The effect of blood usage protocol on the age of packed red blood cell transfusions administered at 2 veterinary teaching hospitals.

Abstract

Controversy exists regarding the optimal duration of storage of units of canine packed red blood cells (PRBC) prior to transfusion, resulting in different blood usage strategies between hospitals. Two hospitals were studied: At North Carolina State University (NCSU), usage protocol dictates that the oldest units of PRBC (stored the longest) are prioritized for transfusion; whereas, at Ontario Veterinary College (OVC), units of PRBC are sorted according to age (days after collection) and PRBC are selected for transfusion according to clinician or technician discretion, such that PRBC could be administered after any storage duration, with no preference given to older units. To evaluate differences in the age of PRBC administered to dogs at 2 veterinary hospitals with different age-related PRBC usage protocols during a 1-year period (2010-2011). The average age of units of PRBC administered at NCSU was older than that at OVC (P < 0.001). Additionally, a higher number of PRBC units older than 14 days old were transfused at NCSU (P < 0.001), and the age of the oldest administered PRBC unit was also older at NCSU (P < 0.001). NCSU discarded approximately 15 expired PRBC units, whereas OVC discarded 96 expired PRBC units during the study period. A standardized protocol for the priority administration of the oldest stored PRBC resulted in the administration of significantly older PRBC, but fewer expired units of PRBC were discarded.