l. Quarantined Blood. Blood collected from a donor later found to have, or to
be at high risk of AIDS should be quarantined immediately, and the Office of Biologics
Research and Review (Division of Blood and Blood Products) should be notified. Each
facility's procedures manual should make it clear that such blood and all components,
products, or samples prepared from it, is potentially infectious and should be labeled,
stored, or shipped with standard precautions for infectious material. Such donor units
may be held in quarantine pending clarification of the donor's diagnosis; used for
investigative use related to AIDS; or disposed of by autoclaving or controlled
incineration. Units should be over wrapped, to protect personnel in case of breakage.
Section II. BLOOD STORAGE AND SHIPMENT
1-17. BACKGROUND INFORMATION
a. The human erythrocyte is a living cell that requires energy to remain viable
and carry out its primary function of delivering oxygen to the tissues. The major
purpose of transfusing whole blood and red blood cells is to provide the recipient with
the means of delivering oxygen to the tissues. Storage conditions, therefore, should be
devised to maintain hemoglobin function and viability of the stored red blood cell mass.
b. Proper maintenance of red blood cell hemoglobin function and viability during
cold storage is accomplished primarily by collecting the blood into an appropriate, sterile
anticoagulant-preservative solution that prevents the blood from clotting and provides
proper nutrients for continuing metabolism in the red blood cell. As with other living
systems, the continued integrity of the stored red blood cell mass is dependent on a
delicate biochemical balance of certain elements such as glucose, pH, ATP (adenosine
triphosphate), and 2,3-DPG (diphosphoglycerate). This balance is further influenced by
the storage temperature of 1C to 6C for whole blood and stored liquid red blood cells.
c. In addition to anticoagulant-preservative requirements, there are rather rigid
regulations for the actual refrigeration of blood at 1C to 6C and 1C to 10C during
transportation. To assure the continued sterility of blood during storage, regulations for
routine inspection of stored blood, for bacteriologic studies of blood in open systems,
and for re-issuance of blood have been instituted.