International Society for Blood Transfusion international survey on blood product wastage in hospitals

Abstract

Background and Objectives The ISBT Working Party on Blood Supply Management undertook an international survey of blood component wastage rates. Materials and Methods Using a survey website, questions were developed and validated to collect information on component wastage rates and the mechanisms for this wastage at hospital transfusion services around the world. Wastage was calculated as a percentage of the units issued (WAPI), which accounts only for the issued products not the size of the blood bank's inventory. Results There were 85 useable responses over an approximately 6‐month period. The majority of respondents were from Europe (53/85, 62%) and North America (19/85, 22%). The rest were from Oceania, Asia and the Middle East. Most respondents were from major academic teaching hospitals (45/85, 53%) with >1000 beds (32/85, 38%). There was no significant difference in the median regional WAPI wastage rates for RBCs and platelets between Europe (1·6%, 3·3%), North America (1·3%, 2·9%) and the rest of the world (2·4%, 7·2%) (P > 0·05 for all comparisons). Plasma wastage rates were also not different between these 3 regions. Neither RBC shelf life (≤35 days vs. 42 days) nor platelet shelf life (5 days vs 7 days) significantly affected the rate of product expiration in the hospital blood bank. Conclusion The median wastage rates are low around the world; a more detailed understanding of the specific mechanisms that lead to wastage around the world will help further reduce the rate.

Platelet Storage Lesions: What More Do We Know Now?

“…However, the merits of intensive clinical data mining to identify such a small selective adverse effect margin has to be questioned in the context of an already short PC shelf life of 5-7 days with little room to move should an adverse effect be found. This is particularly significant considering that median PC expiry rates decrease from 6.8% to 3.1% when moving from 5 to 7 day jurisdictions [85].…”

“…PSLs secondary to platelet metabolism and activation at room temperature storage can be improved via advances in bag materials and storage media (Figure 3). Bag materials such as 1,2-cyclohexane-dicarboxylic acid diisonoylester (DINCH)-PVC are purported to be less toxic than current BTHC-or TEHTM-PVC bags, owing to decreased phthalate contamination [85,86]. Furthermore, PCs stored in DINCH-PVC for 7 days have lower glycolytic activity and platelet activation compared to BTHC-PVC [86].…”

Time–temperature indicators versus temperature indicators for transfusion practice: Application in the real hospital setting

“…Based on this 30-min rule, if RBC transfusion is not initiated within 30 min after issue, RBC wastage may occur [9][10][11][12][13]. In 2015, up to 1.4% of RBC units were discarded due to the use of an inappropriate transport device or temperature [11].…”

Fresh frozen plasma and platelet concentrate storage duration not associated with in hospital mortality risk

“…This is reassuring as PCs can be up to 3 days old by the time they have passed viral screening and are released to administering institutions; meaning that the effective shelf life of PCs is only 2–5 days . Any shortening of PC shelf life would likely lead to significant PC wastage . Notably, it is possible that the relationship between PC storage duration and mortality only manifests at the extremes of storage (>5 days) similar to PRBCs.…”