Doubling the 30-minute rule

The Issue

Doubling the 30-minute rule to reduce waste without compromising red blood cell quality and safety

Since the 1970s, blood operators have limited the length of time red blood cells (RBCs) can be exposed to uncontrolled temperatures to 30 minutes. Called the “30-minute rule”, this international standard was put in place to keep cells usable and limit bacterial growth. However, it is not always possible to transfuse a patient within 30 minutes. As a result, thousands of RBCs are discarded.

The Evidence

Canadian Blood Services’ researchers studied bacteria-free and bacteria-spiked RBCs that were exposed to room temperature for various lengths of time, checking them for quality, temperature and bacterial growth. Results showed that exposing units to room temperature for up to 60 minutes several times during their shelf life did not reduce their quality or safety.

The Impact

This Canadian Blood Services’ research, in collaboration with Héma-Québec, contributed to the Canadian Standards Association’s decision to extend the 30-minute rule to 60 minutes. Effective in 2016, this new standard will reduce the number of units of RBCs discarded and is expected to save the blood system significant funds without affecting blood product efficacy or patient safety. On average, Canadian hospitals (excluding Quebec) discard 119 RBCs each month because of improper storage, including discards because of the 30-minute rule, at a cost of approximately C$40,000/month.

For Canadian Blood Services, the change may lower the number of RBCs discarded during manufacturing, although there are relatively few of these. The Canadian research, together with research from international partners, provided additional evidence to the community to reform standards internationally.

This research was led by Dr. Sandra Ramirez-Arcos.

RED Blog post: Challenging the 30-minute rule for red blood cells (video)

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