Hirani Rena, Tohidi-Esfahani Ibrahim, Mondy Phillip, Irving David O
The Australian Red Cross Blood Service, Sydney, Australia.
Transfusion. 2018 Mar;58(3):669-676. doi: 10.1111/trf.14459. Epub 2017 Dec 17.
Supply of cytomegalovirus (CMV)-seronegative blood products in Australia is an ongoing challenge. Requests for CMV-negative products are increasing with prediction that the demand will exceed supply by 2019. Clinical information evaluating how these products are being utilized by health providers within Australia is limited. This study aimed to identify indications for use of CMV-negative blood products and gather data to support possible practice change.
All CMV-negative products issued to three tertiary Australian hospitals from May 1, 2016, to May 31, 2016, were identified (n = 1219). This equated to 1044 red blood cell units and 175 platelet units. Data were collected on the fate of each unit. Information collected included the indication and urgency of transfusion, reason for discard, product age, and recipient CMV immunoglobulin G status.
Of the units issued during the audit period, 32 (2.6%) were discarded by the hospitals. Transfusion data were collected on 411 units. Of these, 136 (33.1%) were transfused to CMV-positive recipients, in most cases for hematology indications, and 67 units (16.3%) were transfused to CMV-negative requiring recipients. A total of 144 (35%) CMV-negative units were selected based on their irradiation status. Other reasons for the selection of CMV-negative units included product close to expiry (n = 134, 32.6%) or specific patient phenotype requirements (n = 31, 7.5%).
In this study, the majority of CMV-negative blood products were not used for CMV-negative requiring recipients. Alterations to inventory management would be advantageous to ensure continued supply for CMV-negative requiring recipients.
在澳大利亚,供应巨细胞病毒(CMV)血清学阴性的血液制品一直是一项挑战。对CMV阴性产品的需求不断增加,预计到2019年需求将超过供应。关于澳大利亚医疗服务提供者如何使用这些产品的临床信息有限。本研究旨在确定使用CMV阴性血液制品的指征,并收集数据以支持可能的实践改变。
确定了2016年5月1日至2016年5月31日期间发放给澳大利亚三家三级医院的所有CMV阴性产品(n = 1219)。这相当于1044个红细胞单位和175个血小板单位。收集了每个单位的去向数据。收集的信息包括输血指征和紧急程度、废弃原因、产品保存期限以及受血者的CMV免疫球蛋白G状态。
在审核期间发放的单位中,32个(2.6%)被医院废弃。收集了411个单位的输血数据。其中,136个(33.1%)被输给了CMV阳性受血者,大多数情况下用于血液学指征,67个单位(16.3%)被输给了需要CMV阴性血液的受血者。共有144个(35%)CMV阴性单位是根据其辐照状态选择的。选择CMV阴性单位的其他原因包括产品接近有效期(n = 134,32.6%)或特定患者表型要求(n = 31,7.5%)。
在本研究中,大多数CMV阴性血液制品并未用于需要CMV阴性血液的受血者。改变库存管理将有利于确保为需要CMV阴性血液的受血者持续供应。