Logistics of managing a trauma whole blood inventory in a civilian level 1 trauma center. Issue 9 (29th July 2022)

• Record Type: Journal Article
• Authors: Phan‐Tang, Michelle; Lee, Christine M.; Fang, Amy; Rioveros, Jowin; Siletz, Anaar E.; Cryer, Henry; McGonigle, Andrea M.; Ziman, Alyssa; Ward, Dawn C.
• Is Part Of: Transfusion. Volume 62:Issue 9(2022)
• Page Start: 1772
• Page End: 1778
• Publication Date: 2022-07-29
• Subjects: civilian trauma -- donor center -- inventory -- management -- whole blood transfusion; Hematology -- Periodicals; Blood -- Transfusion -- Periodicals; Blood Group Antigens -- Periodicals; Blood Preservation -- Periodicals; Blood Transfusion -- Periodicals; 615
• DOI: 10.1111/trf.17035
• Languages: English
• ISSNs: 0041-1132

Abstract

Abstract: Background: Institutional data on initiating and maintaining a low‐titer O positive whole blood (LTOWB) inventory for the civilian trauma sector may help other institutions start a LTOWB program. This study from a level 1 trauma center with a hospital‐based donor center highlights challenges faced during the collection, maintenance, and utilization of LTOWB. Study Design and Methods: Male O positive donors with low (≤1:100) anti‐A and anti‐B antibody titers were recruited for LTOWB collection. The daily inventory goal of 4 LTOWB units was kept in the emergency department refrigerator and transfused to adult male trauma patients. Unused units older than 10 days were reprocessed into packed red blood cells. Results: Of 900 donors screened, 61% qualified and 52% of eligible donors provided a collective total of 505 LTOWB units over 2.5 years. The number of collected units directly correlated with the availability of inventory; 42% of the units were transfused, 54% were reprocessed, and 4% were discarded. The inventory goal was maintained for 56% of the year 2018 and 83% of the year 2019. Over these 2 years, 52% of patients had their transfusion needs fully met, 41% had their needs partially met, and 6.5% did not have their needs met. Discussion: Initial challenges to LTOWB implementation were inventory shortages, low utilization rates, and failure to meet clinical demand. Proposed solutions include allowing for a higher yet safe titer, extending shelf life, expanding the donor pool, identifying barriers to utilization, and permitting use in female trauma patients beyond childbearing age.