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Munyikwa R, Walker L, Rajendran R. Improvement in Platelet Product Wastage and Reduction of Costs through Implementation of the Pan Genera Detection Test. Lab Med 2023; 54:287-290. [PMID: 36242595 DOI: 10.1093/labmed/lmac111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the effects of Pan Genera Detection (PGD) testing on reducing platelet product wastage and transfusion service costs. METHODS We conducted a retrospective cross-sectional study comparing the number of platelet apheresis units wasted before (March 2017 to February 2019) and after (March 2019 to February 2021) PGD implementation. The PGD testing was performed before transfusion on days 6 and 7. Cost analysis considered the costs of platelet units wasted ($500.00/unit) and PGD test supplies and performance (estimated $26.50 per test). Paired samples t-test was used to compare platelet wastage pre- and post-PGD implementation. RESULTS The number of wasted platelet units decreased from pre-PGD (419) to post-PGD (195), representing a significant decrease in platelet wastage from 17.5% to 9.2% (P < .0001). During the post-PGD period, 366 and 133 units were tested on days 6 and 7, with 28 and 36 units discarded each day, allowing transfusion of an additional 302 platelet units. Costs from platelet wastage decreased from $209,500.00 pre-PGD to $97,500.00 post-PGD. CONCLUSION Our results showed that PGD testing effectively reduced platelet wastage, extended platelet availability, and reduced transfusion service costs.
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Affiliation(s)
- Ru Munyikwa
- Department of Clinical Laboratory Sciences, University of Texas Medical Branch, Galveston, TX, USA
| | - LeeAnn Walker
- Department of Clinical Laboratory Sciences, University of Texas Medical Branch, Galveston, TX, USA
| | - Rajkumar Rajendran
- Department of Clinical Laboratory Sciences, University of Texas Medical Branch, Galveston, TX, USA
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Yang M, Chen X, Luo Z. Optimal ordering policy for platelets: Data-driven method vs model-driven method. FUNDAMENTAL RESEARCH 2021. [DOI: 10.1016/j.fmre.2021.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Lee HJ, Oh SH, Jo SY, Kim IS. Platelet Inventory Management Program: Development and Practical Experience. Ann Lab Med 2021; 41:95-100. [PMID: 32829584 PMCID: PMC7443520 DOI: 10.3343/alm.2021.41.1.95] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/02/2020] [Accepted: 08/02/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Patients with ongoing or expected bleeding require platelet (PLT) transfusions; however, owing to the testing required after a blood donation, manufacturing PLT products may take 1.5-2.0 days after a request is made. This supply-demand mismatch leads clinicians to retain spare PLTs for transfusions, leading to increased PLT discard rates. We developed a PLT inventory management program to supply PLTs more efficiently to patients requiring PLT transfusions within the expiration date, while reducing PLT discard rates. METHODS PLT concentrates (58,863 and 58,357 units) and apheresis products (7,905 and 8,441 units) were analyzed from May 2015 to November 2017 and from December 2017 to January 2020, respectively. We developed a program to manage total PLT inventories and prospective PLT transfusion patients based on blood type, blood product, and remaining period of efficacy; the program facilitates PLT preparation transfer to non-designated patients within the remaining period of efficacy. RESULTS The overall PLT concentrate discard rate was 3,254 (2.78%): 1,811 (3.07%) units before and 1,443 units (2.41%) after program application (P<0.001). The discard rate owing to expiration was reduced from 69 units (3.81%) before to two units (0.14%) after program application (P<0.001). CONCLUSIONS This program can guide the allocation of PLT preparations based on the remaining period of efficacy, enabling PLT products to be used before their expiration date and reducing PLT product discard rate.
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Affiliation(s)
- Hyun-Ji Lee
- Department of Laboratory Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Seung-Hwan Oh
- Department of Laboratory Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Su-Yeon Jo
- Department of Laboratory Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - In-Suk Kim
- Department of Laboratory Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
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Flint AW, McQuilten ZK, Irwin G, Rushford K, Haysom HE, Wood EM. Is Platelet Expiring Out of Date? A Systematic Review. Transfus Med Rev 2019; 34:42-50. [PMID: 31685352 DOI: 10.1016/j.tmrv.2019.08.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 08/16/2019] [Accepted: 08/29/2019] [Indexed: 10/25/2022]
Abstract
Current platelet concentrates are perishable blood products with short shelf lives. Combined with often unpredictable demand, this results in platelet inventory management problems, manifested by high rates of outdating frequently reported at 10% to 20%, and sometimes inadequate clinical supply. The objective of this study was to critically review the published methodologies on measures to reduce platelet outdating rates, in order to determine how platelet outdating and availability can be improved. We performed a systematic review of journal articles published in English to May 2019 identified from MEDLINE, with reported methods to improve platelet inventory outdating rates and availability. The complexity of each methodology was scored based on whether a typical blood bank manager could design, implement and run a platelet outdating program based on the methodology. Twenty-four relevant citations were found-these included 8 citations employing operational research (OR) methodologies, 7 evaluation/best practice, 6 simulation and 3 forecasting. Over half the included studies have been published within the last decade. The citations reporting the lowest predicted outdating were also the most complex methods. Overall predicted outdating and shortages were less than 4% based on the available data. In conclusion, we found that research interest in platelet inventory management problems has increased in line with platelet demand and methods to assist in reducing outdating rates without increased shortages have been available now for 4 decades; high rates of platelet outdating do however continue to be reported around the world. Developments in platelet preparation and storage, and other new approaches, may assist in addressing this problem.
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Affiliation(s)
- Andrew Wj Flint
- Transfusion Research Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia; The Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Royal Australian Navy, Australia
| | - Zoe K McQuilten
- Transfusion Research Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia; The Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Monash Health, Melbourne, Australia
| | | | | | - Helen E Haysom
- Transfusion Research Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Erica M Wood
- Transfusion Research Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia; Monash Health, Melbourne, Australia.
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Barnett CL, Mladsi D, Vredenburg M, Aggarwal K. Cost estimate of platelet transfusion in the United States for patients with chronic liver disease and associated thrombocytopenia undergoing elective procedures. J Med Econ 2018; 21:827-834. [PMID: 29912593 DOI: 10.1080/13696998.2018.1490301] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
AIMS This study aimed to estimate the cost of platelet transfusion in patients with chronic liver disease (CLD)-associated thrombocytopenia undergoing an elective procedure in the United States. MATERIALS AND METHODS The study was conducted in two parts: development of a conceptual framework identifying direct, indirect and intangible costs of platelet transfusion, followed by the estimation of the total cost of platelet transfusion in patients with CLD-associated thrombocytopenia before an elective procedure in the United States using the conceptual framework and cost data obtained from a literature search. The cost of the entire care required to raise a patient's platelet count before the procedure was considered. RESULTS The final conceptual framework included the costs of generating the supply of platelets, the platelet transfusion itself, adverse events associated with platelet transfusion and refractoriness to platelet transfusion. When costs were accounted for in all the framework cost categories, the total direct cost of a platelet transfusion in a patient with CLD and associated thrombocytopenia was estimated to be in the range of $5258 to $13,117 (2017 US dollars) in the United States. The largest portion of costs was incurred by the transfusion event itself ($3723 to $4436) and the cost of refractoriness ($874 to $7578), which included the opportunity cost of a delayed procedure and subsequent platelet transfusions with human leukocyte antigen-matched platelets. LIMITATIONS AND CONCLUSIONS Although we were unable to include all cost components identified in the conceptual framework in our total cost estimate, thus likely underestimating the true total cost, and despite the data gaps and challenges limiting our estimate of the full cost of a platelet transfusion in patients with CLD-associated thrombocytopenia undergoing an elective procedure in the United States, this study outlines a comprehensive conceptual framework for estimating the cost elements of a platelet transfusion in these patients.
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Affiliation(s)
| | - Deirdre Mladsi
- a RTI Health Solutions, Research Triangle Park , NC , USA
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de Kort W, van Kraaij M, van den Hurk K. Donor base management: painting Gabriel's horn - Comment on Beckman et al., 2016. Transfus Med 2017; 27:460-461. [PMID: 29282808 DOI: 10.1111/tme.12499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 12/04/2017] [Indexed: 11/28/2022]
Affiliation(s)
- W de Kort
- Donor Studies Department, Sanquin Blood Supply, Amsterdam, the Netherlands
| | - M van Kraaij
- Donor Studies Department, Sanquin Blood Supply, Amsterdam, the Netherlands
| | - K van den Hurk
- Donor Studies Department, Sanquin Blood Supply, Amsterdam, the Netherlands
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Javadzadeh Shahshahani H, Taghvai N. Blood wastage management in a regional blood transfusion centre. Transfus Med 2017; 27 Suppl 5:348-353. [DOI: 10.1111/tme.12433] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 04/18/2017] [Accepted: 05/21/2017] [Indexed: 11/30/2022]
Affiliation(s)
- H. Javadzadeh Shahshahani
- Blood Transfusion Research Center; High Institute for Research and Education in Transfusion Medicine; Tehran Iran
| | - N. Taghvai
- Blood Transfusion Research Center; High Institute for Research and Education in Transfusion Medicine; Tehran Iran
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Pérez Vaquero MÁ, Gorria C, Lezaun M, López FJ, Monge J, Eguizabal C, Vesga MA. Optimization of the management of platelet concentrate stocks in the Basque Country using mathematical simulation. Vox Sang 2016; 110:369-75. [DOI: 10.1111/vox.12377] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 11/03/2015] [Accepted: 12/10/2015] [Indexed: 12/01/2022]
Affiliation(s)
- M. Á. Pérez Vaquero
- Basque Centre for Transfusion and Human Tissues (CVTTH) Galdakao Bizkaia Spain
| | - C. Gorria
- Department of Applied Mathematics, Statistics and Operations Research University of the Basque Country ‐ UPV/EHU Leioa Bizkaia Spain
| | - M. Lezaun
- Department of Applied Mathematics, Statistics and Operations Research University of the Basque Country ‐ UPV/EHU Leioa Bizkaia Spain
| | - F. J. López
- Department of Statistical Methods Institute for Biocomputation and Physics of Complex Systems (BIFI) University of Zaragoza Zaragoza Spain
| | - J. Monge
- Basque Centre for Transfusion and Human Tissues (CVTTH) Galdakao Bizkaia Spain
| | - C. Eguizabal
- Basque Centre for Transfusion and Human Tissues (CVTTH) Galdakao Bizkaia Spain
| | - M. A. Vesga
- Basque Centre for Transfusion and Human Tissues (CVTTH) Galdakao Bizkaia Spain
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Yazer MH, Deandrade DS, Triulzi DJ, Wisniewski MK, Waters JH. Electronic enhancements to blood ordering reduce component waste. Transfusion 2015; 56:564-70. [DOI: 10.1111/trf.13399] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Revised: 09/18/2015] [Accepted: 09/18/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Mark H. Yazer
- Department of Pathology
- The Institute for Transfusion Medicine
| | | | | | - Mary Kay Wisniewski
- the Donald D. Wolff Jr. Center for Quality, Safety, and Innovation at UPMC; and the McGowan Institute for Regenerative Medicine; Pittsburgh Pennsylvania
| | - Jonathan H. Waters
- Department of Anesthesiology
- Department of Bioengineering; University of Pittsburgh
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10
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Dunbar NM. Modern solutions and future challenges for platelet inventory management. Transfusion 2015; 55:2053-6. [DOI: 10.1111/trf.13192] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 05/05/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Nancy M. Dunbar
- Department of Pathology and Department of Medicine; Dartmouth-Hitchcock Medical Center; Lebanon NH
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11
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Alwan LC, Xu M, Yao DQ, Yue X. The Dynamic Newsvendor Model with Correlated Demand. DECISION SCIENCES 2015. [DOI: 10.1111/deci.12171] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Layth C. Alwan
- Sheldon B. Lubar School of Business; University of Wisconsin-Milwaukee; Milwaukee WI
| | - Minghui Xu
- School of Economics and Management; Wuhan University; Wuhan 430072 China
| | - Dong-Qing Yao
- College of Business and Economics; Towson University; Baltimore MD
| | - Xiaohang Yue
- Sheldon B. Lubar School of Business; University of Wisconsin-Milwaukee; Milwaukee WI
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Gomez AT, Quinn JG, Doiron DJ, Watson S, Crocker BD, Cheng CKW. Implementation of a novel real-time platelet inventory management system at a multi-site transfusion service. Transfusion 2015; 55:2070-5. [DOI: 10.1111/trf.13081] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 02/01/2015] [Accepted: 02/01/2015] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Donald Joseph Doiron
- Pathology Informatics Group; Capital District Health Authority; Halifax Nova Scotia Canada
| | - Stephanie Watson
- Pathology Informatics Group; Capital District Health Authority; Halifax Nova Scotia Canada
| | - Bryan David Crocker
- Pathology Informatics Group; Capital District Health Authority; Halifax Nova Scotia Canada
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14
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Asllani A, Culler E, Ettkin L. A simulation-based apheresis platelet inventory management model. Transfusion 2014; 54:2730-5. [DOI: 10.1111/trf.12570] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 12/10/2013] [Accepted: 12/10/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Arben Asllani
- College of Business; University of Tennessee at Chattanooga; Chattanooga Tennessee
| | | | - Lawrence Ettkin
- College of Business; University of Tennessee at Chattanooga; Chattanooga Tennessee
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15
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Smid WM, Buining R, de Kort W. Blood supply management: experience and recommendations from the Netherlands. ACTA ACUST UNITED AC 2013. [DOI: 10.1111/voxs.12012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- W. M. Smid
- Sanquin Blood Supply; Groningen and Amsterdam; the Netherlands
| | - R. Buining
- Sanquin Blood Supply; Groningen and Amsterdam; the Netherlands
| | - W. de Kort
- Sanquin Blood Supply; Groningen and Amsterdam; the Netherlands
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Abstract
Although blood suppliers are seeing short-term reductions in blood demand as a result of initiatives in patient blood management, modelling suggests that during the next 5-10 years, blood availability in developed countries will need to increase again to meet the demands of ageing populations. Increasing of the blood supply raises many challenges; new approaches to recruitment and retainment of future generations of blood donors will be needed, and care will be necessary to avoid taking too much blood from these donors. Integrated approaches in blood stock management between transfusion services and hospitals will be important to minimise wastage--eg, by use of supply chain solutions from industry. Cross-disciplinary systems for patient blood management need to be developed to lessen the need for transfusion--eg, by early identification and reversal of anaemia with haematinics or by reversal of the underlying cause. Personalised medicine could be applied to match donors to patients, not only with extended blood typing, but also by using genetically determined storage characteristics of blood components. Growing of red cells or platelets in large quantities from stem cells is a possibility in the future, but challenges of cost, scaling up, and reproducibility remain to be solved.
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Optimization of platelet concentrate quality: application of proteomic technologies to donor management. J Proteomics 2012; 76 Spec No.:329-36. [PMID: 22771519 DOI: 10.1016/j.jprot.2012.06.023] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2012] [Revised: 06/22/2012] [Accepted: 06/26/2012] [Indexed: 01/14/2023]
Abstract
Quality management of blood products is essential for blood banking. It is influenced by both processing and donor characteristics and assured by monitoring routine in vitro parameters to defined product specifications. However, these measures correlate poorly with the in vivo behavior of transfused platelets and cannot be used to select optimal donors. Since radiolabeled platelet recovery and survival studies are expensive and time consuming, there is an ongoing search for simpler measures that predict platelet transfusion outcomes. We performed a pilot study using semi-qualitative proteomics to assess changes in the platelet protein profile of donors with either acceptable or unacceptable in vivo radiolabeled autologous platelet recovery and survival measurements. Proteins changing during a 9-day storage period included cytoskeletal elements talin, vinculin and moesin as well as signal transduction proteins 14-3-3, RhoGDI and Rap1. Two of nine donations exhibited a decrease in these proteins and poor in vivo platelet recovery and survival whereas the remaining donors showed acceptable platelet recovery and survival and expected protein profiles. Analyses revealed a significant correlation between protein levels of Rap1 and RhoGDI during storage and platelet recovery and survival. This study provides for the first time preliminary data showing evidence of the utility of protein profiling to predict platelet transfusion quality. This article is part of a Special Issue entitled: Integrated omics.
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