Salvage of red blood cell units using remote electronic blood issue system in operation theater: A pilot study from India

Abstract

Introduction: Anesthetists procure pre-defined number of blood units in advance for surgical patients for ‘just-in-case’ scenarios. This often results in non-usage and discarding of blood units. Blood bank discards blood units returned from operation theatre due to disruption of cold chain. In an effort to reduce this wastage an intervention from transfusion medicine team was undertaken in collaboration with liver transplant team with help of an electronically controlled remote inventory and bedside transfusion management system called BloodTrack Courier. Effectiveness of BloodTrack® Courier in tracing and reducing red cell unit wastage was studied over a four-month period and compared with four-month historical control. Materials and Method: intervention was limited to red cell units issued in elective live-donor liver transplant cases through BloodTrack (Haemonetics Corporation, USA). Controlled access linked to hospital identity cards was provided to Transfusion Medicine Specialists and Liver Transplant anesthetists with different access levels. Pre-allocated RBC units were kept at OT refrigerator for a period of 24-36 hours after which unused units were retrieved by BTS and re-inventoried. Results: Transfusion of RBC units in 60 liver transplant recipients donor before installation was compared with similar 86 liver transplant recipient-donor after installation of BloodTrack. Mean number of RBC units transfused in recipient-donor decreased from 6.2 and 1.0 unit before installation to 5.9 and 0.76 units after installation, respectively. RBC units discarded due to breakage of cold-chain reduced to zero and RBC units successfully returned to blood bank increased 7.6 times. Conclusion: Blood inventory management and remote issue function of Blood Track was very effective in saving RBC units during four-month study period.