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Trochanowska-Pauk N, Walski T, Bohara R, Mikolas J, Kubica K. Platelet Storage-Problems, Improvements, and New Perspectives. Int J Mol Sci 2024; 25:7779. [PMID: 39063021 PMCID: PMC11277025 DOI: 10.3390/ijms25147779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 07/10/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
Platelet transfusions are routine procedures in clinical treatment aimed at preventing bleeding in critically ill patients, including those with cancer, undergoing surgery, or experiencing trauma. However, platelets are susceptible blood cells that require specific storage conditions. The availability of platelet concentrates is limited to five days due to various factors, including the risk of bacterial contamination and the occurrence of physical and functional changes known as platelet storage lesions. In this article, the problems related to platelet storage lesions are categorized into four groups depending on research areas: storage conditions, additive solutions, new testing methods for platelets (proteomic and metabolomic analysis), and extensive data modeling of platelet production (mathematical modeling, statistical analysis, and artificial intelligence). This article provides extensive information on the challenges, potential improvements, and novel perspectives regarding platelet storage.
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Affiliation(s)
- Natalia Trochanowska-Pauk
- Department of Physics and Biophysics, The Faculty of Biotechnology and Food Science, Wrocław University of Environmental and Life Sciences, 50-375 Wrocław, Poland;
| | - Tomasz Walski
- Department of Biomedical Engineering, Faculty of Fundamental Problems of Technology, Wrocław University of Science and Technology, 50-370 Wrocław, Poland;
| | - Raghvendra Bohara
- Centre for Interdisciplinary Research, D.Y. Patil Educational Society, Kolhapur 416006, India;
| | - Julia Mikolas
- Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 41-800 Zabrze, Poland
| | - Krystian Kubica
- Department of Biomedical Engineering, Faculty of Fundamental Problems of Technology, Wrocław University of Science and Technology, 50-370 Wrocław, Poland;
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2
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Patidar GK, Gupta V, Hazarika A. Optimizing blood utilization: Experience of blood redistribution policy from a tertiary care hospital based blood centre. Transfus Med 2024; 34:231-233. [PMID: 38536009 DOI: 10.1111/tme.13037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 03/15/2024] [Accepted: 03/19/2024] [Indexed: 07/03/2024]
Affiliation(s)
- Gopal K Patidar
- Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Vidushi Gupta
- Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Anjali Hazarika
- Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India
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3
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Javadzadeh Shahshahani H, Sharifi S, Nasizadeh S. Impact of Implementing a Standard Operating Procedure to Reduce Blood Wastage in Blood Centers of Iran. ARCHIVES OF IRANIAN MEDICINE 2024; 27:89-95. [PMID: 38619032 PMCID: PMC11017257 DOI: 10.34172/aim.2024.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 01/07/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND Blood wastage leads to additional costs and reduced blood availability to patients. Above all is the moral issue of wasting donor gifts. This study aimed to determine the rate of blood wastage before and after implementing a new standard operating procedure (SOP) in Iran. METHODS In this interventional study, a SOP for wastage management was prepared and implemented in all blood centers throughout the country. Data were extracted from the integrated software of the Iranian Blood Transfusion Organization (IBTO). The wastage rate of blood components in the post-intervention years (2016-2017) was then compared with that in the pre-intervention years (2013-2015) using the Z test. RESULTS The overall wastage rate decreased by 36.86% (P<0.001, 95% CI [36.84-36.88]) after the intervention. Red blood cell (RBC) wastage decreased from 2.6% to 2.5%, platelet wastage from 19.5% to 10.6% and plasma wastage from 15.5% to 7.3% (P<0.001). The highest percentage of waste reduction pertained to plasma components, which decreased by 52.90% (P<0.001, 95% CI [52.86-52.94]). Expiration was the most common cause of RBC and platelet wastage. The most common causes of plasma wastage were RBC contamination and rupture or leakage of the bags. The intervention resulted in a drop of over 250000 discarded components each year, equal to approximately thirty-six million dollars in savings. CONCLUSION This intervention effectively reduced waste and increased efficiency. Ongoing blood wastage reviews, auditing, and receiving feedback from the central headquarters were powerful tools in following the compliance of blood centers. Further studies are recommended, especially concerning blood wastage in hospital blood banks and various wards.
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Affiliation(s)
| | - Shahin Sharifi
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Soheila Nasizadeh
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
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4
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Gnanaraj J, Kulkarni R, Sahoo D, Basavarajegowda A. Audit-based corrective and preventive actions to reduce wastage of blood components at a single blood center: A quality improvement study. Asian J Transfus Sci 2024; 18:27-34. [PMID: 39036679 PMCID: PMC11259350 DOI: 10.4103/ajts.ajts_131_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/29/2022] [Accepted: 12/18/2022] [Indexed: 07/23/2024] Open
Abstract
INTRODUCTION The rate of discarded blood components or "wastage rate" reflects on the whole process, preparation, and production of blood and its quality control. It is the ratio of blood and blood components discarded to the total number of collections. The discard or unusability of blood products are many, and the ones that can be monitored and regarded as indicators to be improvised on are QC failure rate, transfusion-transmitted infection (TTI) positivity, and component discards (other than TTI), including those that caused transfusion reactions. These were studied over four intervention cycles to see if they could be improved. MATERIALS AND METHODS This was a clinical audit and quality improvement study. The clinical audit was conducted over four cycles over 16 months. Each cycle included three stages wherein the data required for calculating those key performance indicators (KPIs) of the blood center were studied and analyzed, and causes for the poorly performing ones were identified; a corrective plan was drawn and implemented, followed by data collection and interpretation of the same in the next cycle for improvement. The data were compiled using a Microsoft Excel spreadsheet and analyzed using SPSS version 19 (IBM Corporation, New York, USA). RESULTS The overall discard rates due to all cumulative causes mentioned were at about 5% at the start of the first cycle. The various factors comprising preparatory, preparation, and the management of inventory and issue were analyzed, and corrective interventions were performed in every cycle. The discard rates were reduced to about 3% by the end of the four cycles. The difference was statistically significant, with a P < 0.05. CONCLUSION The implementation of Corrective and preventive action measures can rectify the deviations in KPIs. The blood center director, staff, and doctors should be responsible for maintaining and continuously improving the quality indicators.
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Affiliation(s)
- John Gnanaraj
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Rajendra Kulkarni
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Dibyajyoti Sahoo
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Abhishekh Basavarajegowda
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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5
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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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6
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Jiang L, Zhang G, Hao K, Xiang W, Zhang Q, Xie Y, Wang Z, Chen B, Du Y. Electronic transfusion consent and blood delivering pattern improve the management of blood bank in China. BMC Health Serv Res 2022; 22:561. [PMID: 35473708 PMCID: PMC9044836 DOI: 10.1186/s12913-022-07825-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 03/22/2022] [Indexed: 11/22/2022] Open
Abstract
Background The aim of this study was to improve the blood transfusion treatment consent accuracy, simplify the verification process, prolong the temperature control time before the blood transfusion, and save the blood transportation labor cost. Methods We designed the blood transfusion consent electronic signing process, which can generate personalized the text content and can automatically check the filling accuracy. The signal can be transmitted to the blood transfusion management system (TMS) to relieving the blood distribution. For blood delivering pattern, we established the blood transport center, recruited full-time nurses and used temperature-controlled blood transfer boxes to deliver blood in batches on a regular basis. Results A quarterly data analysis of blood transfusion quality showed a 100% blood transfusion consent accuracy after an electronic signing process was implemented. The average confirmation time savings between the electronic content and paper content was 26 min for the Department of Emergency (estimated difference 95% CI = 26 (20 to 36), p < 0.05). The blood delivering pattern reduced the time for each unit by leaving the average temperature control by 7.24 min (estimated difference 95% CI = 7.24 (6.92 to 7.56), p < 0.05). Furthermore, $3.67 was saved for the blood transportation labor cost for each unit as well. Conclusion Blood transfusion consent electronic signing process not only ensures the accuracy, but also saves the verification time. Moreover, the blood delivering pattern prolongs the blood temperature control time and saves blood transportation labor costs. Thus, these two improvements could enhance transfusion management. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07825-6.
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Affiliation(s)
- Luxi Jiang
- Laboratory Medicine Center, Department of Transfusion Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), No.158 Shangtang Road, Hangzhou, Zhejiang, China
| | - Guobing Zhang
- XianJu People's Hospital, Zhejiang Southeast Campus of Zhejiang Provincial People's Hospital, No.53 Chengbei East Road, Xianju, Zhejiang, China.,Department of Quality Management, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), No.158 Shangtang Road, Hangzhou, Zhejiang, China
| | - Ke Hao
- Laboratory Medicine Center, Department of Transfusion Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), No.158 Shangtang Road, Hangzhou, Zhejiang, China
| | - Weiling Xiang
- Laboratory Medicine Center, Department of Transfusion Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), No.158 Shangtang Road, Hangzhou, Zhejiang, China
| | - Qin Zhang
- Department of Quality Management, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), No.158 Shangtang Road, Hangzhou, Zhejiang, China
| | - Yiwei Xie
- Laboratory Medicine Center, Department of Transfusion Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), No.158 Shangtang Road, Hangzhou, Zhejiang, China
| | - Zhen Wang
- Laboratory Medicine Center, Department of Transfusion Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), No.158 Shangtang Road, Hangzhou, Zhejiang, China.
| | - Bingyu Chen
- Laboratory Medicine Center, Department of Transfusion Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), No.158 Shangtang Road, Hangzhou, Zhejiang, China.
| | - Yaoqiang Du
- Laboratory Medicine Center, Department of Transfusion Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), No.158 Shangtang Road, Hangzhou, Zhejiang, China.
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7
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Mora P, Araujo CAS. Delivering blood components through drones: a lean approach to the blood supply chain. SUPPLY CHAIN FORUM 2022. [DOI: 10.1080/16258312.2021.1984167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Paula Mora
- COPPEAD/UFRJ, Federal University of Rio de Janeiro – UFRJ, Rio de Janeiro, Brazil
| | - Claudia Affonso Silva Araujo
- COPPEAD/UFRJ, Federal University of Rio de Janeiro – UFRJ, Rio de Janeiro, Brazil
- FGV Saúde, São Paulo School of Business Administration - EAESP-FGV, Sao Paulo, Brazil
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8
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Raykar NP, Makin J, Khajanchi M, Olayo B, Munoz Valencia A, Roy N, Ottolino P, Zinco A, MacLeod J, Yazer M, Rajgopal J, Zeng B, Lee HK, Bidanda B, Kumar P, Puyana JC, Rudd K. Assessing the global burden of hemorrhage: The global blood supply, deficits, and potential solutions. SAGE Open Med 2021; 9:20503121211054995. [PMID: 34790356 PMCID: PMC8591638 DOI: 10.1177/20503121211054995] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 10/04/2021] [Indexed: 01/28/2023] Open
Abstract
There is a critical shortage of blood available for transfusion in many low- and middle-income countries. The consequences of this scarcity are dire, resulting in uncounted morbidity and mortality from trauma, obstetric hemorrhage, and pediatric anemias, among numerous other conditions. The process of collecting blood from a donor to administering it to a patient involves many facets from donor availability to blood processing to blood delivery. Each step faces particular challenges in low- and middle-income countries. Optimizing existing strategies and introducing new approaches will be imperative to ensure a safe and sufficient blood supply worldwide.
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Affiliation(s)
- Nakul P Raykar
- Trauma & Emergency General Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.,Departments of Surgery and Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Jennifer Makin
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | | | - Bernard Olayo
- Center for Public Health and Development, Nairobi, Kenya
| | | | - Nobhojit Roy
- Health Systems Strengthening Unit, CARE-India, Bihar, India.,Department of Surgery, KEM Hospital, Mumbai, India
| | - Pablo Ottolino
- Department of Surgery, Hospital Sotero Del Rio, Universidad Católica, Santiago, Chile
| | - Analia Zinco
- Department of Surgery, Hospital Sotero Del Rio, Universidad Católica, Santiago, Chile
| | - Jana MacLeod
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.,Business School, Strathmore University, Nairobi, Kenya
| | - Mark Yazer
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Jayant Rajgopal
- Department of Industrial Engineering, School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Bo Zeng
- Department of Industrial Engineering, School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Hyo Kyung Lee
- Department of Industrial Engineering, School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Bopaya Bidanda
- Department of Industrial Engineering, School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Pratap Kumar
- Business School, Strathmore University, Nairobi, Kenya
| | - Juan Carlos Puyana
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Kristina Rudd
- Department of Critical Care Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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9
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A Proposed Managerial Model for Improvement of Blood Consumption in the Operating Rooms in Southern Iran. HEALTH SCOPE 2021. [DOI: 10.5812/jhealthscope.117666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: The financial burden of blood wastage in operating rooms of hospitals indicates the importance of managing blood consumption. Objectives: To determine the most influential factors affecting blood utilization management in operating rooms. Methods: This cross-sectional study was conducted in the operating rooms of the largest tertiary referral hospital in Southern Iran from September to November 2019. A researcher-made questionnaire was designed, validated, and completed by 185 related stakeholders. Confirmatory factor analysis was conducted. Results: Model fit indices had acceptable values (P = 0.032). In the suggested model, resource allocation (coefficient = 0.81) and control (coefficient = 0.77) were determined as the two most impressive managerial dimensions of blood utilization management. In the resource allocation dimension, the most effective factors were found to be using trained and oriented personnel to inventory management principles and blood bag handling, storage, and transportation rules and providing in-hospital safe and standard blood transportation equipment. In the control dimension, the most influencing subject was evaluating and reporting the reasons for the date expiry of blood products. Conclusions: Implementing a stepwise evidence-based blood consumption program based on the most prioritized suggested initiatives can be highly cost-effective and presented as a practical guide for policymakers, especially in low socio-economic countries. Based on our results, focusing on using trained blood bank staff in all related parts and providing standard blood transportation equipment as well as attempting to minimize the number of discarded blood units in operating rooms can be highly effective in the reduction of blood wastage and improvement of blood consumption status.
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10
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Bahreini S, Javadzadeh Shahshahani H, Nasizadeh S, Ahmadinejad M. The activity of labile coagulation factors and fibrinogen in thawed plasma during a 5 day storage period in the hospital blood bank refrigerator. Transfus Med 2021; 31:494-498. [PMID: 34605106 DOI: 10.1111/tme.12823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/18/2021] [Accepted: 09/07/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Fresh frozen plasma (FFP) is used to treat coagulation disorders. Even though the activity of labile coagulation factors gradually decreases once thawed, it can be used up to 24 h after thawing, if stored properly. In this study, the level of coagulation factor activity was evaluated in thawed plasma during a 5 day storage period. MATERIALS AND METHODS This cross-sectional study was performed on 40 FFP units prepared in Yazd Blood Center. Samples were thawed in a waterbath for 20-30 min at 30-37°C and then stored in the hospital blood bank refrigerator. The level of fibrinogen concentration, as a stable factor and, coagulation factors V and VIII, as labile factors, were measured in the plasma immediately following the thawing process as well as 24 and 120 h after the process. Data analysis was performed using SPSS software 20. RESULTS The fibrinogen level remained stable for up to 24 h after thawing; after 120 h there was a 1.66% decrease with the mean level of 334.0 ± 53.3 mg/dl. The mean activity of factors V and VIII levels decreased by 12.3%, and 26% respectively over 120 h after thawing when compared to that after 24 h. A 120 h after thawing Factor V activity was above 70% in 87.5% of thawed plasmas and its mean activity was 81.6 ± 11.8. Factor VIII activity was above 70% in only 35% of thawed plasmas with the mean activity of 64.4 ± 17.2. CONCLUSION Thawed plasma can be used for up to 5 days in all therapeutic applications of FFP since it still has the essential hemostatic effects. However, in situations where higher levels of FVIII are needed, Thawed Plasma is not a suitable alternative. In such cases FFP, FVIII concentrate or cryoprecipitated antihemophilic factor should be used.
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Affiliation(s)
- Sahar Bahreini
- Faculty of Medicine, Ali ibn Abitaleb, Islamic Azad University, Yazd, Iran
| | | | - Soheila Nasizadeh
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Minoo Ahmadinejad
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
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11
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Gholami M, Miladi S, Riahi L, Keshtvarz Hesam Abadi AM, Haghpanah S. Strategies for improvement of blood consumption management in the operating rooms: experts´ suggestions. J Community Hosp Intern Med Perspect 2021; 11:635-638. [PMID: 34567454 PMCID: PMC8462842 DOI: 10.1080/20009666.2021.1955449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 07/09/2021] [Indexed: 11/30/2022] Open
Abstract
Background: In operating rooms, blood product wastage occurs with various reasons especially over-demand ordering during elective surgeries. Consequently, it imposes a heavy financial burden on health system. Therefore, managing blood consumption in the operating rooms is of special importance. Surgeons and anesthesiologists play a key role in blood transfusion practice in operating rooms. Objective: To investigate surgeons´ and anesthesiologists´ perspectives in regard to the effective strategies for better management of blood transfusion practice in operating rooms. Method: In this qualitative cross-sectional study, from January to March 2020, 60 surgeons and anesthesiologists were participated. All of them were working in surgical departments of the general hospitals affiliated with Shiraz University of Medical Sciences, in Shiraz, Southern Iran. Their viewpoints regarding the improvement of blood consumption management in operating rooms were recorded through interviews and several focus group sessions. Results: After content analysis, the most important recommendations with the highest scores were regular training programs for surgical team (23.3%), collaboration of surgeons, anesthesiologists, and managers of the surgical departments by arrangement of monthly meetings to estimate the number of required blood bags more accurately (23.3%), establishing a well-organized electronic requesting and registration system (13.3%), promoting the ordering process by a comprehensive preoperative evaluation (11.6%), and updating transfusion protocols based on the standards and monitoring the adherence to these standards (10%). Conclusion: Implementing the proposed policies, which are based on the invaluable experiences of related experts would be effective in improving blood consumption management in operating rooms.
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Affiliation(s)
- Maryam Gholami
- Clinical Research Development Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shima Miladi
- Clinical Research Development Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Leila Riahi
- Department of Health Services Management, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | | | - Sezaneh Haghpanah
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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12
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Zhao HW, Serrano K, Stefanoni D, D'Alessandro A, Devine DV. In Vitro Characterization and Metabolomic Analysis of Cold-Stored Platelets. J Proteome Res 2021; 20:2251-2265. [PMID: 33780259 DOI: 10.1021/acs.jproteome.0c00792] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Platelet concentrates are currently stored at room temperature (RP) under constant agitation for up to 5-7 days depending on national regulations. However, platelet quality deteriorates during storage and room-temperature storage also increases the risk of bacterial growth. Previous studies have shown that cold-stored platelets (CPs) have higher hemostatic functions and can be stored for up to 3 weeks. While these studies have compared the metabolic phenotypes of CPs and RPs, they have neither compared the impact of storage temperature and cold agitation (CPAs) on platelet function nor identified metabolic correlates to such parameters. In vitro analysis showed that CPAs and CPs had reduced count, faster CD62P expression, and increased lactadherin binding. Furthermore, CPAs and CPs had higher maximal aggregation and a reduced aggregation lag phase compared to RPs. Metabolomic analysis revealed that CPAs and CPs exhibited lower oxidative stress shown by preserved glutathione and pentose phosphate pools. CPAs and CPs also had reduced markers of beta-oxidation and amino acid catabolism, demonstrating reduced needs for energy. Agitation did not significantly impact in vitro function or metabolomic parameters of cold-stored platelets. Correlation of in vitro and metabolomic results highlighted important metabolites that may contribute to stored platelet functions. Raw data are publicly available through Metabolomics Workbench with the study identifier ST001644.
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Affiliation(s)
- HanQi Wayne Zhao
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V6T 2B5, Canada.,Centre for Blood Research, University of British Columbia, 2350 Health Sciences Mall, Vancouver, British Columbia V6T 1Z3, Canada
| | - Katherine Serrano
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V6T 2B5, Canada.,Centre for Blood Research, University of British Columbia, 2350 Health Sciences Mall, Vancouver, British Columbia V6T 1Z3, Canada.,Centre for Innovation, Canadian Blood Services, Vancouver, British Columbia V6T 1Z3, Canada
| | - Davide Stefanoni
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver-Anschutz Medical Campus, Aurora, Colorado 80045, United States
| | - Angelo D'Alessandro
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver-Anschutz Medical Campus, Aurora, Colorado 80045, United States
| | - Dana V Devine
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V6T 2B5, Canada.,Centre for Blood Research, University of British Columbia, 2350 Health Sciences Mall, Vancouver, British Columbia V6T 1Z3, Canada.,Centre for Innovation, Canadian Blood Services, Vancouver, British Columbia V6T 1Z3, Canada
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13
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Kron A, Vijenthira S, Pendergrast J, Modi D, McLaren A, MacDonald A, Armali C, Cserti-Gazdewich C, Smith E, Quest G, Gabanowicz K, Lieberman L, Aseltine L, Sani L, Roche M, DeOliviera M, Yu P, Fazari S, Patel S, Lin Y, Kelly Z, Callum J. Multicenter observational study evaluating the impact of platelet transport bags on product wastage. Transfusion 2021; 61:1383-1388. [PMID: 33569779 DOI: 10.1111/trf.16303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/28/2020] [Accepted: 01/11/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Platelets are the most commonly discarded blood product in Canada, with the most common cause of in-date product loss being improper storage. Transport containers to maintain temperature and extend acceptable return time may represent a method to reduce wastage. The objective of this study was to evaluate the impact of a validated Platelet Transport Bag (PTB) on platelet wastage. STUDY DESIGN AND METHODS Thirty-six hospitals with the highest platelet discards were invited to participate in a before-after observational study. Hospitals were instructed to utilize a validated 4-h PTB for clinical situations where immediate transfusion was not planned. Five hospitals audited in-date platelet discards from July 2018 to November 2019 to characterize wastage causes. In-date platelet discard data 12 months before and after the start date for each site were analyzed to determine changes in wastage. RESULTS Of 36 hospital sites, 16 agreed to participate. Pre- and postdiscards were 277 and 301, respectively, for all sites combined. There were no significant before-after change in wastage rate (+0.05%, p = .51). Fifty discards were included in the detailed audit; the most common reasons were return to the blood bank after more than 60 min outside a PTB (n = 17, 34%) and return in a red cell cooler (n = 10, 20%). CONCLUSION Implementation of PTB did not improve wastage. Common causes of in-date discards were return after 1 h outside of a PTB and placement in a red cell cooler in error. Further research is required to investigate potential strategies to mitigate in-date platelet wastage.
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Affiliation(s)
- Amie Kron
- Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,University of Toronto Quality in Utilization, Education and Safety in Transfusion (QUEST) Research Program, Toronto, Ontario, Canada
| | - Shangari Vijenthira
- Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,University of Toronto Quality in Utilization, Education and Safety in Transfusion (QUEST) Research Program, Toronto, Ontario, Canada
| | - Jacob Pendergrast
- University of Toronto Quality in Utilization, Education and Safety in Transfusion (QUEST) Research Program, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada
| | - Dimpy Modi
- Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,University of Toronto Quality in Utilization, Education and Safety in Transfusion (QUEST) Research Program, Toronto, Ontario, Canada
| | | | - Anna MacDonald
- Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Chantal Armali
- Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,University of Toronto Quality in Utilization, Education and Safety in Transfusion (QUEST) Research Program, Toronto, Ontario, Canada
| | - Christine Cserti-Gazdewich
- University of Toronto Quality in Utilization, Education and Safety in Transfusion (QUEST) Research Program, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada
| | - Erica Smith
- IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Graeme Quest
- Department of Pathology and Molecular Medicine, Kingston Health Sciences Centre and Queen's University, Kingston, Ontario, Canada
| | | | - Lani Lieberman
- Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,University of Toronto Quality in Utilization, Education and Safety in Transfusion (QUEST) Research Program, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada
| | - Laura Aseltine
- Pathology and Laboratory Medicine, London Health Sciences Centre, London, Ontario, Canada
| | - Luarne Sani
- Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada
| | - Margaret Roche
- Vancouver General Hospital, Technical Resource Group for Transfusion Medicine, Vancouver, British Columbia, Canada
| | - Maria DeOliviera
- Department of Pathology, William Osler Health System, Brampton, Ontario, Canada
| | - Philip Yu
- Pathology and Laboratory Medicine, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Sandra Fazari
- Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Sneha Patel
- Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Yulia Lin
- Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,University of Toronto Quality in Utilization, Education and Safety in Transfusion (QUEST) Research Program, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Zofia Kelly
- Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Jeannie Callum
- University of Toronto Quality in Utilization, Education and Safety in Transfusion (QUEST) Research Program, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Department of Pathology and Molecular Medicine, Kingston Health Sciences Centre and Queen's University, Kingston, Ontario, Canada
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14
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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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15
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Valsami S, Pouliakis A, Gavalaki M, Argyrou A, Triantafillou E, Arvanitopoulou E, Girtovitis F, Voulgaridou V, Megalou A, Chronopoulou P, Papachronis A, Sakellarakis G, Zervou E, Batsi C, Fountouli K, Athanasopoulos A, Kyriakou E, Cheropoulou A, Livada A, Lebessopoulos K, Papakonstantinou M, Gafou A, Katopi D, Martinis G, Dendrinou I, Katharopoulou H, Politou M, Papadopoulou M, Papadopoulou P, Manaka E, Paneta K, Alepi C, Damaskos C, Garmpis N, Stamoulis K, Grouzi E. Platelets transfusion in Greece: Where, when, why? A national survey. Asian J Transfus Sci 2020; 14:158-166. [PMID: 33767543 PMCID: PMC7983137 DOI: 10.4103/ajts.ajts_72_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 06/02/2019] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Platelet transfusion is among the most useful therapeutic tools in modern clinical settings which mean that ensuring an adequate supply is of paramount importance. AIM The aim of our study was to record the use and wastage of platelet concentrates (PCs) in Greece, so as to come up with evidence-based interventions. METHODS The study was conducted during May and June 2015. We evaluated the use of random-donor platelets (RDPs) and single-donor apheresis platelets (SDPs). We analyzed such parameters as hospital department and diagnosis, indication for transfusion, PCs' age at the time of transfusion, and wastage rate. RESULTS We used data from 21 hospitals across the country. A total of 12,061 RDPs and 1189 SDPs were transfused, with an average of 4.84 (±2.72) and 1.12 (±2.73) units per episode, respectively. Most patients had been admitted to the internal medicine and hematology departments. The transfusions were mostly given prophylactically, usually in cases of acute leukemia, and mostly on the day before expiration. Wastage rate was 16.75% for RPDs and 2.70% for SDPs, primarily because of the expiration of the use-by date. CONCLUSIONS This is the first national survey regarding platelet transfusion in Greece. Since most patients were admitted in internal medicine and hematology departments, we recommend that the staff of the abovementioned departments should undergo training on contemporary transfusion guidelines. Platelet discard rate could further be lowered through the centralization of inventory management along with the extension of the lifetime of PCs by means of emerging technologies.
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Affiliation(s)
- Serena Valsami
- Hematology, Laboratory-Blood Bank Department, Aretaieion Hospital, National and Kapodistrian University of Athens, Medical School, Patras, Greece
| | - Abraham Pouliakis
- Second Department of Pathology, National and Kapodistrian University of Athens, “Attikon” University Hospital, Patras, Greece
| | - Maria Gavalaki
- Department of Blood Transfusion, Laiko General Hospital, Patras, Greece
| | - Aspasia Argyrou
- Department of Blood Transfusion, “Saints Anargyroi” Hospital, Patras, Greece
| | | | | | - Fotios Girtovitis
- Department of Blood Transfusion, AHEPA, University Hospital of Thessaloniki, Thessaloniki, Greece
| | - Virginia Voulgaridou
- Department of Blood Transfusion, AHEPA, University Hospital of Thessaloniki, Thessaloniki, Greece
| | - Aggeliki Megalou
- Department of Blood Transfusion, Evangelismos Hospital, Patras, Greece
| | | | | | | | - Eleftheria Zervou
- Department of Blood Transfusion, University Hospital of Ioannina, Ioannina, Greece
| | - Christina Batsi
- Department of Blood Transfusion, University Hospital of Ioannina, Ioannina, Greece
| | - Kalliopi Fountouli
- Department of Blood Transfusion, University Hospital of Heraklion, Heraklion, Greece
| | | | - Elias Kyriakou
- Laboratory of Hematology and Blood Bank Unit, “Attikon” University Hospital, National and Kapodistrian Athens, Patras, Greece
| | | | - Anastasia Livada
- Department of Transfusion Service and Clinical Hemostasis, “Saint Savvas” Oncology Hospital of Athens, Patras, Greece
| | | | | | - Anthi Gafou
- Department of Blood Transfusion, “Saints Anargyroi” Hospital, Patras, Greece
| | - Despina Katopi
- Department of Blood Transfusion, General Hospital Alexandra, Patras, Greece
| | - George Martinis
- Department of Blood Transfusion, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Ioanna Dendrinou
- Department of Blood Transfusion, General Hospital Nea Ionia “Agia Olga”, Patras, Greece
| | - Hrysanthi Katharopoulou
- Department of Blood Transfusion, “Hatzikosta” General Hospital of Ioannina, Ioannina, Greece
| | - Marianna Politou
- Hematology, Laboratory-Blood Bank Department, Aretaieion Hospital, National and Kapodistrian University of Athens, Medical School, Patras, Greece
| | | | | | - Ekaterini Manaka
- Department of Blood Transfusion, General Hospital of Messologgi, Messologgi, Greece
| | - Konstantina Paneta
- Department of Blood Transfusion, General Hospital of Pirgos, Pirgos, Greece
| | - Chrissoula Alepi
- Department of Blood Transfusion, General Hospital “Tzaneio” of Piraeus, Patras, Greece
| | - Christos Damaskos
- Second Department of Propedeutic Surgery,“Medical School, Laiko” General Hospital, National and Kapodistrian University of Athens, Patras, Greece
| | - Nikolaos Garmpis
- Second Department of Propedeutic Surgery,“Medical School, Laiko” General Hospital, National and Kapodistrian University of Athens, Patras, Greece
| | | | - Elisavet Grouzi
- Department of Transfusion Service and Clinical Hemostasis, “Saint Savvas” Oncology Hospital of Athens, Patras, Greece
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16
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Covo MZ, Cruz EDDA, Maurício AB, Batista J, Souza LALD. Financial cost of whole blood and blood component disposals in a Brazilian coordinating blood center. ACTA ACUST UNITED AC 2019; 40:e20190033. [PMID: 31664326 DOI: 10.1590/1983-1447.2019.20190033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Accepted: 07/17/2019] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To describe the reasons for the disposal of blood in the coordinating blood center of the State of Paraná and to estimate the financial costs resulting from potentially avoidable discards. METHOD A descriptive, retrospective and documentary analysis, with data related to the period from 2010 to 2015 of a Brazilian coordinating blood center collected from a governmental database and analyzed by descriptive statistics. This study was approved by the Ethics Research Committee (CAEE 63074916.0.0000.5225). RESULTS 101,813 units were discarded, representing 22.3% of the total of 455,684 produced; plasma was the most discharged blood component. The main reason for discarding was lipemia (35.8%); the analysis showed that 56.9% of the disposals were considered potentially avoidable with an estimated paid value of approximately US$2 million. CONCLUSION The expressive potential of avoidance of disposal of blood units and blood components highlights the importance of planning actions aiming at their best use, contributing to the reduction of amounts paid for these processes.
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Affiliation(s)
- Magali Zimmermann Covo
- Universidade Federal do Paraná (UFPR), Programa de Pós-Graduação em Enfermagem. Curitiba, Paraná, Brasil.,Centro de Hematologia e Hemoterapia do Paraná (HEMEPAR). Curitiba, Paraná, Brasil
| | | | - Aline Batista Maurício
- Universidade Federal do Paraná (UFPR), Programa de Pós-Graduação em Enfermagem. Curitiba, Paraná, Brasil
| | - Josemar Batista
- Universidade Federal do Paraná (UFPR), Programa de Pós-Graduação em Enfermagem. Curitiba, Paraná, Brasil
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17
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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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18
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Vuk T. When things go badly - Managing quality problems and complaints in transfusion medicine. ACTA ACUST UNITED AC 2018. [DOI: 10.1111/voxs.12465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Tomislav Vuk
- Croatian Institute of Transfusion Medicine; Zagreb Croatia
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19
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Tsang HC, Garcia A, Scott R, Lancaster D, Geary D, Nguyen AT, Shankar R, Buchanan L, Pham TD. Streamlining a blood center and hospital transfusion service supply chain with an informatics vendor-managed inventory solution: development, implementation, and 3-month follow-up. Transfusion 2018; 58:1718-1725. [PMID: 29770454 DOI: 10.1111/trf.14766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 02/15/2018] [Accepted: 02/15/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUND The ordering process at Stanford Health Care involved twice-daily shipments predicated upon current stock levels from the blood center to the hospital transfusion service. Manual census determination is time consuming and error prone. We aimed to enhance inventory management by developing an informatics platform to streamline the ordering process and reallocate staff productivity. STUDY DESIGN AND METHODS The general inventory accounts for more than 50 product categories based on characteristics including component, blood type, irradiation status, and cytomegalovirus serology status. Over a 5-month calibration period, inventory levels were determined algorithmically and electronically. An in-house software program was created to determine inventory levels, optimize the electronic ordering process, and reduce labor time. A 3-month pilot period was implemented using this program. RESULTS This system showed noninferiority while saving labor time. The average weekly transfused:stocked ratios for cryoprecipitate, plasma, and red blood cells, respectively, were 1.03, 1.21, and 1.48 before the pilot period, compared with 0.88, 1.17, and 1.40 during (p = 0.28). There were 27 (before) and 31 (during) average STAT units ordered per week (p = 0.86). The number of monthly wasted products due to expiration was 226 (before) and 196 (during) units, respectively (p = 0.28). An estimated 7 hours per week of technologist time was reallocated to other tasks. CONCLUSION An in-house electronic ordering system can enhance information fidelity, reallocate and optimize valuable staff productivity, and further standardize ordering. This system showed noninferiority to the labor-intensive manual system while freeing up over 360 hours of staff time per year.
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Affiliation(s)
- Hamilton C Tsang
- Department of Laboratory Medicine, University of Washington, Seattle, Washington.,Stanford Hospital Transfusion Service, Stanford, California
| | - Adam Garcia
- Stanford Blood Center, Stanford Health Care, Stanford Medicine, Stanford, California
| | - Robert Scott
- Stanford Hospital Transfusion Service, Stanford, California
| | - David Lancaster
- Stanford Blood Center, Stanford Health Care, Stanford Medicine, Stanford, California
| | - Dianne Geary
- Stanford Blood Center, Stanford Health Care, Stanford Medicine, Stanford, California
| | - Anh-Thu Nguyen
- Stanford Hospital Transfusion Service, Stanford, California
| | - Raina Shankar
- Stanford Hospital Transfusion Service, Stanford, California
| | | | - Tho D Pham
- Stanford Hospital Transfusion Service, Stanford, California.,Stanford Blood Center, Stanford Health Care, Stanford Medicine, Stanford, California.,Department of Pathology, Stanford University School of Medicine, Stanford, California
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