Gammon Richard R, Rosenbaum Lizabeth, Cooke Rhonda, Friedman Mark, Rockwood Linda, Nichols Tracie, Vossoughi Sarah
Scientific Medical and Technical Direction, OneBlood, Inc., Orlando, Florida, USA.
Vitalant, Albuquerque, New Mexico, USA.
Transfusion. 2021 Jan;61(1):294-302. doi: 10.1111/trf.16145. Epub 2020 Nov 18.
The availability of a safe blood supply is a key component of transfusion medicine. A decade of decreased blood use, decreased payment for products, and a dwindling donor base have placed the sustainability of the US blood supply at risk.
A literature review was performed for blood center (BC) and hospital disaster management, chronically transfusion-dependent diseases, and appropriate use of group O-negative red blood cells (RBCs), and the Choosing Wisely campaign. The aim was to identify current practice and to make recommendations for BC and hospital actions.
While BCs are better prepared to handle disasters than after the 9/11 attacks, messaging to the public remains difficult, as donors often do not realize that blood transfused during a disaster was likely collected before the event. BCs and transfusion services should participate in drafting disaster response plans. Hospitals should maintain inventories adequate for patients in the event supply is disrupted. Providing specialty products for transfusion-dependent patients can strain collections, lead to increased use of group O RBCs, and create logistical inventory challenges for hospitals. The AABB Choosing Wisely initiative addresses overuse of blood components to optimally use this precious resource. Group O-negative RBCs should be transfused only to patients who truly need them.
Collecting and maintaining a blood supply robust enough to handle disasters and transfusion-dependent patients in need of specialty products is challenging. Collaboration of all parties should help to optimize resources, ensure appropriate collections, improve patient care, and ultimately result in a robust, sustainable blood supply.
安全血液供应的可及性是输血医学的关键组成部分。十年来，血液使用量减少、产品支付费用降低以及献血者群体不断萎缩，使美国血液供应的可持续性面临风险。
对血液中心（BC）和医院的灾难管理、长期依赖输血的疾病、O型阴性红细胞（RBC）的合理使用以及“明智选择”运动进行了文献综述。目的是确定当前的做法，并就血液中心和医院的行动提出建议。
虽然血液中心比9·11袭击后更有能力应对灾难，但向公众传达信息仍然困难，因为献血者往往没有意识到灾难期间输注的血液很可能是在事件发生前采集的。血液中心和输血服务机构应参与起草灾难应对计划。医院应保持足够的库存，以防供应中断时患者的需求。为依赖输血的患者提供特殊产品可能会给采集工作带来压力，导致O型红细胞的使用增加，并给医院带来后勤库存方面的挑战。美国血库协会（AABB）的“明智选择”倡议旨在解决血液成分过度使用的问题，以最佳方式利用这一宝贵资源。O型阴性红细胞应仅输给真正需要的患者。
收集和维持足够强大的血液供应，以应对灾难和有特殊产品需求的依赖输血患者，是一项具有挑战性的任务。各方合作应有助于优化资源、确保合理采集、改善患者护理，并最终实现强大、可持续的血液供应。
