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Audit of a paediatric directed donation programme
M I Knuckey1, E M Wood, H F Savoia
1Department of Laboratory Services, Women's and Children's Health, Melbourne, Victoria, Australia.
Insights
A paediatric directed donation programme (DDP) shows high wastage rates and is costly. Refinements in referral appropriateness are needed to improve efficiency and reduce blood discard.
Area of Science:
- Paediatric Haematology
- Transfusion Medicine
- Public Health
Background:
- A paediatric directed donation programme (DDP) was established in response to public demand after a HIV transmission case.
- This audit reviews the initial 18 months of the DDP's operation.
Purpose of the Study:
- To assess the effectiveness and efficiency of a newly instituted paediatric directed donation programme.
- To analyze blood collection, transfusion, and wastage rates within the DDP.
Main Methods:
- Retrospective analysis of data from February 2000 to July 2001.
- Examined blood units requested, donated, transfused, and the use of allogeneic blood.
Main Results:
- 125 referrals received; 89 eligible children had blood donated by compatible parents (76%).
- 116 units collected from 221 requested; 53% of collected units were discarded.
- 47% of children received only directed donor blood; 12% received additional non-directed components.
Conclusions:
- The paediatric DDP meets a community need but exhibits significant blood wastage.
- The programme is resource-intensive and costly compared to non-directed blood donation.
- Refining referral criteria is crucial to minimize wastage and improve programme efficiency.
Objective:
A paediatric directed donation programme (DDP) was instituted by Women's and Children's Health in conjunction with the Australian Red Cross Blood Service, Melbourne, Victoria, Australia, in response to public demand following a case of transfusion-transmitted HIV. This audit assesses the first 18 months of the programme.
Methods:
Retrospective analysis, from February 2000 to July 2001, examining the number of units of blood requested, donated, and transfused, as well as the use of allogeneic (non-directed) blood.
Results:
The DDP received 125 referrals. Most (78%) were for elective surgery. Of the 89 eligible children, 76% (68) had blood donated for them by an ABO/Rhesus-compatible parent, 81% of whom were first-time blood-donors. No donor tested positive for infectious markers. In total, 221 units of blood were requested and 116 units were collected. Non-collection was mainly a result of parent-child ABO incompatibility or medical ineligibility of the proposed donor. Of the children for whom blood was collected, 28 (41%) received no transfusion and eight (12%) received non-directed components in addition to DDP blood; thus, 32 (47%) received solely the blood from their directed donor. Of the units collected, 53 (46%) were transfused and 63 (54%) were discarded.
Conclusions:
While the paediatric DDP serves a community need, the programme has a high wastage rate, is time-consuming, labour-intensive and an expensive alternative when compared with the provision of non-directed volunteer blood. In continuing the programme, appropriateness of referral needs to be refined to reduce wastage rates.
