Entwicklung eines Konzepts zur Reduzierung des Verfalls von Erythrozytenkonzentraten
Due to an imbalance between blood donations and demand, there are shortages of erythrocyte concentrates. Therefore, it is essential that all parties involved in using blood as a resource work as effectively as possible. This includes optimizing logistical processes to minimize discard, particularly at the end of use. The aim of this work is to define factors influencing discard and derive measures for expiration reduction applicable to hospitals.
The immunohematologic statistics from 2008 to 2023 for 18 hospitals and their departments were evaluated. These statistics include the number of cross-matches, transfusions, and discarded erythrocyte concentrates. Based on this data, rejection rates and the transfused/cross-matched ratio were calculated for each hospital and department.
Anomalies in the statistics were discussed with the respective transfusion managers in separate interviews, and influencing factors were defined.
Furthermore, a profile was created for each hospital, detailing case numbers and bed capacity, to facilitate comparability later on.
The most notable influencing factors were observed in maximum care hospitals. Hospital Q reduced expiration from 6.32% to 3.29% by revising indication lists and further improved discard rates to 1.16% by using type and screen instead of cross matches.
Hospital H decreased expiration from 16.58% to 7.29% by switching to AB0-compatible transfusions.
In Hospital K, expiration rates increased from 7.43% to 21.64% due to changes in laboratory and clinical structure. Reasons for higher discard are the implementation of patient blood management without reduction of blood bag stock, closing the lab in the hospital, an increase of orders as a panic reaction as well as personal engagement of the transfusion specialists.
Based on the defined influencing factors, a catalogue of measures could be created. This catalogue of measures is an individually usable tool for hospitals, enabling them to identify factors they can optimize without significant additional financial expenses, thereby contributing to an improved supply situation of erythrocyte concentrates.
No conflict of interest.