Changes in the new AABB standards Essay

One of the highlights of the recent American Association of Blood
Banks 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 Technology
panel from 1979 through 1981. In fact, he resigned from the Tips panel
in 1981 to take on the chairmanship of the AABB Standards Committee.

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The new edition of the Standards contains numerous important
changes, plus an entire new section on histocompatibility testing. Dr.
Schmidt provided MLO with a list he compiled of some of the significant
changes. The list contains paraphrases and is not intended as an
interpretation. The published Standards booklet must be consulted for
the test of all standards.



Here, though, is a partial list of the highlights of the 11th
edition:



General



A6.000 Devices in contact with blood shall be nonreausable. (not
just disposable)



A7.000 A.sub.1 and B cells for reverse grouping and IgG sensitized
cells may be prepared locally.



A8.000 The words “by a method known to produce” indicate
that 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 for
AIDS and Kaposi’s sarcoma. (new)


Components



B4.113 If the seal is broken, components must be placed in freezer
within 6 hours. When thawed, they must be transfused within 6 hours if
stored between 20 and 24 C, and within 24 hours is stored between 1 and
6 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. (was
immediately)



Labeling



B6.000 The label shall be eye-readable type and may be
machine-readable.



B6.340 ABO and Rh type may be applied to components to be stored
frozen provided there are steps remaining in the labeling process to
assure accuracy.



B7.200 Components stored frozen should be transported frozen.



B7.210 blood and components shall be inspected immediately before
packing for shipment. (new)



Hemapheresis


C6.300 If a plasmapheresis donor’s weight is 80 kg (176
pounds) or greater, whole blood removed in any 48-hour period shall not
exceed 1,500 ml and within 7 days not exceed 2,400 ml.



C7.000 Testing of the plasmapheresis donor’s blood must be
performed by a laboratory accredited by the American Association of
Blood Banks, or by the College of American Pathologists, or by an
appropriate local, state, or Federal agency.



E1.000 Therapeutic hemapheresis shall be done only at the written
request of the patient’s physician.



Compatibility testing



G3.000 A major crossmatch must use donor cells from the originally
attached donor or component segment.



G4.110 Whole blood or red blood cell components should not contain
the antigen to which the patient has antibodies and should be
crossmatch-compatible. (new)



G5.100 Consideration should be given to using only the “type
and screen” portions of the compatibility test when blood usage is
unlikely. 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 antiglobulin
test, until a compatible crossmatch has been observed.



Transfusion



J1.000 Transfusion must be done under medical supervision, and the
patient must be observed during the transfusion and for an appropriate
time thereafter for suspected adverse reactions.



Histocompatibility testing



Completely new section added to the Standards.

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