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希腊的血小板输注:地点、时间、原因?一项全国性调查。

Platelets transfusion in Greece: Where, when, why? A national survey.

作者信息

Valsami Serena, Pouliakis Abraham, Gavalaki Maria, Argyrou Aspasia, Triantafillou Evagelia, Arvanitopoulou Evagelia, Girtovitis Fotios, Voulgaridou Virginia, Megalou Aggeliki, Chronopoulou Paraskevi, Papachronis Andreas, Sakellarakis George, Zervou Eleftheria, Batsi Christina, Fountouli Kalliopi, Athanasopoulos Aggelos, Kyriakou Elias, Cheropoulou Afrodite, Livada Anastasia, Lebessopoulos Konstantinos, Papakonstantinou Maria, Gafou Anthi, Katopi Despina, Martinis George, Dendrinou Ioanna, Katharopoulou Hrysanthi, Politou Marianna, Papadopoulou Margarita, Papadopoulou Paraskevi, Manaka Ekaterini, Paneta Konstantina, Alepi Chrissoula, Damaskos Christos, Garmpis Nikolaos, Stamoulis Konstantinos, Grouzi Elisavet

机构信息

Hematology, Laboratory-Blood Bank Department, Aretaieion Hospital, National and Kapodistrian University of Athens, Medical School, Patras, Greece.

Second Department of Pathology, National and Kapodistrian University of Athens, "Attikon" University Hospital, Patras, Greece.

出版信息

Asian J Transfus Sci. 2020 Jul-Dec;14(2):158-166. doi: 10.4103/ajts.AJTS_72_18. Epub 2020 Dec 19.

DOI:10.4103/ajts.AJTS_72_18
PMID:33767543
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7983137/
Abstract

BACKGROUND

Platelet transfusion is among the most useful therapeutic tools in modern clinical settings which mean that ensuring an adequate supply is of paramount importance.

AIM

The aim of our study was to record the use and wastage of platelet concentrates (PCs) in Greece, so as to come up with evidence-based interventions.

METHODS

The study was conducted during May and June 2015. We evaluated the use of random-donor platelets (RDPs) and single-donor apheresis platelets (SDPs). We analyzed such parameters as hospital department and diagnosis, indication for transfusion, PCs' age at the time of transfusion, and wastage rate.

RESULTS

We used data from 21 hospitals across the country. A total of 12,061 RDPs and 1189 SDPs were transfused, with an average of 4.84 (±2.72) and 1.12 (±2.73) units per episode, respectively. Most patients had been admitted to the internal medicine and hematology departments. The transfusions were mostly given prophylactically, usually in cases of acute leukemia, and mostly on the day before expiration. Wastage rate was 16.75% for RPDs and 2.70% for SDPs, primarily because of the expiration of the use-by date.

CONCLUSIONS

This is the first national survey regarding platelet transfusion in Greece. Since most patients were admitted in internal medicine and hematology departments, we recommend that the staff of the abovementioned departments should undergo training on contemporary transfusion guidelines. Platelet discard rate could further be lowered through the centralization of inventory management along with the extension of the lifetime of PCs by means of emerging technologies.

摘要

背景

血小板输注是现代临床环境中最有用的治疗手段之一,这意味着确保充足的供应至关重要。

目的

我们研究的目的是记录希腊血小板浓缩物(PCs)的使用和浪费情况,以便提出基于证据的干预措施。

方法

该研究于2015年5月和6月进行。我们评估了随机供体血小板(RDPs)和单采血小板(SDPs)的使用情况。我们分析了诸如医院科室和诊断、输血指征、输血时PCs的保存期限以及浪费率等参数。

结果

我们使用了全国21家医院的数据。共输注了12,061个RDPs和1189个SDPs,每次输注的平均单位数分别为4.84(±2.72)和1.12(±2.73)。大多数患者入住内科和血液科。输血大多是预防性的,通常用于急性白血病患者,且大多在过期前一天进行。RPDs的浪费率为16.75%,SDPs的浪费率为2.70%,主要原因是超过了使用期限。

结论

这是希腊首次关于血小板输注的全国性调查。由于大多数患者入住内科和血液科,我们建议上述科室的工作人员应接受当代输血指南的培训。通过集中库存管理以及借助新兴技术延长PCs的保存期限,血小板丢弃率可进一步降低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/307f/7983137/7d6c23135213/AJTS-14-158-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/307f/7983137/7d6c23135213/AJTS-14-158-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/307f/7983137/7d6c23135213/AJTS-14-158-g001.jpg

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本文引用的文献

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Refrigeration, cryopreservation and pathogen inactivation: an updated perspective on platelet storage conditions.冷藏、冷冻保存与病原体灭活:血小板储存条件的最新观点
Vox Sang. 2018 May;113(4):317-328. doi: 10.1111/vox.12640. Epub 2018 Feb 14.
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Evaluation of the advantages of platelet concentrates stored at 4°C versus 22°C.评估4°C与22°C储存的血小板浓缩物的优势。
Transfusion. 2018 Mar;58(3):736-747. doi: 10.1111/trf.14462. Epub 2017 Dec 21.
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A survey of the blood supply in China during 2012-2014.2012 - 2014年中国血液供应情况调查。
Transfus Med. 2019 Feb;29(1):28-32. doi: 10.1111/tme.12492. Epub 2017 Dec 11.
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Storage time of platelet concentrates and risk of a positive blood culture: a nationwide cohort study.血小板浓缩物的储存时间与血培养阳性风险:一项全国性队列研究。
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Big data modeling to predict platelet usage and minimize wastage in a tertiary care system.大数据建模以预测三级护理系统中的血小板使用情况并最小化浪费。
Proc Natl Acad Sci U S A. 2017 Oct 24;114(43):11368-11373. doi: 10.1073/pnas.1714097114. Epub 2017 Oct 9.
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Blood wastage management in a regional blood transfusion centre.地区输血中心的血液损耗管理
Transfus Med. 2017 Oct;27 Suppl 5:348-353. doi: 10.1111/tme.12433. Epub 2017 Jun 29.
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The practice of platelet transfusion prior to central venous catheterization in presence of coagulopathy: a national survey among clinicians.在存在凝血病的情况下,中心静脉置管前进行血小板输注的实践:一项针对临床医生的全国性调查。
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