Denesiuk Lisa, Richardson Trevor, Nahirniak Susan, Clarke Gwen
Dynacare Kasper Medical Laboratories, Regional Services, Edmonton, Alberta, Canada.
Arch Pathol Lab Med. 2006 Aug;130(8):1178-83. doi: 10.5858/2006-130-1178-IOARSF.
Many remote hospitals keep small on-site stocks of red blood cell (RBC) units for emergency use and to support patient care programs. In Canada, the blood supplier does not accept returned units into inventory. Discard rates can, therefore, be high.
To transport near-outdate RBC units to a high-usage hospital site, which would reduce overall discard rates, thereby increasing overall stock levels available in the blood system.
A blood transportation system was developed and validated. The validation was presented to a high-usage site that agreed to accept near-outdate RBC units transported by this system. Stocks at the remote hospitals were optimized without increasing system-wide discard rates. The redistribution program was implemented in 4 remote sites in northern Alberta, Canada. The final disposition of each transported unit was tracked. Data from the first 2 years were analyzed.
Between April 1, 2003, and March 31, 2005, 106 RBC units were successfully transported to and transfused at the high-usage site. The majority of the units were group O. None of the transfused units were involved in any reported transfusion reactions. The success rate of the transportation system varied among the sites (59%-78% successfully transported and transfused). Changes to the transport system were implemented as problems were discovered. The use of a temperature monitor in each shipment allowed for concurrent revalidation after each change.
Redistribution systems can be an effective way to reduce RBC unit discard rates. Even simple transportation systems have many factors affecting the RBC unit temperature. Novel temperature stabilizing materials may make future transportation of RBC units more reliable.
许多偏远医院会储备少量现场红细胞（RBC）单位用于紧急情况并支持患者护理项目。在加拿大，血液供应商不接受退回的单位库存。因此，丢弃率可能很高。
将接近过期的RBC单位运输到高使用量的医院地点，这将降低总体丢弃率，从而增加血液系统中可用的总体库存水平。
开发并验证了一种血液运输系统。验证结果提交给了一个高使用量地点，该地点同意接受通过该系统运输的接近过期的RBC单位。在不增加全系统丢弃率的情况下优化了偏远医院的库存。重新分配计划在加拿大艾伯塔省北部的4个偏远地点实施。跟踪每个运输单位的最终处置情况。分析了前两年的数据。
在2003年4月1日至2005年3月31日期间，106个RBC单位成功运输到高使用量地点并进行了输血。大多数单位是O型。所有输血单位均未发生任何报告的输血反应。运输系统的成功率在不同地点有所不同（成功运输并输血的比例为59%-78%）。随着问题的发现，对运输系统进行了改进。每次运输中使用温度监测器使得每次更改后都能同时进行重新验证。
重新分配系统可能是降低RBC单位丢弃率的有效方法。即使是简单的运输系统也有许多影响RBC单位温度的因素。新型温度稳定材料可能会使未来RBC单位的运输更加可靠。
