The feasibility of introducing a whole blood component for traumatic haemorrhage in the UK

IF 1.5 4区医学 Q3 HEMATOLOGY

Transfusion Medicine Pub Date : 2024-04-05 DOI:10.1111/tme.13039

Josephine McCullagh, Peter Basham, Jane Davies, Vicky Hicks, Alastair Hunter, Julia Lancut, Laura Green

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引用次数: 0

Abstract

BackgroundThe interest in re‐introducing whole blood (WB) transfusion for the management of traumatic major haemorrhage is increasing. However, due to the current leucodepletion filters used in the UK a WB component was not readily available. Instead, an alternative but similar component, leucocyte depleted red cell and plasma (LD‐RCP), which provided a unique experience in assessing the feasibility of a WB component was used whilst a WB component was being manufactured.Study Design and MethodsBetween November 2018 and October 2020, LD‐RCP replaced RBC as standard of care for all trauma patients with major haemorrhage in London. The aims of the study were to assess (a) deliverability, (b) component wastage and (c) safety.ResultsOver the study period a total of 1208 LD‐RCP units were delivered, of which 96.5% were delivered ‘On Time In Full’ (OTIF). Of the 1208 units, 733 (60.68%) were transfused and 475 (39.3%) units were wasted. Component wastage reduced significantly throughout the study (p = 0.001). A total of 177 patients had a blood group recorded, 86 were group O and 91 were non‐group O. There was no statistically significantly difference between haemoglobin (p = 0.422), or bilirubin levels (p = 0.084) between group O and non‐group O patients.DiscussionIt was feasible for NHS Blood and Transplant to deliver LD‐RCP on time in full, however component wastage was high due to short shelf life and limited use of the component. Low titre group O LD‐RCP units were not associated with clinical evidence of haemolysis.

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在英国引入全血成分治疗创伤性出血的可行性

背景重新引入全血（WB）输注治疗创伤性大出血的兴趣日益浓厚。然而，由于英国目前使用的去白细胞过滤器，无法随时提供全血成分。研究设计和方法2018 年 11 月至 2020 年 10 月期间，LD-RCP 取代 RBC 成为伦敦所有创伤大出血患者的标准治疗方法。研究的目的是评估 (a) 交付能力、(b) 成分浪费和 (c) 安全性。结果在研究期间，共交付了 1208 个 LD-RCP 单位，其中 96.5% 是 "按时足量"（OTIF）交付的。在这 1208 个单位中，733 个（60.68%）被输注，475 个（39.3%）被浪费。在整个研究过程中，成分浪费明显减少（p = 0.001）。O组和非O组患者的血红蛋白（p = 0.422）和胆红素水平（p = 0.084）在统计学上没有明显差异。讨论NHS血液与移植部门按时足量提供低滴度LD-RCP是可行的，但由于该成分保质期短且使用有限，成分浪费率较高。O组低滴度LD-RCP单位与溶血的临床证据无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transfusion Medicine 医学-血液学

CiteScore

2.70

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Transfusion Medicine publishes articles on transfusion medicine in its widest context, including blood transfusion practice (blood procurement, pharmaceutical, clinical, scientific, computing and documentary aspects), immunohaematology, immunogenetics, histocompatibility, medico-legal applications, and related molecular biology and biotechnology. In addition to original articles, which may include brief communications and case reports, the journal contains a regular educational section (based on invited reviews and state-of-the-art reports), technical section (including quality assurance and current practice guidelines), leading articles, letters to the editor, occasional historical articles and signed book reviews. Some lectures from Society meetings that are likely to be of general interest to readers of the Journal may be published at the discretion of the Editor and subject to the availability of space in the Journal.