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Blood product reservation management in teaching hospitals: A case study from northeastern Iran
Parsa Sheybani , Ata Nazarzadeh , Mohammad Reza Keramati , Fatemeh Shams1
1- , shamsf@mums.ac.ir
Abstract:   (3559 Views)
Background: Blood products are vital yet scarce medical resources. In teaching hospitals, inefficient transfusion practices often result in unnecessary waste, compromising both patient safety and healthcare costs. This study investigated the patterns and underlying causes of unused blood products at Imam Reza Hospital, a major tertiary center in northeast Iran, with the aim of delineating modifiable factors contributing to this issue.

Methods: This retrospective cross-sectional study was conducted at Imam Reza Hospital, Mashhad. Data were extracted from the Laboratory Information System (LIS) and the hospital’s dashboard for the period of March 2022–2025. Blood component reserve and return data for five large clinical departments were examined.

Results: Although the total number of returned units declined over time, the return percentage increased in the final year, indicating persisting inefficiencies. By department, Neurology and Gynecology exhibited the highest return percentages, while the Hematology-Oncology ward, Intensive Care Unit (ICU), and Emergency Department reported the highest absolute numbers of returns. Platelets were the most frequently returned product, whereas fresh frozen plasma had the highest relative return rate. The most consistently reported reason for returns was “Physician Decision / Order Canceled,” with returns due to “Patient Death” also showing a gradual increase over the study period.
Conclusion: Despite gradual improvements, systemic challenges—especially poor documentation, absence of digital monitoring tools, and knowledge gaps in transfusion handling—continue to undermine efficient blood product use. Implementing real-time dashboards, enforcing mandatory documentation, educating clinical staff, and adopting AI-based demand prediction tools could dramatically reduce waste and enhance transfusion practices.
Keywords: Blood wastage, Platelets, Erythrocyte Transfusion, Plasma, Cryoprecipitate
Full-Text [PDF 882 kb]   (756 Downloads)    
Research Article: Research Article | Subject: Laboratory hematology
Received: 2025/08/29 | Accepted: 2026/02/7
References
1. Park M, Hur M, Kim H, Oh K, Kim H, Song YH, et al. Questionnaire survey on current red blood cell transport and storage in Korea for reducing wastage. Ann Lab Med. 2022;42(3):342-51. [View at Publisher] [DOI] [PMID] [Google Scholar]
2. Anani H, Baluchi I, Ghazizadeh M, Valandani HM, Khalilabadi RM. Evaluating the effect of tariff on wastage and return of blood products in Kerman province. Transfus Clin Biol. 2018;25(1):44-8. [View at Publisher] [DOI] [PMID] [Google Scholar]
3. Yazer MH, Deandrade DS, Triulzi DJ, Wisniewski MK, Waters JH. Electronic enhancements to blood ordering reduce component waste. Transfusion. 2016;56(3):564-70. [View at Publisher] [DOI] [PMID] [Google Scholar]
4. Murphy C, Jackson B, Fontaine M. Tools for rapid analysis of blood usage and inventory during the COVID ‐19 pandemic. Transfusion. 2020;60(10):2199-202. [View at Publisher] [DOI] [PMID] [Google Scholar]
5. Park M, Hur M, Yi A, Kim H, Lee HK, Jeon EY, et al. Utility of temperature‐sensitive indicators for temperature monitoring of red‐blood‐cell units. Vox Sang. 2019;114(5):487-94. [View at Publisher] [DOI] [PMID] [Google Scholar]
6. Gallagher T, Darby S, Vodanovich M, Campbell L, Tovey J. Patient blood management nurse vs transfusion nurse: is it time to merge? Br J Nurs. 2015;24(9):492-5. [View at Publisher] [DOI] [PMID] [Google Scholar]
7. Aplin K, Pitt T, Allen J, Roy A, Tidey K, Ball J, et al. Extending the 30‐minute rule for red cell units - investigation of the bacterial risk of 60‐minute exposures to ambient temperature. Vox Sang. 2019;114(3):189-97. [View at Publisher] [DOI] [PMID] [Google Scholar]
8. Devine DV, Serrano K. The platelet storage lesion. Clin Lab Med. 2010;30(2):475-87. [View at Publisher] [DOI] [PMID] [Google Scholar]
9. Wu DW, Friedman MT, Lombardi DP, Hwang R, Sender J, Cobaj V, et al. Impact of patient blood management on red blood cell utilization in an urban community teaching hospital: A seven-year retrospective study. Life (Basel). 2024;14(2):232. [View at Publisher] [DOI] [PMID] [Google Scholar]
10. Frank SM, Thakkar RN, Podlasek SJ, Ken Lee KH, Wintermeyer TL, Yang WW, et al. Implementing a health system-wide patient blood management program with a clinical community approach. Anesthesiology. 2017;127(5):754-64. [View at Publisher] [DOI] [PMID] [Google Scholar]
11. Gammon RR, Coberly E, Dubey R, Jindal A, Nalezinski S, Varisco JL. Patient blood management-It is about transfusing blood appropriately. Ann Blood. 2022;7:21. [View at Publisher] [DOI] [Google Scholar]
12. Carson JL, Guyatt G, Heddle NM, Grossman BJ, Cohn CS, Fung MK, et al. Clinical practice guidelines from the AABB: red blood cell transfusion thresholds and storage. JAMA. 2016;316(19):2025-35. [View at Publisher] [DOI] [PMID] [Google Scholar]
13. Saluja K, Thakral B, Marwaha N, Sharma RR. Platelet audit: Assessment and utilization of this precious resource from a tertiary care hospital. Asian J Transfus Sci. 2007;1(1):8-11. [View at Publisher] [DOI] [PMID] [Google Scholar]
14. Joon V, Robins RD, A HH, Kumar S, James S. Evaluating the crossmatch-to-transfusion ratio as a tool for analyzing and optimizing blood bank resource utilization: a retrospective observational study. Cureus. 2024;16(9):e69862. [View at Publisher] [DOI] [PMID] [Google Scholar]
15. Chien J-H, Yao C-Y, Chen H-F, Ho T-F. Trends in blood transfusion and causes of blood wastage: a retrospective analysis in a teaching hospital. BMC Health Serv Res. 2025;25(1):67. [View at Publisher] [DOI] [PMID] [Google Scholar]
16. Murphy S, Gardner FH. Platelet storage at 22 C; metabolic, morphologic, and functional studies. J Clin Invest. 1971;50(2):370-7. [View at Publisher] [DOI] [PMID] [Google Scholar]
17. Harmening DM. Modern blood banking & transfusion practices. 7th ed. Philadelphia: F.A. Davis Company;2018. [View at Publisher] [Google Scholar]
18. Slichter SJ, Corson J, Jones MK, Christoffel T, Pellham E, Bailey SL, et al. Exploratory studies of extended storage of apheresis platelets in a platelet additive solution (PAS). Blood. 2014;123(2):271-80. [View at Publisher] [DOI] [PMID] [Google Scholar]
19. Hoffmeister KM, Felbinger TW, Falet H, Denis CV, Bergmeier W, Mayadas TN, et al. The clearance mechanism of chilled blood platelets. Cell. 2003;112(1):87-97. [View at Publisher] [DOI] [PMID] [Google Scholar]
20. Far RM, Rad FS, Abdolazimi Z, Daneshi Kohan MM. Determination of rate and causes of wastage of blood and blood products in Iranian hospitals. Turk J Haematol. 2014;31(2):161-7. [View at Publisher] [DOI] [PMID] [Google Scholar]
21. Woo JS, Suslow P, Thorsen R, Ma R, Bakhtary S, Moayeri M, et al. Development and implementation of real-time web-based dashboards in a multisite transfusion service. J Pathol Inform. 2019:10:3. [View at Publisher] [DOI] [PMID] [Google Scholar]
22. Kwon HJ, Park S, Park YH, Baik SM, Park DJ. Development of blood demand prediction model using artificial intelligence based on national public big data. Digit Health. 2024;10:20552076231224245. [View at Publisher] [DOI] [PMID] [Google Scholar]
23. Thakur SK, Sinha AK, Negi DK, Singh S. Forecasting demand for blood products: Towards inventory management of a perishable product. Bioinformation. 2024;20(1):20-8. [View at Publisher] [DOI] [PMID] [Google Scholar]
24. Farrington J, Alimam S, Utley M, Li K, Wong WK. Many happy returns: machine learning to support platelet issuing and waste reduction in hospital blood banks. arXiv [Preprint]. 2024. [View at Publisher] [DOI] [Google Scholar]
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