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Old Thu Aug 9, 2007, 02:50 AM
Wendy Beltrami Wendy Beltrami is offline
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Join Date: Aug 2006
Posts: 269
Hi Valerie-
I wish I could tell you that I had something to back it up in writing. I don't. I only have direct experience with Grant's transfusions. I have always charted everything and there is a definite difference we notice with fresh and type specific platelets. We have not noticed any difference between rh positive and rh negative. We have also noticed a difference in prbcs when they are expiring within the week or within 3-4 weeks.

I THINK it was Melissa Rhodes, MD from Vanderbilt in Nashville that told me they always prioritize super fresh blood for their babies and that it does make a difference for them.

Am I crazy or isn't this just common sense? ESPECIALLY with platelets since their life span is so short. Just for argument's sake, let's say that every single platelet in a particular unit is brand new and has 7 full days of life remaining after bacterial quarantine and will remain bacteria free for 7 days. Wouldn't you want those platelets instead of a bag that was expiring the same day?
And obviously, when platelets are collected, they are all in varying stages of their lifespan so a unit would never be 100% fresh platelets anyhow. Some are brand new and some are just about to die so even in the best case scenario, maybe 15% (?) of a unit is brand new super fresh platelets- what do you think? I'm just guessing here.

After the last conference, I asked Marilyn Baker to see if someone could come from a Blood Bank center and talk about this at this year's conference. I wonder if anything ever came of that? She seemed very motivated to follow up on that, based on the panel's response to my questions last year.

As for "knowing someone" in blood bank..., I just flat out refuse the unit if it's old. I tell them that I was not going to accept a product where I didn't believe the benefit for my child outweighed the usual risk of transfusion. Especially now that he has iron overload, why would I give him blood that was adding to his iron overload but not giving him the benefit of the good hemoglobin he needed. I had the support of his doctor as well whose orders always specify "as fresh as possible". Obviously, when they are trying to give you products that are expiring that day, they are not as fresh as possible. I remember once when our hospital blood bank ordered a unit of platelets and told them that we wanted ones that were super fresh (meaning at least 2 days from expiration) the blood center on the other end balked a bit. When the blood bank here said that it was for someone whose platelet level was 4K, then they said "OH, alright". Seriously, I don't think the whole "picture" makes it down the pipeline to the blood bank. All they know is that a unit of O negative is being requested. Unless you make a big issue of it, I don't think they get the information about the patient being transfusion dependent. After all, if you are given products that don't give you an extended boost then you are back all the sooner depleting their supply of blood. We're frequent flyers and should be recognized as such.

Wendy/mom to Grant
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