Changes in the new AABB standards Essay

One of the highlights of the recent American Association of BloodBanks annual meeting was the issuance of the 11th edition of the AABB Standards for Blood Banks and Transfusion Services. Editor of the new edition was an old friend, Paul J. Schmidt, M.D.,who served as the blood bank expert on MLO’s Tips on Technologypanel from 1979 through 1981.

In fact, he resigned from the Tips panelin 1981 to take on the chairmanship of the AABB Standards Committee. The new edition of the Standards contains numerous importantchanges, plus an entire new section on histocompatibility testing. Dr.Schmidt provided MLO with a list he compiled of some of the significantchanges. The list contains paraphrases and is not intended as aninterpretation. The published Standards booklet must be consulted forthe test of all standards.

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Here, though, is a partial list of the highlights of the 11thedition: General A6.000 Devices in contact with blood shall be nonreausable. (notjust disposable) A7.000 A.

sub.1 and B cells for reverse grouping and IgG sensitizedcells may be prepared locally. A8.000 The words “by a method known to produce” indicatethat quality control procedures are not expected. (new definition) Donors B1.110 Omit questions about kidneys.

B1.170 Omit pulse pressure requirements. B1.290 Information on the high risk groups for AIDS.

Screening forAIDS and Kaposi’s sarcoma. (new) Components B4.113 If the seal is broken, components must be placed in freezerwithin 6 hours. When thawed, they must be transfused within 6 hours ifstored between 20 and 24 C, and within 24 hours is stored between 1 and6 C. B4.

223 At time of preparation of deglycerolized red blood cells,the tubing must be filled with an aliquot for compatibility testing. B4.332 Cryoprecipitate shall be refrozen within 1 hour. (wasimmediately) Labeling B6.

000 The label shall be eye-readable type and may bemachine-readable. B6.340 ABO and Rh type may be applied to components to be storedfrozen provided there are steps remaining in the labeling process toassure accuracy. B7.200 Components stored frozen should be transported frozen. B7.

210 blood and components shall be inspected immediately beforepacking for shipment. (new) Hemapheresis C6.300 If a plasmapheresis donor’s weight is 80 kg (176pounds) or greater, whole blood removed in any 48-hour period shall notexceed 1,500 ml and within 7 days not exceed 2,400 ml. C7.000 Testing of the plasmapheresis donor’s blood must beperformed by a laboratory accredited by the American Association ofBlood Banks, or by the College of American Pathologists, or by anappropriate local, state, or Federal agency.

E1.000 Therapeutic hemapheresis shall be done only at the writtenrequest of the patient’s physician. Compatibility testing G3.000 A major crossmatch must use donor cells from the originallyattached donor or component segment. G4.110 Whole blood or red blood cell components should not containthe antigen to which the patient has antibodies and should becrossmatch-compatible. (new) G5.100 Consideration should be given to using only the “typeand screen” portions of the compatibility test when blood usage isunlikely.

G4.110 applies. (new) Neonatial recipients G7.310 If donor red blood cells are incompatible with the mother,units must be crossmatched against the child using the antiglobulintest, until a compatible crossmatch has been observed. Transfusion J1.000 Transfusion must be done under medical supervision, and thepatient must be observed during the transfusion and for an appropriatetime thereafter for suspected adverse reactions.

Histocompatibility testing Completely new section added to the Standards.

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