Author: Jose Quesada, Senior Director, Manufacturing, Transfusion Services and IRL and Components
Every blood donation represents an individual’s voluntary and altruistic commitment to helping save the lives of others. As blood centers, we have a responsibility to honor that gift by ensuring each donation is used to its fullest potential while maintaining the quality and safety standards that patients and healthcare providers expect.
At South Texas Blood & Tissue (STB&T), a review of our discard data revealed an important opportunity. A subset of whole blood units collected for our Low-Titer O Whole Blood (LTOWB) program were being discarded because they either exceeded our titer threshold or experienced prolonged collection times (greater than 15 and less than 20 minutes). While these units no longer met the requirements for LTOWB use, we recognized that the red blood cells themselves might still represent a valuable transfusion resource. This observation led us to ask a simple but important question:
Could transfusable blood components be recovered from these units rather than be discarded?
The answer to this question became the foundation for a project designed to determine whether donations could be safely recovered and repurposed into high-quality blood components, thereby maximizing the value of every blood donor contribution.
Project Overview: Why High-Titer and Long-Draw Whole Blood Units Were Being Discarded
STB&T maintains a dedicated Low-Titer O Whole Blood donor program to support prehospital transfusion, trauma resuscitation, and emergency patient care. To qualify, donors must meet the program’s low-titer threshold of less than 1:256 IgM anti-A and anti-B antibodies and are retested annually to confirm eligibility.
When donors exceed this threshold, their units are classified as high titer and become ineligible for the LTOWB program. Similarly, whole blood collections with prolonged draw times may fail to meet established manufacturing criteria for whole blood products.
Historically, these units were discarded because they could not be used within the LTOWB program. However, ineligibility for use as whole blood products does not necessarily diminish the potential value of the red blood cells contained within the donation.
Turning a Discard Stream into a Recovery Opportunity
Our objective was straightforward: to determine whether high-titer and long-draw whole blood units could be further manufactured into leukoreduced packed red blood cells while maintaining established quality standards.
The project was driven by several goals:
- Maximize the value of every blood donation
- Reduce avoidable product waste
- Improve utilization of collected blood products
- Increase the availability of transfusion-ready components
- Explore a sustainable manufacturing pathway that could potentially benefit other blood centers
Developing a New Manufacturing Pathway
To evaluate the feasibility of component recovery, eligible high-titer and long-draw whole blood units were processed using a hard-spin centrifugation method. Following centrifugation, the packed red blood cells were manually separated from the plasma component.
The plasma was retained as recovered plasma, while the red blood cells underwent leukoreduction and quality control evaluation before being labeled as leukoreduced CPDA-1 packed red blood cells.
Throughout the process, component handling, labeling, traceability, and quality assessments were carefully managed to ensure compliance with established manufacturing, quality, and regulatory requirements.
Results: Recovering Valuable Blood Components
The results of this project demonstrated that this approach can successfully recover usable blood products from units that would otherwise have been discarded.
Between March 30 and May 31, 2026, STB&T further manufactured 83 whole blood units, including:
- 37 high-titer units
- 46 long-draw units
The resulting packed red blood cells successfully met the required quality standards for release. Only one unit was discarded because of a clot or filter-related issue.
These findings suggest that whole blood units excluded from LTOWB use can still provide meaningful value through further manufacturing. More importantly, the project demonstrated that operational discard streams may contain opportunities to recover additional transfusion-ready components without increasing donor collections.
Key Insights for Blood Centers
Several important lessons emerged from this work that other blood centers may benefit from:
- Operational Data Can Reveal Hidden Opportunities
Routine review of manufacturing and discard data can identify opportunities that may not be immediately apparent. What initially appeared to be a relatively small discard category ultimately represented a meaningful source of recoverable blood and blood components. - Innovation Does Not Always Require New Collections
Opportunities to improve the blood supply do not always require expansion of donor recruitment efforts. In many cases, the greatest impact may come from improving utilization of donations already being collected. - Donor Stewardship Matters
Every donation represents a commitment made by a volunteer blood donor to help patients in need. Recovering usable blood components from units that would otherwise be discarded helps ensure that these gifts achieve the greatest possible impact and reinforces our responsibility as stewards of the blood supply. - Collaboration Is Essential
Successful implementation requires close collaboration among donor collections, manufacturing, quality, laboratory, medical, and regulatory teams. A carefully designed and controlled process is essential for maintaining product quality, ensuring regulatory compliance, and supporting patient safety.
Conclusion
This project demonstrated that whole blood units excluded from LTOWB use because of elevated titers or prolonged collection times can be successfully converted into transfusion-ready leukoreduced packed red blood cells while maintaining established quality standards.
By reexamining traditional discard practices and identifying opportunities for component recovery, blood centers can improve utilization of existing donations, reduce product waste, and maximize the lifesaving potential of every donor gift. As demands on the blood supply continue to grow, innovative approaches that enhance stewardship of donated blood will become increasingly important to supporting patients and healthcare systems alike.
To learn more about this project or reach the author, please email Jose.Quesada@southtexasblood.org
Review the study findings here: Download the research poster
