Variability in the application of patient blood management programs in the Iberian peninsula

Abstract

Background

In 2010, the World Health Organization (WHO) called for global implementation of Patient Blood Management (PBM) programs to optimize transfusion practices and reduce variability in blood utilization. This study examines the evolution of red cell, platelet, and plasma consumption in Iberia (Spain and Portugal), comparing trends within the region and with European benchmarks like the United Kingdom, Germany, and Italy.

Methods

National transfusion activity reports from Spain, Portugal, the United Kingdom (2011–2023) were analyzed. Key metrics included transfusion rates per 1,000 inhabitants for red cells, platelets, and fresh frozen plasma. Statistical analyses were performed using Kruskal–Wallis tests and ANOVA to identify differences between countries and over time.

Results

From 2011 to 2023, red cell transfusion rates decreased by 30% in the UK, 6% in Spain, and 15% in Portugal. Germany showed a modest decline, while Italy maintained stable rates exceeding 40 units per 1,000 inhabitants. Platelet and plasma consumption exhibited distinct patterns, with Portugal showing a steeper decline compared to Spain, and the UK maintaining the lowest overall rates. Platelet consume is clearly increasing.

Conclusions

The analysis reveals significant differences in blood component utilization across Iberia and Europe, reflecting varying levels of PBM adoption. Despite WHO and Council of Europe recommendations, Iberian countries lag behind the UK in reducing red cell transfusion rates. These findings underscore the need for uniform PBM implementation to harmonize practices and optimize resource use, not only Red Cell Concentrates. The creation of the Iberian task-force (section of the Ibero-American PBM Society (SIAPBM) could be an opportunity to create the necessary awareness in our countries and become a meeting point between America and Europe.