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- Title
Logistics of managing a trauma whole blood inventory in a civilian level 1 trauma center.
- Authors
Phan‐Tang, Michelle; Lee, Christine M.; Fang, Amy; Rioveros, Jowin; Siletz, Anaar E.; Cryer, Henry; McGonigle, Andrea M.; Ziman, Alyssa; Ward, Dawn C.; Phan-Tang, Michelle
- Abstract
<bold>Background: </bold>Institutional data on initiating and maintaining a low-titer O positive whole blood (LTOWB) inventory for the civilian trauma sector may help other institutions start a LTOWB program. This study from a level 1 trauma center with a hospital-based donor center highlights challenges faced during the collection, maintenance, and utilization of LTOWB.<bold>Study Design and Methods: </bold>Male O positive donors with low (≤1:100) anti-A and anti-B antibody titers were recruited for LTOWB collection. The daily inventory goal of 4 LTOWB units was kept in the emergency department refrigerator and transfused to adult male trauma patients. Unused units older than 10 days were reprocessed into packed red blood cells.<bold>Results: </bold>Of 900 donors screened, 61% qualified and 52% of eligible donors provided a collective total of 505 LTOWB units over 2.5 years. The number of collected units directly correlated with the availability of inventory; 42% of the units were transfused, 54% were reprocessed, and 4% were discarded. The inventory goal was maintained for 56% of the year 2018 and 83% of the year 2019. Over these 2 years, 52% of patients had their transfusion needs fully met, 41% had their needs partially met, and 6.5% did not have their needs met.<bold>Discussion: </bold>Initial challenges to LTOWB implementation were inventory shortages, low utilization rates, and failure to meet clinical demand. Proposed solutions include allowing for a higher yet safe titer, extending shelf life, expanding the donor pool, identifying barriers to utilization, and permitting use in female trauma patients beyond childbearing age.
- Subjects
WOUND care; ABO blood group system; TRAUMA centers; BLOOD transfusion; BLOOD collection; RESUSCITATION
- Publication
Transfusion, 2022, Vol 62, Issue 9, p1772
- ISSN
0041-1132
- Publication type
journal article
- DOI
10.1111/trf.17035