Optimizing blood bank resources when implementing a low‐titer group O+ whole blood program: an in silico study
- 8 June 2020
- journal article
- research article
- Published by Wiley in Transfusion
- Vol. 60 (8), 1793-1803
- https://doi.org/10.1111/trf.15826
Abstract
INTRODUCTION Low‐titer group O+ whole blood (LTOWB) is becoming commonly used in massive bleeding resuscitation, but the impact on blood center O+ RBCs has not been studied. This in silico model simulated a variety of different LTOWB production and utilization patterns. METHODS Collections and distributions data from a large blood collector were scaled to vary the total number of O+ red blood cell (RBC) collections, the O+ RBC collection: import ratio, and the O+ RBC apheresis: whole blood (WB) collection ratio. Daily LTOWB demand was determined by the daily number of LTOWB recipients, average number of LTOWB units transfused per patient, maximum number of LTOWB units a single patient can receive, and seasonality of LTOWB use. LTOWB program factors included the high‐titer exclusion %, the LTOWB expiry, and whether LTOWB units were reclaimed as O+ RBC units on the date of expiry. Simulations using unique combinations of the above input parameters were performed. RESULTS For the 1,224,720 unique combinations of input parameters simulated, the average increase in the fraction of additional O+ RBC units required to meet hospital demand was only 0.02%. Higher daily LTOWB demand resulted in more LTOWB shortages. Increasing the minimum LTOWB inventory threshold reduced LTOWB shortages without increasing the number of required additional RBC units. LTOWB wastage was minimal but was lower with longer LTOWB shelf life or manufacture of RBC units from unused LTOWB on Day 14. CONCLUSION Implementing an LTOWB program does not have a major impact on the blood collectors' needs for additional RBC units to meet hospital demands.Keywords
This publication has 19 references indexed in Scilit:
- Clinical outcomes among low‐titer group O whole blood recipients compared to recipients of conventional components in civilian trauma resuscitationTransfusion, 2018
- Prehospital Plasma during Air Medical Transport in Trauma Patients at Risk for Hemorrhagic ShockThe New England Journal of Medicine, 2018
- Association of Prehospital Blood Product Transfusion During Medical Evacuation of Combat Casualties in Afghanistan With Acute and 30-Day SurvivalJAMA, 2017
- Extending R with C++: A Brief Introduction to RcppPeerJ Preprints, 2017
- Continued decline in blood collection and transfusion in the United States–2015Transfusion, 2017
- Changes in blood center red blood cell distributions in the era of patient blood management: the trends for collection (TFC) studyTransfusion, 2016
- Data AnalysisPublished by Springer Science and Business Media LLC ,2016
- ggplot2Published by Springer Science and Business Media LLC ,2016
- The Split-Apply-Combine Strategy for Data AnalysisJournal of Statistical Software, 2011
- RPrograms for Computing Truncated DistributionsJournal of Statistical Software, 2006