Don't break the (blood) bank: Can waste be minimized in a whole blood program?

Am J Surg. 2024 Nov 17:240:116082. doi: 10.1016/j.amjsurg.2024.116082. Online ahead of print.

Abstract

Background: Wastage concerns are a barrier to adopting whole blood (WB) therapy in trauma patients. Converting aging WB to red blood cell units (RBCs) may minimize wastage.

Methods: Blood bank records for WB and standard blood products were retrospectively reviewed at a level 1 trauma center from 8/2020 - 3/2023. Secondary analysis of outcomes for patients requiring trauma activation and receiving WB or RBC within 4 ​h of arrival was performed. Blood wastage and outcomes were compared.

Results: WB and type-O RBCs had comparable wastage rates (0.7 vs 0.5 ​%). 677 WB units were transfused, while 668 were converted and transfused as RBCs. 9 were wasted, none expired. 496 patients met secondary analysis criteria. 168 received WB. WB transfusion ratios were more balanced and outcomes were similar compared to component therapy (COMP).

Conclusion: Converting aging WB to RBCs resulted in minimal blood wastage, with similar outcomes and more balanced transfusion ratios compared to COMP.

Keywords: Expiration; Transfusion; Trauma; Waste; Whole blood.