O– product transfusion, inventory management, and utilization during shortage: the OPTIMUS study

Dunbar, Nancy M.; Yazer, Mark H.

doi:10.1111/trf.14547

Cited by 32 publications

(22 citation statements)

References 19 publications

(53 reference statements)

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“…Although overall blood use is decreasing, this increased proportion could result in shortages, particularly for group O Rh(D)‐negative blood. Other countries have described similar trends . Recommendations for blood collection centers and transfusion services have been published to reduce the use of group O Rh(D)‐negative RBCs (Group O).…”

Section: Discussionmentioning

confidence: 79%

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Supplemental findings of the 2017 National Blood Collection and Utilization Survey

et al. 2020

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INTRODUCTION This report provides supplemental results from the 2017 National Blood Collection and Utilization Survey on characteristics of the donor population, autologous and directed donations and transfusions, platelets, plasma and granulocyte transfusions, pediatric transfusions, severe donor‐related adverse events, cost of blood units, hospitals policies and practices, and inventory, dosing, and supply. METHODS Weighting and imputation were used to generate national estimates including number of donors, donations, donor deferrals, autologous and directed donations and transfusions, severe donor‐related adverse events, platelet and plasma collections and transfusions, number of cross‐match procedures, irradiation and leukoreduction, and pediatric transfusions. RESULTS Between 2015 and 2017, successful donations decreased slightly by 2.1% with a 10.3% decrease in donations by persons aged 16‐18 years and a 14.4% increase in donations by donors aged >65 years. The median price paid for blood components by hospitals decreased from $211 to $207 for leukoreduced red blood cell units, from $523 to $517 for leukoreduced apheresis platelet units, and from $54 to $51 for fresh frozen plasma units. Plasma transfusions decreased 13.6%, but group AB plasma units transfused increased 24.7%. CONCLUSION Between 2015 and 2017, blood donations declined slightly because of decreases in donations from younger donors, but the number of donations from older donors increased. The price hospitals pay for blood has continued to decrease. Plasma transfusions have decreased, but the proportion of plasma transfusions involving group AB plasma have increased.

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Section: Discussionmentioning

confidence: 79%

“…Recommendations for blood collection centers and transfusion services have been published to reduce the use of group O Rh(D)‐negative RBCs (Group O). Group O Rh(D)‐negative blood use could be reduced by an estimated 44.5% by transfusing only age and sex groups at the highest risk of D aolloimmunization …”

Section: Discussionmentioning

confidence: 99%

Supplemental findings of the 2017 National Blood Collection and Utilization Survey

et al. 2020

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“…Some common solutions to decrease ON‐RBC use identified in this bulletin include reserving the blood product for females of childbearing potential, using O‐positive RBCs in males and females >50 years of age, and establishing policies for switching particular patients to Rh(D)‐positive RBCs during heavy use. The Choosing Wisely campaign for the American Board of Internal Medicine suggested similar policies to preserve ON‐RBCs, but the recent OPTIMUS study identified that hospital blood banks are not adequately enforcing these suggestions and the use of ON‐RBCs could have been reduced by 44.5% if O‐negative patients over the age of 50 were transfused with O‐positive RBCs …”

mentioning

confidence: 99%

“…The Choosing Wisely campaign for the American Board of Internal Medicine suggested similar policies to preserve ON-RBCs, but the recent OPTIMUS study identified that hospital blood banks are not adequately enforcing these suggestions and the use of ON-RBCs could have been reduced by 44.5% if O-negative patients over the age of 50 were transfused with O-positive RBCs. 7,8 Furthermore, one of the recommendations offered by AABB was to "establish inventory processes and procedures that reduce the risk that group O RBCs, near expiry, are transfused out-of-group solely to avoid outdate." Given that ON-RBCs are the universal red cell product, a certain surplus of this inventory must be maintained to safely supply a hospital, and these out-of-group transfusions will never be entirely eliminated.…”

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confidence: 99%

Optimizing O‐negative RBC utilization using a data‐driven approach

Virk

Lancaster

Quach³

et al. 2020

Transfusion

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BACKGROUND O‐negative red blood cells (ON‐RBC) are a precious resource and the international blood banking community has become increasingly concerned with its inappropriate utilization. AABB recently made several recommendations to address the issue. Solutions must be multifaceted and involve donor centers, blood banks, and clinical departments. From the perspective of a hospital blood bank, it is difficult to rely solely on increased donor recruitment and ubiquitous blood typing of the entire in‐patient population. We therefore focused on interventions within the blood bank to optimize inventory and policies to ensure appropriate ON‐RBC utilization. STUDY DESIGN AND METHODS Transfusion data over one year was examined for the rate of out‐of‐group/inappropriate ON‐RBC. Furthermore, we assessed whether that rate was related to product life on the day of transfusion. We also examined our stock inventory levels and how excess inventory can contribute to inappropriate ON‐RBC usage. RESULTS The ON‐RBC inventory level was decreased in order to reduce the rate of inappropriate transfusions while maintaining a safe level for optimal patient care. Compared to baseline, our intervention caused ON‐RBCs to be transfused earlier in their shelf‐life (9.27 vs. 11.15 days from expiration [DFE], p = 0.0012). This reduced the overall rate of inappropriate ON‐RBC transfusions (67% vs. 54%, p = 0.0035), approximating 185 units of ON‐RBC saved over the course of 6 months. CONCLUSIONS A data‐driven approach to optimize stock inventory levels is widely applicable; it can be adopted by numerous institutions to improve utilization and establish a benchmark for the broader blood banking community.

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“…In this issue of TRANSFUSION , Dunbar and colleagues retrospectively review ONEG RBC transfusions during calendar year 2016 across 31 participating national and international centers, which were mostly academic in nature. The study was cross‐sectional and descriptive.…”

mentioning

confidence: 99%

Conservation of O– red blood cells: a fresh look at a shared responsibility

DeSimone

Sachais

2018

Transfusion

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O– product transfusion, inventory management, and utilization during shortage: the OPTIMUS study

Abstract: During O- shortages, O+ switching rules based on the recipient's age and hospital location can be applied for routine transfusions to ensure the availability of O- RBC units for O- females of childbearing age.

Cited by 32 publications

References 19 publications

Supplemental findings of the 2017 National Blood Collection and Utilization Survey

Supplemental findings of the 2017 National Blood Collection and Utilization Survey

Optimizing O‐negative RBC utilization using a data‐driven approach

Conservation of O– red blood cells: a fresh look at a shared responsibility

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