LEUKOCYTES REDUCED IRRADIATED
05761	AS-3 RED BLOOD CELLS LEUKOCYTES REDUCED IRRADIATED (CP2D) (PHERESIS) (BAG 2)
05771	AS-3 RED BLOOD CELLS LEUKOCYTES REDUCED IRRADIATED (ACD-A) (PHERESIS) (BAG 1)
05781	AS-3 RED BLOOD CELLS LEUKOCYTES REDUCED IRRADIATED (ACD-A) (PHERESIS) (BAG 2)
05900	RED BLOOD CELLS WASHED IRRADIATED
06041	RED BLOOD CELLS LEUKOCYTES REDUCED WASHED (PHERESIS) (BAG 1)
06061	RED BLOOD CELLS LEUKOCYTES REDUCED WASHED (PHERESIS) (BAG 2)
06100	RED BLOOD CELLS LEUKOCYTES REDUCED WASHED IRRADIATED
06141	RED BLOOD CELLS LEUKOCYTES REDUCED WASHED (PHERESIS) (BAG 1)
06161	RED BLOOD CELLS LEUKOCYTES REDUCED WASHED (PHERESIS) (BAG 2)
06400	RED BLOOD CELLS DEGLYCEROLIZED
06411	RED BLOOD CELLS DEGLYCEROLIZED (PHERESIS) (BAG 1)
06451	RED BLOOD CELLS DEGLYCEROLIZED (PHERESIS) (BAG 2)
06500	RED BLOOD CELLS REJUVENATED DEGLYCEROLIZED
06600	RED BLOOD CELLS REHUJEVNATED WASHED
06700	RED BLOOD CELLS LEUKOCYTES REDUCED FROZEN
06711	RED BLOOD CELLS FROZEN (PHERESIS) (BAG 1)
06761	RED BLOOD CELLS FROZEN (PHERESIS) (BAG 2)
06780	RED BLOOD CELLS LEUKOCYTES REDUCED FROZEN REJUVENATED
06800	RED BLOOD CELLS LEUKOCYTES REDUCED DEGLYCEROLIZED
06880	RED BLOOD CELLS LEUKOCYTES REDUCED DEGLYCEROLIZED REJUVENATED
07200	RED BLOOD CELLS FROZEN IRRADIATED
07400	RED BLOOD CELLS DEGLYCEROLIZED IRRADIATED
07411	RED BLOOD CELLS DEGLYCEROLIZED IRRADIATED (PHERESIS) (BAG 1)
07451	RED BLOOD CELLS DEGLYCEROLIZED IRRADIATED (PHERESIS) (BAG 2)
07500	RED BLOOD CELLS REJUVENATED DEGLYCEROLIZED IRRADIATED
07600	RED BLOOD CELLS REJUVENATED IRRADIATED
07731	RED BLOOD CELLS LEUKOCYTES REDUCED FROZEN IRRADIATED (PHERESIS) (BAG 1)
07741	RED BLOOD CELLS LEUKOCYTES REDUCED FROZEN IRRADIATED (PHERESIS) (BAG 2)
07780	RED BLOOD CELLS DEGLYCEROLIZED IRRADIATED
07841	RED BLOOD CELLS LEUKOCYTES REDUCED DEGLYCEROLIZED IRRADIATED (PHERESIS) (BAG 1)
07851	RED BLOOD CELLS LEUKOCYTES REDUCED DEGLYCEROLIZED IRRADIATED (PHERESIS) (BAG 2)
07880	RED BLOOD CELLS LEUKOCYTES REDUCED REJUVENATED DEGLYCEROLIZED IRRADIATED
10100	CRYOPRECIPITATED, AHF
10151	CRYOPRECIPITATED, AHF (PHERESIS) (BAG 1)
10152	CRYOPRECIPITATED, AHF (PHERESIS) (BAG 2)
10153	CRYOPRECIPITATED, AHF (PHERESIS) (BAG 3)
10191	CAF POOLED
12000	PLATELET CONCENTRATE
12001	PLATELET CONCENTRATE CONTENTS VARIABLE
12010	Platelets Pheresis (VARIABLE ANTICOAGULANTS)
12011	Platelets Pheresis (VARIABLE CONTENTS AND ANTICOAGULANTS)
12050	PLATELETS PHERESIS (ACD-A) (SPLIT 2)
12070	PLATELETS LEUKOCYTES REDUCED (CPD OR CP2D)
12071	PLATELETS LEUKOCYTES REDICED (VARIABLE CONTENTS) (CP2D)
12080	PLATELETS PHERESIS (ACD-A) (SPLIT 3)
12090	PLATELET CONCENTRATE WASHED
12600	PLATELETS IRRADIATED (CPD)
12610	Platelets Pheresis IRRADIATED (VARIABLE ANTICOAGULANTS)
12611	PLATELETS PHERESIS IRRADIATED (ACD-A) (VARIABLE CONTENTS)
12650	PLATELETS PHERESIS IRRADIATED (ACD-A) (SPLIT 2)
12670	PLATELETS LEUKOCYTES REDUCED IRRADIATED (CP2D)
12671	PLATELETS LEUKOCYTES REDUCED IRRADIATED (CP2D) (VARIABLE CONTENTS)
12680	PLATELETS PHERESIS IRRADIATED (ACD-A) (SPLIT 3)
12710	PLATELETS PHERESIS LEUKOCYTES REDUCED (NON-SPLIT OR SPLIT 1)
12711	PLATELETS PHERESIS LEUKOCYTES REDUCED (ACD-A) (VARIABLE CONTENTS)
12750	PLATELETS PHERESIS LEUKOCYTES REDUCED (ACD-A) (SPLIT 2)
12780	PLATELETS PHERESIS LEUKOCYTES REDUCED (ACD-A) (SPLIT 3)
12810	PLATELETS PHERESIS LEUKOCYTES REDUCED IRRADIATED (VARIABLE ANTICOAGULANTS)
12811	PLATELETS PHERESIS LEUKOCYTES REDUCED IRRADIATED (ACD-A) (VARIABLE CONTENTS)
12850	PLATELETS PHERESIS LEUKOCYTES REDUCED IRRADIATED (ACD-A) (SPLIT 2)
12880	PLATELETS PHERESIS LEUKOCYTES REDUCED IRRADIATED (ACD-A) (SPLIT 3)
16401	GRANULOCYTES
16411	GRANULOCYTES PHERESIS
18101	PLASMA FROZEN WITHIN 24 HOURS AFTER PHLEBOTOMY (VARIABLE ANTICOAGULANTS)
18201	FRESH FROZEN PLASMA (VARIABLE ANTICOAGULANTS)
18211	FRESH FROZEN PLASMA (ACD-A OR CP2D) (PHERESIS)
18212	FRESH FROZEN PLASMA (ACD-A OR CP2D) (PHERESIS) (BAG 2)
18251	FRESH FROZEN PLASMA (ACD-A OR CP2D) (APHERESIS)
18401	PLASMA
18435	PLASMA CRYOPRECIPITATE REDUCED
18501	LIQUID PLASMA
27050	RED BLOOD CELLS (CPD) (AUTOLOGOUS)
27071	FRESH FROZEN PLASMA (AUTOLOGOUS)
27110	RED BLOOD CELLS (AS-1) (AUTOLOGOUS)
27161	WHOLE BLOOD (AUTOLOGOUS)
27161	WHOLE BLOOD (CPDA-1) (AUTOLOGOUS)
27166	RED BLOOD CELLS WASHED REJUVENATED (AUTOLOGOUS)
27200	RED BLOOD CELLS FROZEN (AUTOLOGOUS)
27211	SINGLE DONOR PLATELET WASHED (PHERESIS) (BAG 1)
27212	SINGLE DONOR PLATELET WASHED (PHERESIS) (BAG 2)
27213	SINGLE DONOR PLATELET WASHED (PHERESIS) (BAG 3)
27214	SINGLE DONOR PLATELET VOLUME REDUCED (PHERESIS) (BAG 1)
27215	SINGLE DONOR PLATELET VOLUME REDUCED (PHERESIS) (BAG 2)
27216	SINGLE DONOR PLATELET VOLUME REDUCED (PHERESIS) (BAG 3)
27260	RED BLOOD CELLS (CPDA-1) (AUTOLOGOUS)
27266	RED BLOOD CELLS WASHED (AUTOLOGOUS)
27300	RED BLOOD CELLS FROZEN REJUVENATED (AUTOLOGOUS)
27400	RED BLOOD CELLS DEGLYCEROLIZED (AUTOLOGOUS)
27500	RED BLOOD CELLS DEGLYCEROLIZED REJUVENATED (AUTOLOGOUS)
27771	FIBRIN ADHESIVE (AUTOLOGOUS)
27901	SINGLE DONOR PLATELET VOLUME REDUCED IRRADIATED (PHERESIS) (BAG 1)
27902	SINGLE DONOR PLATELET VOLUME REDUCED IRRADIATED (PHERESIS) (BAG 2)
27903	SINGLE DONOR PLATELET VOLUME REDUCED IRRADIATED (PHERESIS) (BAG 3)
27911	SINGLE DONOR PLATELET WASHED IRRADIATED (PHERESIS) (BAG 1)
27912	SINGLE DONOR PLATELET WASHED IRRADIATED (PHERESIS) (BAG 2)
27913	SINGLE DONOR PLATELET WASHED IRRADIATED (PHERESIS) (BAG 3)
34061	CPDA-1 RED BLOOD CELLS DIVIDED (PART 1)
34062	CPDA-2 RED BLOOD CELLS DIVIDED (PART 2)
34063	CPDA-1 RED BLOOD CELLS DIVIDED (PART 3)
34361	CPDA-1 RED BLOOD CELLS LEUKOCYTES REDUCED DIVIDED (PART 1)
34362	CPDA-1 RED BLOOD CELLS LEUKOCYTES REDUCED DIVIDED (PART 2)
34363	CPDA-1 RED BLOOD CELLS LEUKOCYTES REDUCED DIVIDED (PART 3)
35061	CPDA-1 RED BLOOD CELLS IRRADIATED DIVIDED (PART 1)
35062	CPDA-1 RED BLOOD CELLS IRRADIATED DIVIDED (PART 2)
35063	CPDA-1 RED BLOOD CELLS IRRADIATED DIVIDED (PART 3)
35361	CPDA-1 RED BLOOD CELLS LEUKOCYTES REDUCED IRRADIATED DIVIDED (PART 1)
35362	CPDA-1 RED BLOOD CELLS LEUKOCYTES REDUCED IRRADIATED DIVIDED
35363	CPDA-1 RED BLOOD CELLS LEUKOCYTES REDUCED IRRADIATED DIVIDED
48201	FRESH FROZEN PLASMA DIVIDED (CPD OR CP2D) (PART 1)
48202	FRESH FROZEN PLASMA DIVIDED (CPD OR CP2D) (PART 2)
48203	FRESH FROZEN PLASMA DIVIDED (CPD OR CP2D) (PART 3)
48204	FRESH FROZEN PLASMA DIVIDED (CPD OR CP2D) (PART 4)
48211	FRESH FROZEN PLASMA DIVIDED (ACD-A OR CP2D) (PHERESIS) (PART 1)
48212	FRESH FROZEN PLASMA DIVIDED (ACD-A OR CP2D) (PHERESIS) (PART 2)
48213	FRESH FROZEN PLASMA DIVIDED (ACD-A OR CP2D) (PHERESIS) (PART 3)
48214	FRESH FROZEN PLASMA DIVIDED (ACD-A OR CP2D) (PHERESIS) (PART 4)
48215	FRESH FROZEN PLASMA DIVIDED (ACD-A) (PHERESIS) (PART 5)
50000	PLATELETS PHERESIS -7d LEUKOCYTES REDUCED
50001	PLATELETS PHERESIS-7d LEUKOCYTES REDUCED (ACD-A) (SPLIT 2)
50002	PLATELETS PHERESIS - 7d LEUKOCYTES REDUCED (ACD-A) (SPLIT 3)
50003	PLATELETS PHERESIS - 7d LEUKOCYTES REDUCED IRRADIATED (ACD-A) (NON-SPLIT OR SPLIT 1)
50004	PLATELETS PHERESIS - 7d LEUKOCYTES REDUCED IRRADIATED (ACD-A) (SPLIT 2)
50005	PLATELETS PHERESIS - 7d LEUKOCYTES REDUCED IRRADIATED (ACD-A) (SPLIT 3)
50054	PLATELETS PHERESIS - 7d LEUKOCYTES REDUCED (ACD-A) (VARIABLE CONTENTS)
50055	PLATELETS PHERESIS - 7d LEUKOCYTES REDUCED IRRADIATED (ACD-A) (VARIABLE CONTENTS)

Commonly Ordered Derivative Products

Rh Immune Globulin (Human)

Available in regular dose or microdose. The regular dose (1 mL) contains 300 mcgs of of immune globulin, which will protect against 15 mL of Rh positive RBCs (30 mL whole blood). The microdose may be used only after termination of pregnancy up to and including the 12th week of gestation.

Antihemophiliac Factor (AHF, Factor VIII)

Used for treatment of bleeding due to Hemophilia A. The dose is dependent upon the nature of the bleeding episode and severity of Factor VIII deficiency. The dose must be calculated. Several different formulations of recombinant and plasma derived Factor VIII are available. Refer to package insert for dosage and half-life specifics.

Factor IX, Factor VII

Several different kinds of Factors are available. Refer to package insert for dosage and half-life specifics.

Varicella Zoster Immune Globulin (Human)

Available in pediatric and adult dosages. Used for passive immunization of exposed, susceptible individuals who are at risk of complications from varicella infection.

Other derivatives are available upon request.

Contact BioCare representative Andrew Lefevre for additional information. Call (714) 743-0749 or email .(JavaScript must be enabled to view this email address).

Modified Blood Components

Leukocyte Reduced: Blood Centers of the Pacific routinely provides leukocyte reduced RBC and platelet components. An occasional special unit (e.g., autologous or HLA matched unit imported from another center or a deglycerolized RBC) may not be leukocyte reduced. If the unit is required to be transfused as leukocyte reduced then the transfusion facility must use a leukocyte reduction filter.

Irradiated: Patients at risk for developing graft-versus-host disease should receive irradiated cellular components:

• Severely immunocompromised patients
• Hematopoetic cell transplant candidates and recipients
• Patients undergoing intrauterine transfusions
• Recipients of donor directed components from a blood relative of the recipient
• If the donor is selected for HLA compatibility by typing or crossmatching

Irradiated RBCs have a maximum expiration date of 28 days from irradiation. The BCP operating systems assigns irradiated blood components an expiration date that is 28-days from the date of COLLECTION after irradiation. If the unit has an expiration date less than 28 days prior to irradiation the shorter date must be used.

Volume Reduced: Removal of excess donor plasma from cellular components is indicated in selected patients who cannot tolerate the full volume or when ABO incompatible single donor platelets are transfused.

Approximately 10% of platelets are lost in this process and the extra centrifugation step may cause some platelet activation and loss of function. Volume Reduced platelets have a 4 hour expiration date.

Washed: Patients with severe life threatening plasma allergies uncontrolled by medications or volume reduction may require use of washed RBCs and Platelets. The units are suspended in saline, with very little plasma proteins remaining. Washed RBCs have a 24 hour expiration date. The recovery and function of platelets after washing are severely impaired. Washed platelets have a 4 hour expiration date.

Deglycerolized: RBCs may be frozen up to 10 years when their antigen makeup is considered ‘rare’ or for other special reasons. When a transfusion service requests antigen negative blood not found in liquid units, frozen units may be available. Through a process of deglycerolization, the cells are thawed and suspended in saline for transfusion. Deglycerolized RBCs have a 24 hour expiration date.

CMV sero-negative: CMV sero-negative cellular components are provided upon request. Both leukoreduced blood and CMV sero-negative blood have a much-reduced risk of transmitting CMV infection through transfusion.

Hemoglobin S negative: Patients with Sickle Cell Disease should be given Hemoglobin S negative RBCs.

Blood Components

Red Blood Cells

One unit of red blood cells (RBC) contains approximately 200 mL red blood cells, 100 mL additive solution (AS-1, AS-3) and ~30 mL plasma. Additive solutions replace the majority of plasma from a whole blood unit and extend storage life of the unit. Some RBCs are available without the additive solution, with only anticoagulant present with the plasma (CPDA-1, CP2D, CPD). Each configuration contains the pertinent information on the product or component label. Expiration dating depends on the additive or anticoagulant present in the unit. RBCs must be stored at 1-6C.

Platelets

Apheresis leukocyte reduced platelets, collected from a single donor, are prepared in 200-400 mL of plasma, and contain a minimum yield of 3.0x 10" platelets. Each pheresis unit is equivalent to 6-8 whole blood derived platelet concentrates and is usually an adequate dose for an average size adult. Platelets expire in 5 days or 7 days. The expiration date will be clear on the product label. Platelets must be stored between 20-24C with gentle agitation.

Blood Centers of the Pacific does not supply platelet concentrates produced from Whole Blood donations.

Platelets supplied by BCP have been screened for bacterial contamination and found to be negative in compliance with AABB Standard 5.1.5.1. Additional testing is not required by the Transfusion Facility.

Plasma Products

Several plasma component configurations are available. Anticoagulant and volume depend on the collection process. Plasma provided from whole blood donations contains approximately 250mL. Plasma provided from apheresis donations contains a minimum of 200 mL. Pediatric configurations can be provided from apheresis fresh frozen plasma products. Each unit contains the pertinent information on the component or product label.

Depending on center processes, plasma may be provided as:

• Fresh Frozen Plasma (FFP)
• Plasma Frozen within 24 Hours
• Cryo-Reduced Plasma

Frozen expiration date is 365 days. Expiration dating of a thawed component depends on the type of plasma component. Thawed FFP must be transfused within 24 hour of thawing. Other thawed plasma products must be transfused within 5 days of thawing. Frozen plasma units must be stored at <-18C. Thawed plasma must be stored between 1-6C.

Cryoprecipitated Anti Hemophiliac Factor (Cryo, Cryoppt, Cryoprecipitate)

Cryo is prepared from plasma collected from a whole blood donation and contains Fibrinogen (>150 mg), von Willebrand Factor, Factor VIII (>80 IU), Factor XIII and Fibronectin. Cryo is the only adequate fibrinogen concentrate available for intravenous use. Each cryo unit contains approximately 15 mL plasma. Frozen expiration date is 365 days. Thawed cryo has an expiration date of 4 hours. Frozen cryo must be stored at <-18C. Thawed cryo must be stored at room temperature.

Granulocytes

Granulocytes prepared by apheresis are indicated for a very limited use. The Transfusion Facility must discuss use of this component with the BCP Medical Director to coordinate collection. Granulocytes have a short expiration time after collection (24 hours). They are stored at 20-24C without agitation.

Shipping & Distribution

The Hospital Services department of Blood Centers of the Pacific (BCP) distributes blood products to hospitals and other transfusion facilities for patient use. Hospital Services is also responsible for handling patient specimens requiring testing at the blood center and blood products returned to the blood center.

Each transfusion facility must sign a “Hospital Services Agreement” detailing expectations and requirements for delivery and storage of blood products, return privileges when applicable, and special services provided by Blood Centers of the Pacific.

This section of the Web site covers topics related to the order and delivery of blood products, in addition to other issues covered in the Agreement, Contact Hospital Services’ Richard Harveston for additional information. Call (415) 749-6630 or email .(JavaScript must be enabled to view this email address).

Special Donations

In addition to accepting community blood donations, you can also donate blood for your own upcoming surgery or treatment (autologous donation) or donate blood for a friend or family member (designated donation).

Please contact our Special Donations department to learn more.  Call 800-215-6225 or email .(JavaScript must be enabled to view this email address).

Blood Components & Derivatives

Blood Centers of the Pacific distributes a variety of blood components and derivatives. The various component categories are listed below, along with specific components and their commonality codes.

Many Transfusion Service staff have requested a guideline for the use of blood components. The most authoritative source is the most recent version of the Circular of Information (COI) for the Use of Blood and Blood Components.

This brochure is produced jointly by the AABB, America’s Blood Centers, and the American Red Cross. You can view the current version of the COI online here. Copies are also available from your Blood Centers of the Pacific location.

If you have questions concerning availability of particular blood components or special transfusion needs, please contact your blood center.

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