Perioperative PBM in liver transplant patients: establishment and implementation / 中国输血杂志

【Objective】 To establish a practical and feasible blood management (PBM) model for clinical liver transplant patients, so as to optimize the perioperative blood usage and improve patient prognosis and survival rate. 【Methods】 Led by the Medical Department, a questionnaire survey Establishment and Implementation of a Blood Management Model for Organ Transplant Patients on the importance of establishing a PBM model for liver transplant patients in clinical practice was conducted among 71 staff from relevant departments such as the Anesthesiology Department, Hepatobiliary Department, Blood Transfusion Department, and ICU Medical Department. After statistical analysis, the important items of PBM for liver transplant patients were determined, and a (trial) plan was organized by the Medical Department and training was conducted by Blood Transfusion Department for medical staff training from departments as Anesthesiology, Hepatobiliary and Pancreatology, and ICU; PBM measures for liver transplant patients before, during and after surgery were determined by the Anesthesiology Department, Hepatobiliary and Pancreatic Department, and ICU; PBM was fully implemented in the experimental group with liver transplant patients in our hospital in 2021 as subjects; 30 cases of liver transplantation performed in our hospital in 2020 were selected as the control group, and the general data, preoperative laboratory examination results, and preoperative, intraoperative, and postoperative blood transfusion of the two groups of patients were compared. 【Results】 Compared with the control group, the experimental group did not receive any blood component transfusion before surgery. Intraoperative blood transfusion volume of allogeneic components: red blood cells(U) were 12.75(8.75, 18.63) vs 15.25(8.38, 26.13)(P>0.05), apheresis platelet (treatment volume) was 0(0, 2) vs 1(0, 4.25)(P>0.05), plasma(U) was 2 300(1 550, 3 763) vs 3 650(2 075, 5 400)(P0.05), platelets were not transfused, plasma(U) was 0(0, 0) vs 0(0, 600)(P>0.05), and cryoprecipitates were not transfused. 【Conclusion】 The establishment of PBM model for liver transplant patients and the application of its management measures before, during and after transplantation significantly reduced the intraoperative blood transfusion volume and improved the prognosis of patients after transplantation.

Clinical blood use in Tibet Autonomous Region People′s Hospital: A respective study of 2014~2018 / 中国输血杂志

【Objective】 To retrospectively investigate the clinical transfusion status in Tibet Autonomous Region People′s Hospital, in order to provide data basis for further improvement of the rational and scientific blood use in our hospital. 【Methods】 Medical records of transfusion recipients in our hospital from 2014 to 2018 were investigated via HIS system, and such indicators as total clinical blood use, usage of whole blood and blood components, blood transfusion per capita, usage of blood components with different types. and the usage of red blood cells and plasma in each clinical department were retrospectively analyzed. 【Results】 The total clinical blood usage of our hospital increased from 3 930.5 U in 2014 to 4 949 U in 2018, with an annual growth rate of 5.93%. The average blood use per capita in 2014 and 2018 was 0.205 U vs 0.218 U, and incidence of blood component transfusion was 47.18% vs 99.02% The proportion of blood component (red blood cell and plasma) usage was 36.0%, 35.9%, 20.7% and 7.4% for blood type O, A, B and AB, respectively. The usage of total blood, red blood cell and plasma in internal and surgical departments were 13 883.8 U vs 7 080.8 U, 4 963.3 U vs 3 647.3 U and 6 055 U vs 1 170 U, respectively. 【Conclusion】 The total clinical blood usage and the proportion of blood component transfusion in our hospital is increasing year by year. Therefore, rational and scientific blood use should be further improved.

Long Term Prospects for the Blood Supply and Demand / 대한수혈학회지

BACKGROUND: There is a need to prepare an adequate blood supply because of the imbalance between the blood supply and demand and the advent of an aging society. This paper presents the basic data for the blood supply and demand through an estimation of the blood donation and blood usage over the next ten years. METHODS: Data analysis was carried out using time-series methods. The data for the monthly blood donation from the Korean Red Cross from 1992 to 2004 was used to estimate the blood donation, and data of the blood supply from the Korean Red Cross and hospitals from 2000 to 2004 for the estimation of the blood supply for transfusion. In order to overcome the limits of the time-series methods, one prospect excluding the data from the year 2004 and the other prospect including the data from the year 2004 were analyzed simultaneously. RESULTS: According to the analysis performed with data from the year 2004 excluded, blood donation rate is expected to decrease to 2.5% in 2015 and the total blood demand (1,435,903 units), which is composed of RBC and single donor platelet, is expected to exceed the total blood donation (1,408,244 donors) by 2015. According to the analysis performed with the data from the year 2004 included, the blood donation rate is expected to decrease to 1.3% in 2015 and the total blood demand (1,760,219 units) is expected to exceed the total blood donation (1,639,042 donors) in 2009. CONCLUSION: A shortage of blood supply is expected to occur during the next ten years. In order to eliminate this blood shortage, a national data management system for blood collection and usage will be needed. In addition, adequate donor resources as well as a monitoring system will be needed to improve the efficiency of blood usage.

Survey of Blood and Blood Components Usages at Ten University Hospitals in Korea, 1995 to 2004 / 대한수혈학회지

BACKGROUND: The management of blood program is difficult, because there is no comprehensive data collection system in place that gathers data about blood and blood components (blood) usage in Korea. To provide basic data for estimating future blood needs and thereby adjusting the blood program to those needs, data of blood usage in ten Korean university hospitals was analyzed. METHODS: The amount of blood used in Korea from 1995 to 2004 was estimated from the data of the Korean Red Cross Blood Centers (KRCBC) and from blood collection data of hospitals. Ten top ranking hospitals regarding blood usage were selected based on a previous report, and the data for blood usage in these hospitals were evaluated. RESULTS: About 20% of red blood cells (RBC) including whole blood > or =40% of platelets (PLT), > or =30% of plasma products (Plasma), and > or =70% of single donor apheresis platelets (SDP) transfused in Korea were used in ten University hospitals. The pattern of blood utilization in ten hospitals was different from that in total hospitals in Korea. The mean units of blood transfused per 1000 admitted patients in these ten hospitals increased steadily until 2000, but from 2001 the amount of blood transfused reached a plateau until 2004, although variations between hospitals is noticed, it seems to be stabilized. About 35% of RBC, 33% of Plasma and 27% of PLT were transfused for patients aged 60 years or more, and the transfusion rate for RBC was between 5% and 17% showing an increasing tendency proportional to patients age in two hospitals. CONCLUSION: This study provides baseline data for planning a blood program, and for a blood monitoring program a continuous and comprehensive data collection system for blood supply and blood demand needs to be established at a National level.