Blood Bank QEH- An era of bankruptcy??Department of Haematology Dr. Rene Boyce Dr. Theresa Laurent (consultant/advisor)

The rational use of blood and blood products

Presentation Aims

To discuss the following:

The various components available from blood

The rational use of blood and its componentsProblems faced by QEH

Proposals for improved blood product usage in QEH

Blood is an amazing fluid! Keeps us warm Provides nutrients for cells, tissues and organs Removes waste products from various sites

What is blood?

A highly specialised circulating tissue which has several types of cells suspended in a liquid medium called plasma. Origins from Greek haima

Blood is a life sustaining fluid

Blood componentsPacked red cells Platelets Fresh Frozen Plasma Frozen plasma Cryoprecipitate Albumin Immunoglobulins

Local study

Looked at the donations over period January 1, 2006 to December 31, 2006 Examined the various products collected during that period

Study limitations

Blood groups by month200 180 160 140 Number of 120 100 units 80 60 40 20 0 January

O+ OA+ AB+ BMay September AB+ AB-

Month

Table of ABO and Rh distribution by nation

ABO and Rh blood type distribution by nation (averages for each population)

Population Australia[11]

O+ 40%

A+ 31%

B+ 8%

AB+ 2%

O 9%

A 7%

B 2%

AB 1%

CanadaFinland France

[12][13]

39%35% 27% 36%[16]

36%37% 38% 37% 26% 32% 37% 35% 34%

7.6%8% 15% 9% 27% 15% 10% 8% 9%

2.5%4% 7% 3% 7% 7% 5% 3% 3%

7%6% 4% 6%

6%7% 6% 7%

1.4%2% 2% 1%

0.5%1% 1% 1%

Denmark

[14]

[15]

Hong Kong, China

40% 31% 32% 37% 38%

50 000 > 30 000 > 20 000 > 10 000 > 5 000 Clinical Condition Major abdominal, chest or neurosurgery Trauma, major surgery Minor surgical procedures Prevention/treatment of bleeding in pts with sepsis, leukemia, malignancy Uncomplicated malignancy, leukemia ITP patients at low risk

FFP

Fresh Frozen Plasma Plasma collected from single donor units or by apheresis Frozen within 8 hours of collection

-18o to -30o CCan last for a year

FFP1 unit is 250 ml Contains all plasma proteins Indications:

Correction of bleeding due to excess warfarin, Vitamin K deficiency, liver disease DIC, dilutional coagulopathy Inherited factor XI deficiency TTP

FFP

Dose: 15 mls/kg about 3-5 units FFP and INR