Application and retrospective analysis of the indicator system for non-conforming blood products in Beijing

Systematic evaluations of blood discard patterns remain limited. We analysed decade-long discard trends at a representative blood establishment to identify quality improvement opportunities.

Discard data for blood products collected from 1 January 2015 to 31 December 2024 were obtained from the Beijing Red Cross Blood Center, classifying discards as test-related or non-test-related. Pareto charts identified major drivers of discard, and ${\chi }^2$ and Cochran-Armitage trend tests were used.

The overall discard rate averaged 3.050%, peaking at 4.398% in 2021 before declining to 2.410% in 2024 (Z = -6.111, p < 0.0001). Non-test-related discards increased significantly from 0.720% in 2015 to 2.636% in 2021 (mean: 1.118%/year; Z = 26.478, p < 0.0001), before recovering to below pre-pandemic levels by 2024. Test-related discards decreased significantly from 2.254% in 2015 to 1.663% in 2020 and continued to decrease through 2024 (mean: 1.921%/year; Z = -27.454, p < 0.0001). Major discard drivers included lipaemic blood retest (LBR) in plasma, crossmatch incompatibility (CI) in red blood cell (RBC) products and alanine aminotransferase (ALT) retest failure. Plasma bag leakage (BL), platelet visual inspection abnormality (VIA), expired units and Treponema pallidum antibody (TP-Ab) and hepatitis C virus antibody (HCV-Ab) test-related discards, all showed significant downward trends (p < 0.001).

Divergent trends between test-related discards (declining from 2.254% to 1.663%) and non-test-related discards (increasing from 0.720% to 2.636%) indicate that although laboratory screening has improved substantially, greater attention is needed to optimize collection, processing and handling practices.