How do I implement a whole blood program with low blood wastage?

Area of Science:

• Transfusion Medicine
• Emergency Medicine
• Logistics and Supply Chain Management

Background:

• Low-titer O whole blood (LTOWB) is increasingly used in civilian prehospital care for major bleeding.
• LTOWB provides a balanced transfusion of red blood cells, coagulation factors, and platelets.
• Challenges include LTOWB availability and predicting demand, risking wastage.

Purpose of the Study:

• To describe logistical strategies for implementing LTOWB in Swedish civilian healthcare.
• To analyze experiences from five transfusion centers regarding production, usage, and wastage.
• To identify effective methods for reducing LTOWB wastage.

Main Methods:

• A descriptive study involving five Swedish transfusion centers producing LTOWB.
• Data collection on production lines, usage patterns, and wastage rates.
• Analysis of implemented logistical strategies to mitigate wastage.

Main Results:

• LTOWB is utilized prehospital (HEMS, rapid response vehicles) and inhospital (University Hospitals).
• Logistical strategies include rotating unused prehospital LTOWB for inhospital use and preparing RBC units from older LTOWB.
• Wastage rates ranged from 0%-13% in four centers, with one center reporting 34% wastage.

Conclusions:

• Predicting the need for LTOWB in prehospital emergencies is challenging.
• Minimizing wastage requires tailored logistical chains based on local conditions.
• Swedish centers employ LTOWB rotation or RBC preparation to manage supply and demand.