A novel allocation strategy for blood transfusions: investigating the tradeoff between the age and availability of transfused blood

  title={A novel allocation strategy for blood transfusions: investigating the tradeoff between the age and availability of transfused blood},
  author={Michael P. Atkinson and Magali J. Fontaine and Lawrence T Goodnough and Lawrence M. Wein},
BACKGROUND: Recent studies show that transfusing older blood may lead to increased mortality. This raises the issue of whether transfusing fresher blood can be achieved without jeopardizing blood availability. 

Reducing the age of transfused red blood cells in hospitals: ordering and allocation policies

There may still be a need for inventory management policies that could reduce the age of transfused RBCs without compromising availability or resulting in excessive outdates.

Ensuring blood is available when it is needed most

The provision of blood to patients in need is an imperative faced by all countries and inventory managers at hospitals need to know how many RBCs to order so that the supply of blood can be guaranteed.


A simulation model is built to study the impact of racial and ethnic diversity in combination with a blood allocation threshold and shows that for many diverse cities like New York City that the increased diversity of the population can lead to a large mismatch between blood supply and demand.

Allocation Policies in Blood Transfusion

It is found that when reducing the shelf-life has a high impact on availability, the threshold policy is more effective, and this is observed, in particular, for blood types with lower demand, for smaller hospitals, and when a lower age of transfused RBCs is required.

Modeling the potential impact on the US blood supply of transfusing critically ill patients with fresher stored red blood cells

This study represents the first attempt to develop a comprehensive framework to evaluate the impact of preferentially transfusing fresher stored red blood cells to the higher-risk critically ill patients on supply.

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

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.

Threshold-Based Allocation Policies for Inventory Management of Red Blood Cells

This work studies the performance of a practical family of threshold-based allocation policies, designed to trade off the age of RBC transfusions with their availability at hospitals, using a stylized model of a hospital blood bank that procures its required blood from local donations.

A stock‐and‐flow simulation model of the US blood supply

Lack of reporting requirements for the amount of blood stored in blood banks and hospitals poses challenges to effectively monitor the US blood supply. Effective strategies to minimize collection and

Where now for transfusion: the evolution of a paradigm and its logical progression

A critical look is taken at blood transfusion as it is practiced today, and whether it serves the individual patient as effectively as the interests of those who administer it.

Risk factors for transfusion-associated complications and nonsurvival in dogs receiving packed red blood cell transfusions: 211 cases (2008-2011).

Prospective randomized studies are needed to determine whether conservative transfusion strategies will reduce transfusion-associated complications and improve outcome in dogs.



Age of blood as a limitation for transfusion: potential impact on blood inventory and availability

Trials evaluating the benefits of transfusing fresher blood to acutely ill patients with evolving concerns about storage lesions for red blood cells suggest that transfusing fresh blood to patients with acutely ill conditions is a viable option.

Association between duration of storage of transfused red blood cells and morbidity and mortality in adult patients: myth or reality?

The duration of red blood cell storage before transfusion may alter RBC function and, therefore, influence the incidence of complications.

The societal unit cost of allogenic red blood cells and red blood cell transfusion in Canada

The objective of this study was to determine the unit cost of allogenic RBCs and RBC transfusion in Canada from a societal perspective.

Does red blood cell storage affect clinical outcome? When in doubt, do the experiment

This issue of TRANSFUSION offers two articles that address the current level of understanding of the impact of RBC storage on patient outcomes and point out some of the difficulties of interpreting the data from these clinical studies.

Influence of Erythrocyte Concentrate Storage Time on Postsurgical Morbidity in Cardiac Surgery Patients

Prolonged storage of erythrocytes does not increase morbidity in cardiac surgery, however, storage for longer than 28 days could be a risk factor for the acquisition of nosocomial pneumonia.

Duration of red-cell storage and complications after cardiac surgery.

In patients undergoing cardiac surgery, transfusion of red cells that had been stored for more than 2 weeks was associated with a significantly increased risk of postoperative complications as well as reduced short-term and long-term survival.

Increased rate of infection associated with transfusion of old blood after severe injury.

Transfusion of old blood is associated with increased infection after major injury, and other options, such as leukocyte-depleted blood or blood substitutes, may be more appropriate in the early resuscitation of trauma patients requiring transfusion.

Storage time of transfused blood and disease recurrence after colorectal cancer surgery

Transfusion of buffy-coat-depleted red cells suspended in saline, adenine, glucose, and mannitol blood stored for < 21 days may be an independent risk factor for development of recurrence after elective colorectal cancer surgery.

Association of mortality with age of blood transfused in septic ICU patients

This is the first study to report a correlation of mortality with the age of PRBC transfused, and if this association is confirmed by a prospective randomised tnal it would have major implications for the use ofPRBC in severe sepsis.