Hi Ira,

Of course, this is one of the biggest challenges facing the transfusion services globally. In term of platelets units, it is the difficult one because the lower shelf life and I saw a several publications for the cold platelets (CP) and may will be use in the near future instead of room temperature platelet (RP). I think if these research successes that can increase the use of platelets from 7 days to around 21 days in some articles. The issue with the RBCs units are the lesions. It is really interesting area of research and hopefully will find a great findings in the near future.

the options available might include addition of Additive solutions

use of Red cell freezing techniques

The most important question is why RBCs are unsuitable. If the reason is excessive collection or collection of blood from rare groups (AB, Kell+ and others), the solution is better scheduling of the collection. For example, AB or Kell+ donors may only donate apheresis plasma.

Like any "industrial" activity, however, the waste of a part of the product guarantees a constant supply to users.

Until we can resort to blood produced by stem cells or other laboratory procedures, there are not many other solutions. Freezing, due to its difficulties, will always be reserved for rare groups or war medicine.

Consider keeping a registray of rare blood groups. You can call them when required and screen them via molecular testing and prepare components as and when required for very rare blood group

Calculate work load of the draining hospital and area maintain your stock at that level keeping 10 % extra8 for emergency . If you know a situation will arise where extra req of RCC will arose call from registary

While RBG a possibility of Freezing of blood and calling from central blood banks is also a good option

Singhal et al. (2013) stated that the most common cause of disposal of pRBCs was expiry, while whole blood was usually discarded due to insufficient quantity. Therefore, reducing blood disposal can begin with proper collection and handling. Medical laboratory scientists need to be trained and should be updated with the latest guidelines given by the local blood banking council. Blood bags should be double-checked to avoid insufficient quantity. Next, blood components should also be in a temperature-controlled storage until they are ready to be administered to patients. With this, blood bags will last until their expected shelf life. Lastly, medical personnel should practice better inventory management to ensure that no blood goes to waste. By creating an ideal inventory level, medical personnel can avoid expiry and reduce wastage (Vatkar et al., 2023).

Reference:

Singhal, M., Patel, M., Kapoor, D., & Mittal, D. (2013). A research analysis on blood component usage and wastage in blood bank and blood component center. J Physiol Pathophysiol, 4(2), 23-8.

Vatkar, A., Shinde, S., Bhor, P., Kale, S., Kale, S., Doshi, S., Dey, J., Mandal, S., & Simha, K. (2023). Causes of blood product discard in the Blood Bank of Tertiary Health Center over 5 years: A retrospective study. MGM Journal of Medical Sciences, 10(2), 252–256. https://doi.org/10.4103/mgmj.mgmj_77_23

In research conducted by Collins et al. (2015), affordable strategies such as educational outreach, printed and digital communication, and enhanced transportation and component identification methods were introduced. The same study concluded that these affordable interventions can swiftly and significantly decrease blood wastage, leading to cost-effectiveness and resource conservation. Applying such interventions can be crucial in avoiding wastage, with the ongoing disposal of unsuitable blood. Furthermore, another study by Kingsley et al. (2020) stated that providing technical staff with training can decrease the rate of discards and alleviate the scarcity of these valuable resources. Through this initiative, technicians will gain comprehensive knowledge of strategies to avoid blood wastage thus mitigating limited blood supplies.

References:

Collins, R., Wisniewski, M. K., Waters, J. H., Triulzi, D. J., & Yazer, M. H. (2015). Effectiveness of multiple initiatives to reduce blood component wastage. American Journal of Clinical Pathology, 143(3), 329–335. https://doi.org/10.1309/ajcp42wmhsstphxi

Kingsley, S., Ambroise, M. M., & Ramdas, A. (2020). Analysis of blood and blood components wastage in a tertiary care hospital in South India. Journal of Curremt Research in Scientific Medicine/Journal of Current Research in Scientific Medicine, 6(1), 39. https://doi.org/10.4103/jcrsm.jcrsm_9_20

Implementation of advanced screening technologies like nucleic acid testing (NAT) and improved testing methodologies minimizes unsuitable blood discarding. NAT enhances viral pathogen detection, including HIV and hepatitis, during the window period. Rapid molecular assays detect bacterial contamination more efficiently, reducing unnecessary blood wastage. Risk-based donor deferral policies, guided by epidemiological data, mitigate bloodborne pathogen transmission risk. These interventions enable blood banks to conserve more units for transfusion, easing strain on blood supplies and ensuring safer transfusions (Cazenave & Waller, 2017).

Reference:

Bloch, E. M., Vermeulen, M., & Murphy, E. L. (2012). Blood transfusion safety in Africa: A literature review of infectious disease and organizational challenges. Transfusion Medicine Reviews (Print), 26(2), 164–180. https://doi.org/10.1016/j.tmrv.2011.07.006