Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
University of Toronto Quality in Utilization, Education and Safety in Transfusion (QUEST) Research Program, Toronto, Ontario, Canada.
Transfusion. 2021 May;61(5):1383-1388. doi: 10.1111/trf.16303. Epub 2021 Feb 11.
Platelets are the most commonly discarded blood product in Canada, with the most common cause of in-date product loss being improper storage. Transport containers to maintain temperature and extend acceptable return time may represent a method to reduce wastage. The objective of this study was to evaluate the impact of a validated Platelet Transport Bag (PTB) on platelet wastage.
Thirty-six hospitals with the highest platelet discards were invited to participate in a before-after observational study. Hospitals were instructed to utilize a validated 4-h PTB for clinical situations where immediate transfusion was not planned. Five hospitals audited in-date platelet discards from July 2018 to November 2019 to characterize wastage causes. In-date platelet discard data 12 months before and after the start date for each site were analyzed to determine changes in wastage.
Of 36 hospital sites, 16 agreed to participate. Pre- and postdiscards were 277 and 301, respectively, for all sites combined. There were no significant before-after change in wastage rate (+0.05%, p = .51). Fifty discards were included in the detailed audit; the most common reasons were return to the blood bank after more than 60 min outside a PTB (n = 17, 34%) and return in a red cell cooler (n = 10, 20%).
Implementation of PTB did not improve wastage. Common causes of in-date discards were return after 1 h outside of a PTB and placement in a red cell cooler in error. Further research is required to investigate potential strategies to mitigate in-date platelet wastage.
血小板是加拿大最常被废弃的血液制品，导致在有效期内产品损失的最常见原因是储存不当。维持温度并延长可接受的返还时间的运输容器可能是减少浪费的一种方法。本研究的目的是评估经过验证的血小板运输袋（PTB）对血小板浪费的影响。
邀请了 36 家血小板丢弃量最高的医院参加一项前后观察研究。医院被指示在不计划立即输血的临床情况下使用经过验证的 4 小时 PTB。五个医院对 2018 年 7 月至 2019 年 11 月期间的在效期血小板丢弃物进行审核，以确定浪费的原因。对每个地点开始日期前 12 个月的在效期血小板丢弃数据进行分析，以确定浪费的变化。
在 36 个医院中，有 16 家同意参与。所有医院的丢弃物分别为 277 个和 301 个。丢弃率没有明显的前后变化（+0.05%，p=0.51）。50 个丢弃物被包括在详细审核中；最常见的原因是在 PTB 外超过 60 分钟返回血库（n=17，34%）和返回红细胞冷却器（n=10，20%）。
实施 PTB 并没有改善浪费情况。在效期丢弃的常见原因是在 PTB 外 1 小时返回和错误放置在红细胞冷却器中。需要进一步研究以调查减少在效期血小板浪费的潜在策略。
