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Discard rate in blood transfusion service – A critical tool to support blood inventory management

Rakesh Kumar Luhar, Ripal J Shah, Harimoorthy V.




Abstract

Background: Blood and blood component plays a key role in health-care management. Even after enormous efforts, there is no substitute available. Blood is a scarce resource and blood wastage could impose a very serious impact on health care.

Objective: The current study was conducted to determine rate and reasons for wastage of blood and its blood components.

Materials and Methods: A retrospective study was conducted in one of the largest standalone blood centers of West India. Data were retrieved from indigenous Integrated Blood Bank Management System software. The data were analyzed for a period of 12 months, from January 1, 2019, to December 31, 2019.

Results: The total collection of blood units during the study period was 30,960 units. As per the policy of blood center, all the blood units were subjected to component separation with preparation with 88,973 components, including red cells, platelet concentrates (PLT), fresh frozen plasma (FFP), cryoprecipitate (CRYO) cryo-poor plasma (CPP), and single donor platelet (SDP). A total of 2637 blood and blood components (2.96%) were discarded during the study period. Discard rate among blood and blood component as per separation was found whole blood 0.99%, red blood cells 2.28%, FFP 1.88%, PLT 4.66%, CRYO 3.88%, CPP 1.25%, and SDP 0.47%, respectively. Among total discard rates, the major reason is seroreactivity of blood donor (1.11%), followed by expiry (0.67%), quality checks (0.29%), clotted bag (0.03%), Direct antiglobulin test (DAT/DCT) positivity (0.00%), and other causes (0.06%).

Conclusion: Worldwide comprehensive standards have been formulated to ensure better quality control in each step of blood transfusion service including collection, storage, testing, and distribution of blood and components. To prevent wastage of rare commodity, continued medical education for technical staff, self-audit, and tracking quality indicators for the blood components is highly recommended.

Key words: Blood; Blood Component; Discard Rate; Quality Indicator; Quality Control; Audit






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