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O– product transfusion, inventory management, and utilization during shortage: the OPTIMUS study
Author(s) -
Dunbar Nancy M.,
Yazer Mark H.
Publication year - 2018
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.14547
Subject(s) - abo blood group system , economic shortage , medicine , blood product , blood transfusion , intensive care unit , emergency medicine , surgery , linguistics , philosophy , government (linguistics)
BACKGROUND Despite conservation strategies, shortages of O– red blood cells (RBCs) occur. The goal of this study was to determine how utilization of O– RBCs can be reduced using age‐ and location‐based O+ substitution for routine transfusions in O– patients during O– shortages. STUDY DESIGN AND METHODS Recipient age and ABO and D group were obtained for allogeneic RBC transfusions during the 2016 calendar year from 31 participating centers. ABO and D group of each RBC unit was compared to that of the recipient to determine the number of O– RBC units transfused to all patients, the number of RBC units transfused to O– patients, and the number of O– RBC units transfused to O– patients. O– RBC transfusions to O– patients were further analyzed by patient age and location. RESULTS The fraction of all transfused RBCs that were O– at the participating centers ranged from 3.0% to 13.9%. The percentage of O– RBCs transfused to O– patients ranged from 36.6% to 93.7%. Hospitals differed in the frequency of issuing O– RBCs for O– patient transfusions (55.9%‐100%). Relative to current issuing practice, overall use of O– RBCs could have been reduced by 44.5% if O+ units had been given to all O– patients at least 50 years old, 9.9% for all O– patients at least 80 years old, or 8.7% for all O– critical care patients at least 50 years old. CONCLUSION 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.