The estimated negative impacts on the red blood cell inventory of reducing shelf-life at two large health authorities in British Columbia, Canada, using a discrete-event simulation model.

Publisher: Blackwell Science Country of Publication: England NLM ID: 0413606 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1423-0410 (Electronic) Linking ISSN: 00429007 NLM ISO Abbreviation: Vox Sang Subsets: MEDLINE

Publication: 2001- : Oxford, UK : Blackwell Science
Original Publication: Basel : Karger

Erythrocytes* ; Blood Preservation*; Humans ; British Columbia ; Blood Banks ; Computer Simulation

Background and Objectives: Reducing the maximum red blood cell (RBC) shelf-life is under consideration due to potential negative effects of older blood. An assessment of the impacts of this change on blood supply chain management is evaluated.
Materials and Methods: We performed a simulation study using data from 2017 to 2018 to estimate the outdate rate (ODR), STAT order and non-group-specific RBC transfusion at two Canadian health authorities (HAs).
Results: Shortening shelf-life from 42 to 35 and 28 days led to the following: ODRs (in percentage) in both HAs increased from 0.52% (95% confidence interval [CI] 0.50-0.54) to 1.32% (95% CI 1.26-1.38) and 5.47% (95% CI 5.34-5.60), respectively (p < 0.05). The estimated yearly median of outdated RBCs increased from 220 (interquartile range [IQR] 199-242) to 549 (IQR 530-576) and 2422 (IQR 2308-2470), respectively (p < 0.05). The median number of outdated redistributed units increased from 152 (IQR 136-168) to 356 (IQR 331-369) and 1644 (IQR 1591-1741), respectively (p < 0.05). The majority of outdated RBC units were from redistributed units rather than units ordered from the blood supplier. The estimated weekly mean STAT orders increased from 11.4 (95% CI 11.2-11.5) to 14.1 (95% CI 13.1-14.3) and 20.9 (95% CI 20.6-21.1), respectively (p < 0.001). The non-group-specific RBC transfusion rate increased from 4.7% (95% CI 4.6-4.8) to 8.1% (95% CI 7.9-8.3) and 15.6% (95% CI 15.3-16.4), respectively (p < 0.001). Changes in ordering schedules, decreased inventory levels and fresher blood received simulated minimally mitigated these impacts.
Conclusion: Decreasing RBC shelf-life negatively impacted RBC inventory management, including increasing RBC outdating and STAT orders, which supply modifications minimally mitigate.
(© 2023 The Authors. Vox Sanguinis published by John Wiley & Sons Ltd on behalf of International Society of Blood Transfusion.)

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Hemerus Medical, LLC

Keywords: blood components; quality management; red cell components

Date Created: 20230303 Date Completed: 20230517 Latest Revision: 20230517

20240829

10.1111/vox.13417

36866649