Dalhousie University, Halifax, Nova Scotia, Canada.
Transfusion. 2013 Jul;53(7):1544-58. doi: 10.1111/j.1537-2995.2012.03947.x. Epub 2012 Nov 12.
Since the 1970s red blood cells (RBCs) have had a rated shelf life of 42 days. Recently, studies have suggested poorer patient outcomes when older blood is transfused. However, shortening the shelf life of RBCs may increase costs and lead to greater instances of outdates and shortages.
A simulation method to evaluate the impact of a shorter shelf life for RBCs on a regional blood network was developed. A network model of the production and distribution system in the province of Quebec was built and validated.
The model suggests that a shelf life of 21 or 28 days will have modest impact on outdate and shortage rates. A shelf life of 14 days will create significant challenges for both blood suppliers and hospitals and will result in systemwide outdate rates of 6.64% and shortage rates of 2.75%. The impact of a shorter shelf life for RBCs will disproportionately affect smaller and midsize hospitals.
A shelf life of 28 or 21 days is feasible without excessive increases to systemwide outdate, shortage, or emergency ordering rates. Large hospitals will see minimal impact; smaller hospitals will see larger increases and may be unable to find inventory policies that maintain both low outdate and shortage rates. Reducing the shelf life to 14 days, or lower, results in significant challenges for suppliers and hospitals of all sizes. All hospitals will see an impact on outdate and shortage rates; overall systemwide outdate rates (6% or more) will reach levels that would currently be considered unacceptably high.
自 20 世纪 70 年代以来，红细胞（RBC）的保质期已定为 42 天。最近的研究表明，输注陈旧血液会导致患者预后较差。然而，缩短 RBC 的保质期可能会增加成本，并导致更多的过期和短缺情况。
开发了一种评估 RBC 保质期缩短对区域血液网络影响的模拟方法。建立并验证了魁北克省生产和分配系统的网络模型。
该模型表明，保质期为 21 天或 28 天对过期和短缺率的影响不大。保质期为 14 天将给血液供应商和医院带来重大挑战，导致系统范围内的过期率为 6.64%，短缺率为 2.75%。RBC 保质期缩短的影响将不成比例地影响规模较小和中等规模的医院。
保质期为 28 天或 21 天是可行的，不会导致系统范围内的过期、短缺或紧急订购率大幅上升。大型医院的影响最小；较小的医院将看到更大的增长，并且可能无法找到既保持低过期率又保持低短缺率的库存政策。将保质期缩短至 14 天或更短，会给所有规模的供应商和医院带来重大挑战。所有医院的过期和短缺率都会受到影响；总体系统范围内的过期率（6%或更高）将达到目前认为不可接受的水平。
