The Viability of Whole Blood and Packed Cells at the Time of Transfusion at the University Teaching Hospital in Lusaka Zambia

Abstract

In low-and middle-income countries (LMICs) the maintenance of standards relating to the transport and storage of blood may be more difficult to achieve. Bacteria contamination and hyperkalemia represent two significant risks. The objectives of this study were to assess the viability of transfused blood defined by negative blood culture and potassium concentration of less than 42mmol/l. Samples from 84 units of whole blood and packed cells were collected aseptically and analyzed to determine the presence of bacteria by culturing and the level of potassium. Method of storage/transport once the units left the blood bank (cool box or room temperature) was also recorded. Results. 8 samples (10.5%) showed a positive culture and the organisms isolated included Pseudomonas fluorescens, Corynabacterium, Acinetobacter baumannii and Staphylococcus capitis. Only 12.5% of the culture positive units were stored in cooler boxes compared to 35.5% of the culture negative units. The mean potassium content was 12.25mmol/l (±7.4SD). None of these were outside the expected range for stored blood. However, blood stored at room temperature was found to have a higher potassium concentration than blood stored in a cool box. The median time between blood leaving the blood bank to the time the transfusion was actually commenced was 6(IQR±6) hours and a range of 1-14hours. Under the prevailing circumstances at the University Teaching Hospital, bacterial contamination remains a significant risk in recipients of whole blood and packed cells. The current practice, therefore, needs improvement. This study recommends continued medical education in the transport and storage of blood and blood products.