International Society for Blood Transfusion international survey on blood product wastage in low‐ and middle‐income countries

Abstract

Background and objectives In 2015, the ISBT Working Party on Blood Supply Management published the results of an international survey on blood product wastage in hospitals. The responses were predominantly from Europe and North America, and it was decided to form another survey concentrating on low-and middle-income countries (LMIC). Materials and methodsThe survey was designed by the authors and translated into an online survey tool by the ISBT office. A pilot survey was produced and completed by 3 volunteer contributors. Where necessary, amendments were made and the survey was sent by the ISBT to 33 participants from LMIC. The survey was further distributed by participants to colleagues in their or other countries. ResultsIn total, 31 completed surveys were received from 11 different countries. Not all respondents answered all questions meaning different questions may have been answered by a different combination of respondents. The demographics of hospital type, size and distance from the blood supplier varied considerably. Redblood-cell (RBC) wastage was estimated to be <5% (n=9 respondents), 5-10% (n=3) or 10-25% (n=5). The most important category of wastage was outdated RBCs in the blood bank or after issue. Wastage as a result of an RBC being issued to a patient and not completely transfused because the patient did not require the entire volume was <10% (n=18), 10-20% (n=3), 20-30% (n=1), 40-50% (n=1) and >50% (n=1).Conclusion Wastage rates varied considerably between countries, and innovative solutions will be required to reduce this problem.

Validated transport conditions maintain the quality of washed red blood cells

“…For example, JPAC guideline 7.7.5 states that in “some instances it is necessary to issue red cell components that have not been cooled to their storage temperature prior to placing in the transit container. The transport temperature specified [between 2°C and 10°C] is not applicable for such consignments.” 8 While product wastage in many settings is often due to outdating blood products, 20,21 at one U.S. institution, 87% of blood product wastage was due to units considered out of temperature range or directly related to time outside of refrigeration, with the remaining wastage due to other factors (i.e., processing, bag breakage, or units outdating) 22 …”

“…The transport temperature specified [between 2°C and 10°C] is not applicable for such consignments." 8 While product wastage in many settings is often due to outdating blood products, 20,21 at one U.S. institution, 87% of blood product wastage was due to units considered out of temperature range or directly related to time outside of refrigeration, with the remaining wastage due to other factors (i.e., processing, bag breakage, or units outdating). 22 Many institutions use "fresh," just irradiated units for neonatal patients and multiple pediatric indications.…”