DEHP and blood transfusion

Blood storage bags and the tubing used to collect and store blood components contain di-(2-ethylhexyl) phthalate (DEHP).

What is DEHP?

DEHP is a plasticiser used in many medical products that’s flexible and has a beneficial effect on red cells during storage as it considerably increases the shelf life of products.

DEHP is widespread in our environment with everyday exposure through food, plastic products, air and water. Phthalates, including DEHP, are in a huge number of common items, from plastic household products to food and drink containers, flooring, roofing, wall coverings, cables, paints, pharmaceutical products and clothing.

Are there any side effects from DEHP?

In more than 40 years of its use in medical products, there have been no significant adverse effects demonstrated in humans.

Use of PVC medical devices may lead to a higher exposure to DEHP compared to everyday sources affecting the general population. 

Several procedures may lead to high exposure from DEHP potentially leaching from the device used such as: 

  • exchange transfusion of blood in neonates 
  • extracorporeal membrane oxygenation (ECMO) treatment of neonates and adults 
  • total parenteral nutrition (TPN) in neonates 
  • haemodialysis 
  • enteral nutrition in neonates and adults 
  • heart transplantation or coronary artery bypass graft surgery 
  • massive blood transfusion of red blood cells and plasma, or 
  • peritoneal dialysis. 

Some blood bags and tubing contain DEHP which means patients receiving blood products, especially those who are very small and/or receive a large number of transfusions, are at risk of exposure. Lifeblood manages this risk by ensuring at-risk groups receive blood products that have been stored for the shortest possible time as these have less DEHP.

Lifeblood continues to monitor research for potential DEHP alternatives. However, as long as it remains in use, the small risk of exposure in blood transfusions should be considered in the context of the considerable benefits of the treatment.