Utility of type and screen policy for pretransfusion compatibility testing at an urban level Ι apex trauma center

نویسندگان

1 Department of Transfusion Medicine, All India Institute of Medical Sciences (AIIMS) New Delhi, India

2 Department of Immunohaematology & Blood Transfusion Medicine, Government Medical College & Hospital (GMCH) Jammu, Jammu & Kashmir, India

3 Department of Laboratory Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi

4 Department of Transfusion Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, India

5 Department of Transfusion Medicine, All India Institute of Medical Sciences (AIIMS) New Delhi, India

doi
10.34172/jept.2021.26
چکیده

Objective: Type and crossmatch (TC) policy is the most common approach for pretransfusion compatibility testing prior to issue of blood for transfusion. As it involvesreserving of the blood units (usually up to 72 hours) prior to issue or un-reserving, it can leadto excessive blood cross matching, inventory management problems, undue workload,blood outdating and reagent wastage. Type and screen (TS) policy is an alternativeapproach without the need to cross match and reserve blood units prior to issue. The aimof the current study was to retrospectively assess the impact of the implementation of TSpolicy for pre-transfusion compatibility testing on blood transfusion services at an urbanlevel Ι trauma center.Methods: The study was done in two phases in the Department of Transfusion Medicineat Jai Prakash Narayan Apex Trauma Center AIIMS, New Delhi, India. Transfusion data wascollected and compared during two phases: initial phase (Oct 2016-Mar 2017) of TC policyand second phase (Apr 2017-Sept 2017) of TS policy.Results: TS policy resulted in the reduction of C:T ratio from 5.3 to 1.9. Transfusionprobability increased to 29.5% during TS policy from 23.6% during TC policy. Issuable stockindex (ISI) also showed reduction from 12.5 to 11.4 after TS policy. Wastage as percentageof issue (WAPI) was reduced from 2.3% (TC) to 1.3% (TS). TS policy also led to reductionin expenses incurred on pre-transfusion compatibility testing by 35%. No hemolytictransfusion reaction was reported during the study.Conclusion: TS policy was found to be a safe and an efficient alternative approach to TCpolicy for pre-transfusion compatibility at our center. We recommend the implementationof TS policy, but each center should first assess its feasibility based on patient population,blood bank resources and staff knowledge