Shipping & Distribution

The Hospital Services department of United Blood Services distributes blood products to hospitals and other transfusion facilities for patient use. Hospital Services is also responsible for handling patient specimens requiring testing at the blood center and blood products returned to the blood center. Derivatives and reagents may be delivered by Hospital Services personnel at some centers.

Each transfusion facility must sign a “Hospital Services Agreement Letter” detailing expectations and requirements for delivery and storage of blood products, return privileges when applicable, and special services provided by United Blood Services or Blood Systems Laboratories.

This section of the Web site covers topics related to the order and delivery of blood products, in addition to other issues covered in the Agreement Letter. Contact Hospital Services for routine communications or the Hospital Services Director for other questions you may have. Certain topics are dependent on specific United Blood Services center processes. For questions, contact the Hospital Services department or Director for the center supplying your blood.

If you utilize United Blood Services for compatibility testing services, please go to the Transfusion Medicine section of the Web site for placing orders and delivery of these components.

ORDERING COMPONENTS
FROM UNITED BLOOD SERVICES

Regular Orders

Regular orders of components are for ones that United Blood Services keeps in stock. Time frame of delivery (for stock, routine, ASAP, STAT) depends on the distance from the blood center to your facility.

The following guidelines are used by United Blood Services for time frames to ship regular orders. Stated time is from the order time to when the shipment leaves the center.

  • STAT: Not more than 1 hour from the time an order is taken to the time it is shipped.
  • ASAP: Not more than 4 hours from the time an order is taken to the time it is shipped.
  • Stock (standing orders/routines): Order is shipped as workload and product availability permit, but not later than 24 hours from the time the order is taken.
  • Surgery: As designated by the customer. From the time the order is taken to the time it needs to be shipped to meet the customer’s need.

Time frames may vary by location, so contact your blood center for clarifications. They may also vary due to other factors (e.g., blood shortages, 3 day weekends, high usage).

A blood stock level, as determined by United Blood Services and the transfusion facility, is rotated on a scheduled basis as agreed upon. When possible, United Blood Services requests the use of shorter dated units first, and the timely release of untransfused, crossmatched blood for other patient use or return to the blood center.

When placing an order, indicate type(s) of blood component(s), quantity and time frame for delivery.

Special Orders

Special Orders are for components that require special handling, testing, or components not available in stock at United Blood Services. Not all blood centers may provide the complete list of options.

PEDIATRIC COMPONENTS Units requested for pediatric use may be aliquoted by United Blood Services (plasma) or supplied with a satellite bag (or bags) attached to the primary unit for aliquoting at the Transfusion Facility.
WASHED Red Cells or Platelets requested as washed have a reduced outdate (24 hours and 4 hours respectively).
IRRADIATED Cellular components can be requested as irradiated. Directed Donor units from blood relatives require irradiation.
DIRECTED DONOR/ AUTOLOGOUS These reserved units must be ordered to be drawn prior to transfusion need by the patient’s attending physician. (See Special Collections.)
ANTIGEN NEGATIVE Red cell units can be supplied as confirmed or unconfirmed depending on transfusion facility request and blood center policy. Rare units may be available as liquid or frozen, but may need to be imported from another center. If frozen, United Blood Services will deglycerolize the unit prior to delivery; this shortens the shelf life of the units to 24 hours.
CMV SERONEGATIVE Cellular components can be requested as CMV seronegative.
HGB S NEGATIVE Red cell components can be requested as Hgb S negative.
GRANULOCYTES Collected only after discussion with the United Blood Services Medical Director.
WHOLE BLOOD Available at special request.
Special platelet considerations:
REDUCED VOLUME Platelet pheresis components can be prepared to remove plasma volume. This process shortens the shelf life to 4 hours from when the process starts, and allows only a very short time for administration at the Transfusion Facility.
LOW PLATELET YIELD Transfusion Facilities may choose to accept platelet pheresis components with a platelet yield less than 3.0 x 1011. Platelet units containing <3.0 but >2.5 x 1011 will be charged as normal units. Platelet units containing >1.5 but <2.5 x 1011 will be charged at a lesser fee.
UNAVAILABLILITY OF BACTERIALLY SCREENED UNITS Platelets are screened for bacterial contamination which takes approximately 48 hours from collection. If required for transfusion prior to this time, Hospital Services initiates the approval from the Transfusion Facility. Once testing is completed, the Transfusion Facility will only be notified if testing is positive.
HLA MATCHED (refer to BSL instructions for the HLA lab found at this link)
CROSSMATCHED (refer to BSL instructions for the IHS lab found at this link)

Contact your blood center for center-specific procedures for ordering these components.

 

Emergency Release Process

A discussion with Hospital Services and/or the United Blood Services Medical Director may facilitate the process for delivery of these special units.

Units that are not yet completely tested require release following the United Blood Services Emergency Release Process. Whole blood and blood components may be issued only when such issue is essential to allow time for transportation to ensure arrival of the blood by the time it is needed for transfusion. Contact your blood center representative for the proper documentation for Emergency Release.

Certain components that cannot be completely tested may also be released upon approval by the attending physician (and our receipt of a signed Emergency Releasae Document, BS 341, available from your blood center representative). Rare, unlicensed frozen units fall in this category.

Process for Issuing Unlicensed Components

Certain components are only available as unlicensed by FDA. The requesting physician must supply a medical need statement for delivery of these products.

 

DELIVERY OF COMPONENTS

Packing Configurations

There are several shipping containers configurations used for each required shipping temperature and container design. Centers may use all or only certain types of containers for transport. Containers have been validated for the transport times listed in the following table.

Temp. Component Type Coolant Container Designation Transport Time
1-10C Red Cells/ Whole Blood BSI Blue Ice

CF45/CF89/

< 48 hours/

20-24C Platelets/ Granulocytes Gel Coolant E-38UB

< 24 hours

<-20C Plasma/ Cryoprecipitate Dry Ice CF45/CF89 Dependent on amount of dry ice. Shipment is acceptable if dry ice is still present.

A packing slip will accompany each shipment.

To return components to United Blood Services, they must be packed in the shipping container with appropriate coolant determined for the type of product. If you have any questions concerning packing units for return, contact the Hospital Services department at you blood center.

The CF-45 and CF-89 shipping containers may be used for temporary storage of blood products in the case of a storage unit failure. Proper packing and temperature measurement and recording every 4 hours is required. Contact Hospital Services to arrange to return units, when applicable, or provide adequate shipping containers and packing materials for short term storage.

 

Packing Supplies and Configuration for Returning Red Cells to United Blood Services

Packing supplies are available from United Blood Services. RBCs may be returned to United Blood Services when the following packing configuration is followed:

  • BSI Blue Ice: Do not store at temperatures colder than -35C. If stored at <-20C, leave ice at ambient room temperature for at least 15 minutes prior to packing. Ensure BSI Blue Ice is frozen solid prior to packing shipping container.
  • Gel packs (8 oz): Equilibrate to a temperature of 1-6C for red cells/whole blood.
  • Plastic Bags (4 mil)
  • Absorbent Pads
  • CF-45/CF-89 Shipping Container with polyurethane liners

  1. Place plastic bag inside inner box.
    1. The CF-45 holds one inner box, the CF-89 holds two.
    2. If the CF-89 container is used, ensure both inner boxes are packed appropriately.
  2. Place one frozen solid BSI Blue Ice on each end of the cardboard sleeve, positioned between the sleeve and the inner box wall.
  3. Place one absorbent pad flat inside plastic bag.
  4. Place 2 units on top of the absorbent pad.
  5. Repeat layering of absorbent pads and units until the box is full, ending with absorbent pad.
    1. Caution: Minimum component load is 1200 mL. Add refrigerated gel packs to bring the total component load to at least 1200mL.
    2. If gel packs are used to add volume, treat them as units and layer as described above.
  6. Close and secure plastic bag.
  7. Insert top polyurethane panel.
  8. Close and seal container.
  9. Ship to United Blood Services to ensure container is received within 48 hours.

 

Packing Supplies and Configuration for Returning Platelets to United Blood Services

Packing supplies are available from United Blood Services. Platelets may be returned to United Blood Services when allowed by the Service Agreement and the following packing configuration is followed:

  • Gel packs (48oz): Equilibrate to a temperature of 20-24C for platelets.
  • Plastic Bags (4 mil)
  • Absorbent Pads
  • E-38UB Shipping Container with polyurethane liners
  • Use of a Temperature Stabilizing Unit is recommended anytime the ambient temperature is colder than 50F. Contact United Blood Services to discuss this option.

  1. Place plastic bag inside inner box.
  2. Place two gel packs (flat) inside the plastic bag.
  3. Place two absorbent pads flat on top of gel packs, absorbent side up.
  4. Place unit(s) on top of the absorbent pads.
  5. Repeat layering of absorbent pads and units until the box is full, ending with absorbent pad, absorbent side down.
  6. Place 2 gel packs on top of the absorbent pad.
  7. Close and secure plastic bag.
  8. Insert top foam panel.
  9. Close and seal container.
  10. Ship to United Blood Services to ensure container is received within 24 hours.

 

Packing Supplies and Configuration for Returning Frozen Plasma Products to United Blood Services

Packing supplies (except dry ice) are available from United Blood Services. Frozen Plasma Products may be returned to United Blood Services when allowed by the Service Agreement and the following packing configuration is followed:

  • Dry Ice
    • Dry Ice is considered a Class 9 hazardous material regulated by 49 CFR. Handle with caution.
    • DRY ICE labeling of shipping container is required.
  • Shredded paper
  • Plastic Bags (4 mil)
  • Absorbent Pads
  • Bubble bags
  • CF-45/CF-89 Shipping Container with polyurethane liners

  1. Layer approximately 1 inch of shredded paper into the bottom of the shipping container.  
  2. Place plastic bag inside inner box. 
    1. The CF-45 holds one inner box, the CF-89 holds two.
    2. If the CF-89 container is used, ensure both inner boxes are packed appropriately.
  3. Place sufficient amount of absorbent pads into bottom of plastic bag to absorb amount of frozen product to be shipped (each pad absorbs approximately 700 mL of liquid).
  4. Place frozen products in bubble bags/wrapping.
  5. Place frozen products on top of absorbent pads.  Fill any spaces around the units with shredded paper to prevent shifting during transit.
  6. Place sufficient amount of absorbent pads on top of frozen products.
  7. Close and secure plastic bag.
  8. Insert shredded paper around the sides and over the top of the plastic bag to secure the contents.
  9. Add DRY ICE on top of the contents.
    If using a

    And the shipment
    time is

    Then add this
    amount of
    DRY ICE
    CF-45 >3 or <38 hours 12 lbs.
    <3 hours 2 lbs.
    CF-89 >3 or <38 hours 15 lbs.
    <3 hours 3 lbs.
  10. Insert top polyurethane panel.
  11. Close and seal container.
  12. Ship to United Blood Services to ensure container is received within 48 hours.

 

Couriers

United Blood Services supplies couriers for transfusion facilities and hospitals within driving distance (determined by blood center distribution locations). Schedule of routine runs is dependent on the transfusion facility or hospital. Other couriers not currently in contract may be used in certain situations. Discuss these options with your blood center.

Couriers may facilitate transfer of components between transfusion facilities or hospitals. In very limited circumstances, the Transfer Document form, (BS 5150) may not be required for transfers within the same healthcare organization in the same service area, sharing the same computer system and having a method in place to document transport time and temperature. Please check with your UBS Hospital Services Director.

To transfer components between hospitals or transfusion facilities using the BS 5150, the sending facility must inspect each blood component, sign the blood storage and handling statement, document the date and time of component inspection/packing and identify, on the BS 5150, the person performing the inspection and packing. Place the original BS 5150 in the shipper and retain a copy at the hospital.

The receiving hospital must inspect the packing configuration and document acceptability, measure and record the receipt temperature of the shipment, verify shipper contents and sign the “Received By” section of the BS 5150, recording the date and time of receipt. Send a completed copy of the form to the local United Blood Services center and retain a copy at the facility.

Other Delivery Mechanisms

Out of town delivery depends on the location of the Transfusion Facility. Contact Hospital Services for specific details.

Receipt of Shipments Using non-United Blood Services Couriers

When a shipment is delivered by a non-United Blood Services courier, evaluate appropriate packing configuration and temperature for type of component. Contact the Hospital Services department at your blood center if you have any questions concerning deviations or questionable storage conditions.

 

RETURN OF COMPONENTS

Return Privileges for Credit

Returning short-dated units for use by another facility benefits everyone; ensuring an adequate blood supply is everyone’s responsibility. Return privileges are defined in the Agreement Letter. Units must be properly packed in appropriate shipping containers for return, and red cells must have a minimum of 2 segments remaining on the unit. Units must have been stored at the Transfusion Facility following required storage conditions, and monitored during the storage period. Your United Blood Services center conducts visits to your facility to ensure acceptable storage is maintained (see section on Facility Inspection and Shipping Quality Control).

Units Returned for Quality Issues

Units that are returned for quality issues or at the request of United Blood Services are automatically credited.

Hospital Services may request return of a component for several reasons (e.g., recall, market withdrawal, positive bacterial detection of a platelet, shortage of a particular blood type at another facility). In some cases, United Blood Services will request destruction of the unit on site if not transfused, and will provide credit if this is done.

Units of questionable quality identified at the transfusion facility are returned to United Blood Services for evaluation. Contact Hospital Services to report the specific situation. The unit must be appropriately “flagged” and Hospital Services staff must be notified prior to returning the shipment to prevent re-distribution.

Required Documentation

Complete applicable sections of the Transfer Document form (BS 5150) for a unit returned to United Blood Services. This form is completed when transferring a unit to another Transfusion Facility. In very limited circumstances, the BS 5150 may not be required for transfers within the same healthcare organization in the same service area, sharing the same computer system and having a method in place to document transport time and temperature. Please check with your UBS Hospital Services Director.

To complete the BS 5150 when returning components to a United Blood Services center, the sending hospital must inspect each blood component, sign the blood storage and handling statement, document the date and time of component inspection/packing and identify, on the BS 5150, the person performing the inspection and packing. Place the original BS 5150 in the shipper and retain a copy at the hospital.

Complete applicable sections of the Credit Request form (BS 340) for requesting credit for a unit disposed of at the Transfusion Facility. (Contact your local blood center representatiave for credit request forms.)

 

POLICIES FOR PROPER STORAGE OF BLOOD COMPONENTS

Requirements

As stated in the Hospital Blood Services Agreement, the Transfusion Facility (“facility”) must furnish specific storage units, restricted to storage of blood and other biologicals, which are capable of maintaining required storage temperatures, as specified in Title 21 of the Code of Federal Regulations, Standards of the AABB and these United Blood Services policies and procedures.

Temperature Monitoring of Approved Storage Units

Storage units approved for storage of blood or blood components at the facility must be equipped with a system that monitors continuously and records temperatures at least every 4 hours and with an alarm that sounds if temperature limits are reached.

The facility must notify United Blood Services within 24 hours of any occurrence of temperature deficiencies in the storage of blood and blood components and agrees not to return units subjected to temperatures outside the required ranges, unless approved for return by United Blood Services.

Documentation of storage temperatures may be required during inspections by regulatory agencies, and the facility agrees to provide records to United Blood Services upon request.

Requirements for Blood Storage Units

Component Storage Temperature
Whole Blood, Red Blood Cells 1-6C
Plasma, Cryoprecipitated AHF -18C or colder
Platelets 20-24C, with gentle agitation
Granulocytes 20-24C, without agitation

Additional Criteria for Storage and Handling

  • Blood component receipt temperature must be documented.
  • Blood and blood products must be stored in approved and labeled storage areas/units.
  • Store in an orderly fashion to prevent crowding and to allow air circulation.
  • Do not store quarantined components above other components.
  • Do not store reagents above blood components.
  • Do not overlap platelet bags during storage.
  • Store red cells to allow visual observation of hemolysis at the red cell interface.
  • Segregate autologous components from allogeneic components.
  • United Blood Services boldly labels autologous components with positive test results as Biohazardous and may ship such units in special Biohazardous shipping containers. Biohazard-labeled autologous components should be kept segregated from other non-biohazardous autologous components.
  • When released to another department, blood components must be maintained within appropriate storage temperatures or returned to proper storage within a specified time if storage is not available and the component is not transfused.

Storage Unit Failures

In the event of a storage unit failure, components must be moved to appropriate alternative storage. If alternative storage is not available with a temperature monitoring system that alarms for out of range temperatures, contact United Blood Services Hospital Services to discuss alternative storage at United Blood Services, the use of United Blood Services shipping containers as alternative storage or other suitable solutions.

Please follow the table below if using shipping containers as alternative storage.

Component Type Action
Red Blood Cells (RBCs)
  • Pack up to 12 RBCs per inner box in the CF-89
  • Re-ice at least once every 24 hours
  • Temperature must be maintained at 1-6C
  • Take temperature of shipper contents every 4 hours
Platelets
  • Pack up to 10 apheresis platelets per E-38UB
  • Do not store off agitation for more than 24 hours
  • Temperature must be maintained at 20-24C
  • Take temperature of shipper contents every 4 hours
Frozen Components
  • Pack up to 15 frozen plasma OR up to 15 pooled Cryo OR
    up to 30 Cryo per CF-89
  • Fill box with dry ice
  • Inspect for thawing and reapply dry ice at least every 24 hours

Additional Assistance

United Blood Services Hospital Services and our Quality Source consulting group stand ready to help your facility with questions or concerns about new equipment validation, recording chart issues, alarm checks and related concerns. Please contact your local blood center or send email to Qsource@bloodsystems.org.

Refer to Storage and Record Keeping Requirements for Transfusable Blood Components for valuable information regarding component temperature requirements, storage of blood components, identifying and documenting deviations, reporting requirements, and hospital inspections by the blood center. This presentation may be used for training new staff.

 

DERIVATIVES/REAGENTS

Blood product derivatives and serologic reagents are available from BioCARE through your United Blood Services center. Contact the Hospital Services department to obtain information on ordering the derivatives/reagents. The Hospital Services department may deliver the supplies to your facility. BioCARE personnel deliver directly to some locations.

Available from BioCARE:

  • Albumin
  • Coagulants
  • Fibrin Sealant
  • Hyper Immune Globulin
  • IM Immune Globulin
  • IV Immune Globulin
  • Rh Immune Globulin
  • Blood Banking Reagents

Refer to the Blood Components and Derivatives section of this Handbook for information relating to commonly ordered derivatives.

 

BILLING PROCESSES

Blood center component service (processing) fees should be listed on patients’ bills separately from hospital blood related charges. 
 
Contact your Blood Center Hospital Services department with questions related to product or service fees, requests for credits or billing issues. They may refer you to the Blood Systems corporate Finance department.

 

FACILITY INSPECTION
& SHIPPING QUALITY CONTROL

Upon request by the FDA, CAP, AABB or United Blood Services, its agents and employees, the transfusion facility shall allow reasonable on-site inspection of blood storage facilities during normal business hours. They shall also allow the review and copying of the storage facility’s SOP for blood component storage and quality assurance records relating to blood component storage and handling.

Inspection of storage records is performed by United Blood Services on an annual basis, unless the facility has current AABB certification and two consecutive years of satisfactory inspections. In these cases, the inspection is performed every two years. Results of the inspection are shared with the transfusion facility.

During the inspection, United Blood Services employees will complete an inspection checklist when observing storage devices. There is one checklist for each temperature range:

  • Storage at 20-24C: BS 983A
  • Storage at 1-6C: BS 983B
  • Storage at or colder than –18C: BS 983C