Flint Andrew Wj, McQuilten Zoe K, Irwin Gregory, Rushford Kylie, Haysom Helen E, Wood Erica M
Transfusion Research Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia; The Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Royal Australian Navy, Australia.
Transfusion Research Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia; The Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Monash Health, Melbourne, Australia.
Transfus Med Rev. 2020 Jan;34(1):42-50. doi: 10.1016/j.tmrv.2019.08.006. Epub 2019 Oct 23.
Current platelet concentrates are perishable blood products with short shelf lives. Combined with often unpredictable demand, this results in platelet inventory management problems, manifested by high rates of outdating frequently reported at 10% to 20%, and sometimes inadequate clinical supply. The objective of this study was to critically review the published methodologies on measures to reduce platelet outdating rates, in order to determine how platelet outdating and availability can be improved. We performed a systematic review of journal articles published in English to May 2019 identified from MEDLINE, with reported methods to improve platelet inventory outdating rates and availability. The complexity of each methodology was scored based on whether a typical blood bank manager could design, implement and run a platelet outdating program based on the methodology. Twenty-four relevant citations were found-these included 8 citations employing operational research (OR) methodologies, 7 evaluation/best practice, 6 simulation and 3 forecasting. Over half the included studies have been published within the last decade. The citations reporting the lowest predicted outdating were also the most complex methods. Overall predicted outdating and shortages were less than 4% based on the available data. In conclusion, we found that research interest in platelet inventory management problems has increased in line with platelet demand and methods to assist in reducing outdating rates without increased shortages have been available now for 4 decades; high rates of platelet outdating do however continue to be reported around the world. Developments in platelet preparation and storage, and other new approaches, may assist in addressing this problem.
目前的血小板浓缩物是保质期较短的易腐血液制品。再加上需求往往不可预测，这就导致了血小板库存管理问题，表现为经常报告的高达10%至20%的高过期率，有时临床供应也不足。本研究的目的是严格审查已发表的关于降低血小板过期率措施的方法，以确定如何提高血小板的过期率和可获得性。我们对截至2019年5月从MEDLINE中检索到的以英文发表的期刊文章进行了系统综述，这些文章报道了提高血小板库存过期率和可获得性的方法。根据典型的血库管理人员是否能够基于该方法设计、实施和运行血小板过期计划，对每种方法的复杂性进行评分。共找到24篇相关文献，其中包括8篇采用运筹学（OR）方法的文献、7篇评估/最佳实践文献、6篇模拟文献和3篇预测文献。超过一半的纳入研究是在过去十年内发表的。报告预测过期率最低的文献也是最复杂的方法。根据现有数据，总体预测过期率和短缺率低于4%。总之，我们发现随着血小板需求的增加，对血小板库存管理问题的研究兴趣也在增加，并且在不增加短缺的情况下有助于降低过期率的方法已经存在了40年；然而，世界各地仍不断有高血小板过期率的报道。血小板制备和储存方面的进展以及其他新方法可能有助于解决这一问题。
