Blake John T
Department of Industrial Engineering, Dalhousie University, Halifax, Nova Scotia, Canada.
Canadian Blood Services, Halifax, Nova Scotia, Canada.
Transfusion. 2017 Dec;57(12):3001-3008. doi: 10.1111/trf.14305. Epub 2017 Sep 6.
The regulatory shelf life for platelets (PLTs) in many jurisdictions is 5 days. PLT shelf life can be extended to 7 days with an enhanced bacterial detection algorithm. Enhanced testing, however, comes at a cost, which may be offset by reductions in wastage due to longer shelf life. This article describes a method for estimating systemwide reductions in PLT outdates after PLT shelf life is extended.
A simulation was used to evaluate the impact of an extended PLT shelf life within a national blood network. A network model of the Canadian Blood Services PLT supply chain was built and validated. PLT shelf life was extended from 5 days to 6, 7, and 8 days and runs were completed to determine the impact on outdates.
Results suggest that, in general, a 16.3% reduction in PLT wastage can be expected with each additional day that PLT shelf life is extended. Both suppliers and hospitals will experience fewer outdating units, but wastage will decrease at a faster rate at hospitals. No effect was seen by blood group, but there was some evidence that supplier site characteristics influences both the number of units wasted and the site's ability to benefit from extended-shelf-life PLTs.
Extended-shelf-life PLTs will reduce wastage within a blood supply chain. At 7 days, an improvement of 38% reduction in wastage can be expected with outdates being equally distributed between suppliers and hospital customers.
在许多司法管辖区,血小板(PLT)的规定保质期为5天。采用增强的细菌检测算法可将PLT保质期延长至7天。然而,增强检测是有成本的,而保质期延长导致的浪费减少可能会抵消这一成本。本文描述了一种估算PLT保质期延长后全系统PLT过期减少情况的方法。
采用模拟方法评估在全国血液网络中延长PLT保质期的影响。构建并验证了加拿大血液服务中心PLT供应链的网络模型。将PLT保质期从5天延长至6天、7天和8天,并进行运行以确定对过期情况的影响。
结果表明,一般来说,PLT保质期每延长一天,预计PLT浪费可减少16.3%。供应商和医院的过期单位都会减少,但医院的浪费减少速度更快。血型未产生影响,但有证据表明供应商地点特征会影响浪费的单位数量以及该地点从延长保质期的PLT中受益的能力。
延长保质期的PLT将减少血液供应链中的浪费。在7天时,预计浪费可减少38%,过期情况在供应商和医院客户之间平均分布。