Stem Cell Transport in 2013: Introducing the Credo Cooler to TOH BMT Program

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Allen O’Brien’
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1 Stem Cell Transport in 2013: Introducing the Credo Cooler to TOH BMT Program Carey Landry, PhD Program Analyst The Ottawa Hospital Blood and Marrow Transplant Program Why Change Coolers? Need to take advantage of current technologies for improved reliability and quality in SC product transport 2 1

Credo Cooler Developed by Minnesota Thermal Science (MTS), with rigorous testing/validation. Originally designed for U.S. military transport of blood supplies to far reaching combat zones under extreme temperature conditions.

2 Credo Cooler Developed by Minnesota Thermal Science (MTS), with rigorous testing/validation. Originally designed for U.S. military transport of blood supplies to far reaching combat zones under extreme temperature conditions. Validated externally by the National Marrow Donor Program (NMDP) specifically for transporting marrow and apheresis derived hematopoietic progenitor cells and therapeutic cells. Currently being validated by TOH BMT program, and other Canadian Transplant Centres. 3 Credo Cooler: Parts and Specs Fabric shell Vaccuum Insulated Panel (VIP) Container Improved retention of internal temperature 6 Thermal Insulated Chamber (TIC) panels Contains Phase Change Material (PCM) for improved temperature control 12.5 x 10.5 x 10.5 in 11 lbs (no load; TIC panels included) Fabric Shell VIP Container TIC Panels (aka PCM Plates) 4 2

Apheresis Product (Stem Cell) Transport TIC panels require freezing for at least 24 hours, plus 25 minute pack out from freezer prior

5 Courier Instruction Stem Cells Prior to Departure 1) Freeze TIC panels in home freezer (min. of 24 hr).

4) Place five TIC panels in VIP container, creating the base and side walls of the Credo cooler.

3 Apheresis Product (Stem Cell) Transport TIC panels require freezing for at least 24 hours, plus 25 minute pack out from freezer prior to cooler assembly. This will create a refrigeration temperature environment for transport (1 10 o C). 5 Courier Instruction Stem Cells Prior to Departure 1) Freeze TIC panels in home freezer (min. of 24 hr). 2) Take TIC panels out of freezer (called pack out ). Check for sloshing sound. 3) Lay flat at room temperature for 25 min. 4) Place five TIC panels in VIP container, creating the base and side walls of the Credo cooler. 5) Place temperature monitor/probe in the pre cooled container. 6) Replace last TIC panel over top, close VIP lid, fasten Velcro, and zip fabric shell closed. 7) Ensure you have all additional required courier travel items and documentation. 6 3

Courier Instruction Stem Cells NOTE: For overseas pickup or pick ups occurring > 48 hours after initial departure, re freeze plates at hotel or

This extra step does not replace the need for initial freezing prior to departure.

2) Place product in Ziploc bag and specimen tubes in separate biohazard bag (with packing slip). 3) Open cooler, remove top TIC panel.

4 Courier Instruction Stem Cells NOTE: For overseas pickup or pick ups occurring > 48 hours after initial departure, re freeze plates at hotel or Collection Centre, and pack out 25 minutes prior to assembly for product pickup. This extra step does not replace the need for initial freezing prior to departure. 7 Courier Instruction Stem Cells At Pickup 1) Complete relevant fields on form: Courier Transportation Record Unrelated Stem Cell Product. 2) Place product in Ziploc bag and specimen tubes in separate biohazard bag (with packing slip). 3) Open cooler, remove top TIC panel. Record time (EST) and temperature on Transportation Record form. 4) Affix the temperature probe on product. 5) Wrap product and specimen tubes in non insulated filler sheet. Place items in cooler with temperature monitor, replacing top PCM plate quickly to minimize warming. 6) Close VIP lid, fasten Velcro, and zip fabric shell closed. 8 4

5 Completing the Courier Transportation Record Stem Cells * *Should be within 1 10 o C range 9 Courier Instruction Stem Cells In Transit 1) If the cooler is opened at any time during transit, record the time (EST) and temperature on the Transportation Record. On Arrival 1) Deliver the product and specimens to The Ottawa Hospital, Transfusion Medicine (3rd floor). 2) Deliver product container with contents to transfusion medicine staff and obtain signatures. Document the time and temperature on the Transportation Record. 3) Place all other documents, including transport document in envelope and leave it with the product. 4) The cooler will be stored 4 o C. 5) If assistance is needed after hours call the BMT Physician on call:

Marrow Product Transport No TIC panels required Transport at Room Temperature (15 25 o C) 11 Courier Instruction Marrow Prior to Departure 1) Ensure you have VIP container in fabric shell,

2) Place product in Ziploc bag and specimen tubes in separate biohazard bag (with packing slip). 3) Open container. Record time (EST) and temperature on Transportation Record form.

6 Marrow Product Transport No TIC panels required Transport at Room Temperature (15 25 o C) 11 Courier Instruction Marrow Prior to Departure 1) Ensure you have VIP container in fabric shell, temperature probe and all additional required courier travel items and documentation. At Pickup 1) Complete relevant fields on form: Courier Transportation Record Unrelated Stem Cell Product. 2) Place product in Ziploc bag and specimen tubes in separate biohazard bag (with packing slip). 3) Open container. Record time (EST) and temperature on Transportation Record form. 4) Affix the temperature probe on product. 5) Wrap product and specimen tubes in non insulated filler sheet. Place items in container with temperature monitor. 6) Close VIP lid, fasten Velcro, and zip fabric shell closed. 12 6

7 Courier Instruction Marrow In Transit 1) If the container is opened at any time during transit, record the time (EST) and temperature on the Transportation Record. On Arrival 1) Deliver the product and specimens to The Ottawa Hospital, Transfusion Medicine (3rd floor). 2) Deliver product container with contents to transfusion medicine staff and obtain signatures. Document the time and temperature on the Transportation Record. 3) Place all other documents, including transport document in envelope and leave it with the product. 4) If assistance is needed after hours call the BMT Physician on call: Completing the Courier Transportation Record Marrow * *Should be in room temperature range 14 7

Considerations The cooler should remain in your sight at all times between time of product pick up at Collection Centre and Drop off at Transfusion Medicine.

8 Considerations The cooler should remain in your sight at all times between time of product pick up at Collection Centre and Drop off at Transfusion Medicine. Exception: On the plane, the credo cooler can be stored in the overhead compartment directly above your seat if it will not fit under your seat. Pre boarding the plane with priority seating is recommended; ask the stewardess for assistance if required. 15 Information Resources Courier Training Session Courier Checklist Courier Instructions BMT Staff Coming soon: Training Video BMT P&P C

9 Questions/Comments Carey Landry, PhD Program Analyst, Donor Search and Quality Management TOH Blood and Marrow Transplant Program ext

The transfer of all HPC products should be transferred to and from the courier in a clinical setting.

The transfer of all HPC products should be transferred to and from the courier in a clinical setting. INTRODUCTION The WMDA is a worldwide network of organisations that provide haematopoietic progenitor cells (HPC) from voluntary unrelated donors to those in need of hematopoietic stem cell transplantation.