Background. Although blood ordering is a common practice in surgical field, the average requirement for a particular procedure is usually based on subjective anticipation of blood loss rather than on evidence based estimates. Overordering with minimal utilization squanders technical time, reagent and imposes extra expenses on patients. This study was conducted to assess blood utilization practices. Methods. Cross-sectional study was conducted in Gondar Hospital. Five-month data were collected from all discharged surgical patients and blood bank registries. Blood utilization was calculated using crossmatch to transfusion ratio (C/T), transfusion probability (&#x25;T), and transfusion index (TI) indices. Results. A total of 982 patients were requested to prepare 1,072 crossmatched units. Of these, 468 units were transfused for 286 patients. The overall ratios of C/T, &#x25;T, and TI index were 2.3, 47&#x25;, and 0.77, respectively. Blood transfusion from the units crossmatched was 43.6&#x25;. Moreover, the highest C/T ratio was observed in elective surgical patients. Conclusions. The overall blood utilization was encouraging, but excessive crossmatching with minimal transfusion practice was observed in elective surgical patients. Blood ordering pattern for elective procedures needs to be revised and overordering of blood should be minimized. Moreover, the hospital with blood transfusion committee should formulate maximum surgical blood ordering policies for elective surgical procedures and conduct regular auditing.

Tadesse Belayneh

Gashaw Messele

Zewditu Abdissa

Birehanemeskel Tegene

Blood Requisition and Utilization Practice in Surgical Patients at University of Gondar Hospital, Northwest Ethiopia

Introduction. Adequate and safe blood supply has remained a challenge in developing countries like ours. There is a high dependency on family replacement and remunerated blood donors in our environment which carries an attendant increased risk of transfusion transmissible infection. Objectives. The objectives of this study were to assess the knowledge, attitude, and practice of voluntary blood donation among healthcare workers (nonphysicians) and to identify and recruit potential voluntary blood donors. Methodology. This was a cross-sectional descriptive study carried out at the University of Benin Teaching Hospital, Benin City. A total of 163 staffs were recruited. Pretest questionnaires were used to assess their knowledge, attitude, and practice of voluntary blood donation. Statistical Analysis. The responses were collated and analyzed with the Statistical Package for Social Sciences (SPSS) 16. The association between blood donation practice and gender of respondents, category of staff, and level of education was tested using Chi-square and Fisher&#x2019;s tests where appropriate. <svg style="vertical-align:-0.1638pt;width:58.712502px;" id="M1" height="11.375" version="1.1" viewBox="0 0 58.712502 11.375" width="58.712502" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,11.112)"><path id="x1D443" d="M619 482q0 -69 -40.5 -119t-96 -72.5t-118.5 -26.5h-44l-70 20l-31 -151q-14 -67 0.5 -83t89.5 -22l-5 -28h-287l8 28q65 7 81.5 22t29.5 83l79 398q12 56 0.5 70.5t-78.5 20.5l7 28h255q108 0 164 -43t56 -125zM524 478q0 141 -146 141q-25 0 -47 -8q-16 -6 -20.5 -13.5&#xA;t-10.5 -39.5l-43 -241q37 -13 83 -13q67 0 125.5 45t58.5 129z" /></g><g transform="matrix(.017,-0,0,-.017,15.582,11.112)"><path id="x3C" d="M512 -3l-437 233v51l437 233v-58l-378 -200v-2l378 -199v-58z" /></g><g transform="matrix(.017,-0,0,-.017,30.286,11.112)"><path id="x30" d="M241 635q53 0 94 -28.5t63.5 -76t33.5 -102.5t11 -116q0 -58 -11 -112.5t-34 -103.5t-63.5 -78.5t-94.5 -29.5t-95 28t-64.5 75t-34.5 102.5t-11 118.5q0 58 11.5 112.5t34.5 103t64.5 78t95.5 29.5zM238 602q-32 0 -55.5 -25t-35.5 -68t-17.5 -91t-5.5 -105&#xA;q0 -76 10 -138.5t37 -107.5t69 -45q32 0 55.5 25t35.5 68.5t17.5 91.5t5.5 105t-5.5 105.5t-18 92t-36 68t-56.5 24.5z" /></g><g transform="matrix(.017,-0,0,-.017,38.446,11.112)"><path id="x2E" d="M113 -12q-24 0 -39.5 16t-15.5 42q0 24 16 40.5t40 16.5t40 -16.5t16 -40.5q0 -26 -16 -42t-41 -16z" /></g><g transform="matrix(.017,-0,0,-.017,42.321,11.112)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,50.481,11.112)"><path id="x35" d="M153 550l-26 -186q79 31 111 31q90 0 141.5 -51t51.5 -119q0 -93 -89 -166q-85 -69 -173 -71q-32 0 -61.5 11.5t-41.5 23.5q-18 17 -17 34q2 16 22 33q14 9 26 -1q61 -50 124 -50q60 0 93 43.5t33 104.5q0 69 -41.5 110t-121.5 41q-53 0 -102 -20l38 305h286l6 -8&#xA;l-26 -65h-233z" /></g>

		
	
</svg> were considered statistically significant. Results. The median age of the respondents was 32 years (18&#x2013;56) with females accounting for 55.6&#x25; (90). A total of 74.8&#x25; (122) attained tertiary education, and 55.8&#x25; (91) of respondents were senior staffs. The majority has good knowledge and positive attitude towards donation; however, only 22.1&#x25; (36) have donated blood with 41.7&#x25; (15) of these being voluntary. Male workers were more likely to donate (<svg style="vertical-align:-0.1638pt;width:58.712502px;" id="M2" height="11.375" version="1.1" viewBox="0 0 58.712502 11.375" width="58.712502" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,11.112)"><use xlink:href="#x1D443"/></g><g transform="matrix(.017,-0,0,-.017,15.582,11.112)"><use xlink:href="#x3C"/></g><g transform="matrix(.017,-0,0,-.017,30.286,11.112)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,38.446,11.112)"><use xlink:href="#x2E"/></g><g transform="matrix(.017,-0,0,-.017,42.321,11.112)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,50.481,11.112)"><use xlink:href="#x35"/></g>

		
	
</svg>). There is no significant association between blood donation and level of education. Conclusion. There is a strong disparity between the knowledge, attitude, and practice of voluntary donation amongst healthcare workers.

Benedict Nwogoh

Usimenahon Aigberadion

Alexander Ikenna Nwannadi

Knowledge, Attitude, and Practice of Voluntary Blood Donation among Healthcare Workers at the University of Benin Teaching Hospital, Benin City, Nigeria

Background. The use of plasma frozen within 24&#x2009;hrs is likely to increase. Whole blood (WB) and buffy coats (BCs) can be held for a few hrs or overnight before processing. 
Methods. Twenty-four bags of WB for plasma and 12 bags for platelet (PLT) concentrates were collected. The fresh frozen plasma (FFP) was prepared within 6&#x2009;hrs. I-FP24 and II-FP24 samples were prepared either from leukodepleted WB that was held overnight or from WB that was held overnight before leukodepletion. The PLT concentrates (PCs) were prepared from BCs within 6&#x2009;hrs (PC1) and within 18 to 24&#x2009;hrs (PC2). The typical coagulation factors and some biochemical parameters were determined. 
Results. Compared to the FFP samples, the levels of FVII and FVIII in the I-FP24 and II-FP24 samples decreased significantly. The pH, Na+, LDH, and FHb levels differed significantly between II-FP24 and FFP. Compared to PC1, PC2 exhibited lower pH, pO2, and Na+ levels, a higher PLT count, and increased pCO2, K+, Lac, and CD62P expression levels. 
Conclusion. FP24 is best prepared from WB that was stored overnight at 4&#xb0;C and then leukodepleted and separated within 24&#x2009;hrs. PCs are best produced from BCs derived from WB that was held overnight at room temperature.

Shichun Wang

Tiantian Wang

Yahan Fan

Shan Huang

Zhongmei Yi

Ruiqing Li

Shuming Zhao

A Comparison Study of the Blood Component Quality of Whole Blood Held Overnight at 4&#xb0;C or Room Temperature

The utilization of autologous and allogeneic transfusions in total joint arthroplasties was to characterize patients who may benefit from giving preoperative blood donations. We conducted a retrospective chart review of 525 patients to document preoperative hematocrit, estimated blood loss, length of stay, transfusions, and medical comorbidities. Results of our review showed that total hip arthroplasty revision (THA-R) had the highest prevalence of transfusions (60&#x25;) followed by total hip arthroplasty (THA, 53&#x25;), total knee arthroplasty-revision (TKA-R, 33&#x25;), and total knee arthroplasty (TKA, 23&#x25;). There was significant waste of autologous donations: 92&#x25; of TKA patients, 64&#x25; of THA, and 33&#x25; of THA-R patients wasted on average 1.527, 1.321, and 1.5 autologous units, respectively. Pre-operative hematocrit was the strongest predictor of future transfusion need across all procedures, and primary THA had additional predictors in age and gender.

Sean Robinson

Owen McGonigle

Sam Volin

Yung-Chi Sung

Matthew Moore

Charles Cassidy

Eric Smith

Comprehensive Look at Blood Transfusion Utilization in Total Joint Arthroplasty at a Single Academic Medical Center under a Single Surgeon

The elimination of a thorough manual mixing of whole blood (WB) which takes place following the overnight hold, but before the first centrifugation step, during buffy coat component production at Canadian Blood Services (CBS) was investigated. WB was pooled after donation and split. Pairs of platelet, red blood cell (RBC), and plasma components were produced, with half using the standard method and half using a method in which the mixing step was eliminated. Quality assessments included yield, pH, CD62P expression and morphology for platelets, hemoglobin, hematocrit, hemolysis, and supernatant K+ for RBCs, and volume and factor VIII activity levels for plasma. All components, produced using either method, met CBS quality control criteria. There were no significant differences in platelet yield between components produced with and without mixing. A significant difference was seen for RBC hemolysis at expiry (<svg style="vertical-align:-0.1638pt;width:58.712502px;" id="M1" height="11.375" version="1.1" viewBox="0 0 58.712502 11.375" width="58.712502" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg"><g transform="matrix(.017,-0,0,-.017,.062,11.112)"><path id="x1D443" d="M619 482q0 -69 -40.5 -119t-96 -72.5t-118.5 -26.5h-44l-70 20l-31 -151q-14 -67 0.5 -83t89.5 -22l-5 -28h-287l8 28q65 7 81.5 22t29.5 83l79 398q12 56 0.5 70.5t-78.5 20.5l7 28h255q108 0 164 -43t56 -125zM524 478q0 141 -146 141q-25 0 -47 -8q-16 -6 -20.5 -13.5&#xA;t-10.5 -39.5l-43 -241q37 -13 83 -13q67 0 125.5 45t58.5 129z" /></g><g transform="matrix(.017,-0,0,-.017,15.582,11.112)"><path id="x3D" d="M535 323h-483v50h483v-50zM535 138h-483v50h483v-50z" /></g><g transform="matrix(.017,-0,0,-.017,30.286,11.112)"><path id="x30" d="M241 635q53 0 94 -28.5t63.5 -76t33.5 -102.5t11 -116q0 -58 -11 -112.5t-34 -103.5t-63.5 -78.5t-94.5 -29.5t-95 28t-64.5 75t-34.5 102.5t-11 118.5q0 58 11.5 112.5t34.5 103t64.5 78t95.5 29.5zM238 602q-32 0 -55.5 -25t-35.5 -68t-17.5 -91t-5.5 -105&#xA;q0 -76 10 -138.5t37 -107.5t69 -45q32 0 55.5 25t35.5 68.5t17.5 91.5t5.5 105t-5.5 105.5t-18 92t-36 68t-56.5 24.5z" /></g><g transform="matrix(.017,-0,0,-.017,38.446,11.112)"><path id="x2E" d="M113 -12q-24 0 -39.5 16t-15.5 42q0 24 16 40.5t40 16.5t40 -16.5t16 -40.5q0 -26 -16 -42t-41 -16z" /></g><g transform="matrix(.017,-0,0,-.017,42.321,11.112)"><use xlink:href="#x30" /></g><g transform="matrix(.017,-0,0,-.017,50.481,11.112)"><path id="x33" d="M285 378v-2q65 -13 102 -54.5t37 -97.5q0 -57 -30.5 -104.5t-74 -75t-85.5 -42t-72 -14.5q-31 0 -59.5 11t-40.5 23q-19 18 -16 36q1 16 23 33q13 10 24 0q58 -51 124 -51q55 0 88 40t33 112q0 64 -39 96.5t-88 32.5q-29 0 -64 -11l-6 29q77 25 118 57.5t41 84.5&#xA;q0 45 -26.5 69.5t-68.5 24.5q-67 0 -120 -79l-20 20l43 63q51 56 127 56h1q66 0 107 -37t41 -95q0 -42 -31 -71q-22 -23 -68 -54z" /></g></svg>), but for both groups, levels met quality control requirements. Noninferiority of components produced without mixing was confirmed for all parameters. Manual mixing is laborious and has a risk of repetitive strain for production staff and its significance is unclear. Elimination of this step will improve process efficiencies without compromising quality.

Cherie Mastronardi

Peter Schubert

Elena Levin

Varsha Bhakta

Qi-Long Yi

Adele Hansen

Tamiko Stewart

Craig Jenkins

Wanda Lefresne

William Sheffield

Jason P. Acker

Process Improvement by Eliminating Mixing of Whole Blood Units after an Overnight Hold Prior to Component Production Using the Buffy Coat Method

Erythrocyte concentrates (ECs) stored for transfusion purposes still represent a lifesaving solution in a wide series of clinically occurring circumstances, especially for traumatized and perioperative patients. However, concerns still arise and persist as to whether current criteria for collection and storage of ECs might actually represent the best case scenario or there might rather be still room for improvement. In particular, the prolonged storage of EC has been associated with the accumulation of a wide series of storage lesions, either reversible (metabolism) or irreversible (protein and morphology). Independent laboratories have contributed to propose alternative strategies, among which is the introduction of oxygen removal treatments to ECs. Convincing biochemical and preliminary clinical evidences have been produced about the benefits derived from the introduction of this practice. We, hereby, propose a rapid, efficient, and time-effective strategy for blood deoxygenation which might fit in current EC production chain. The proposed strategy resulted in the complete deoxygenation of red blood cell hemoglobin (<svg style="vertical-align:-3.27605pt;width:92.162498px;" id="M1" height="15.5125" version="1.1" viewBox="0 0 92.162498 15.5125" width="92.162498" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,11.363)"><path id="x70" d="M169 380l92 53q26 16 49 16q80 0 128.5 -56t48.5 -133q0 -108 -72.5 -180.5t-176.5 -91.5q-38 1 -69 18v-131q0 -57 13 -70t71 -18v-27h-236v27q49 5 61 17t12 61v452q0 48 -9.5 58.5t-56.5 16.5v24q66 11 145 43v-79zM169 346v-270q37 -39 94 -39q63 0 101.5 50&#xA;t38.5 134q0 78 -38.5 123t-95.5 45q-45 0 -100 -43z" /></g><g transform="matrix(.017,-0,0,-.017,8.97,11.363)"><path id="x4F" d="M381 665q131 0 226.5 -93t95.5 -239q0 -158 -96 -253t-238 -95q-137 0 -231 95t-94 238q0 142 92.5 244.5t244.5 102.5zM359 629q-89 0 -151 -74.5t-62 -208.5q0 -141 69 -233t175 -92q90 0 150.5 74t60.5 211q0 152 -69 237.5t-173 85.5z" /></g>

			<g transform="matrix(.012,-0,0,-.012,21.662,15.45)"><path id="x32" d="M412 140l28 -9q0 -2 -35 -131h-373v23q112 112 161 170q59 70 92 127t33 115q0 63 -31 98t-86 35q-75 0 -137 -93l-22 20l57 81q55 59 135 59q69 0 118.5 -46.5t49.5 -122.5q0 -62 -29.5 -114t-102.5 -130l-141 -149h186q42 0 58.5 10.5t38.5 56.5z" /></g>

			<g transform="matrix(.017,-0,0,-.017,32.725,11.363)"><path id="x3C" d="M512 -3l-437 233v51l437 233v-58l-378 -200v-2l378 -199v-58z" /></g><g transform="matrix(.017,-0,0,-.017,47.412,11.363)"><path id="x30" d="M241 635q53 0 94 -28.5t63.5 -76t33.5 -102.5t11 -116q0 -58 -11 -112.5t-34 -103.5t-63.5 -78.5t-94.5 -29.5t-95 28t-64.5 75t-34.5 102.5t-11 118.5q0 58 11.5 112.5t34.5 103t64.5 78t95.5 29.5zM238 602q-32 0 -55.5 -25t-35.5 -68t-17.5 -91t-5.5 -105&#xA;q0 -76 10 -138.5t37 -107.5t69 -45q32 0 55.5 25t35.5 68.5t17.5 91.5t5.5 105t-5.5 105.5t-18 92t-36 68t-56.5 24.5z" /></g><g transform="matrix(.017,-0,0,-.017,55.571,11.363)"><path id="x2E" d="M113 -12q-24 0 -39.5 16t-15.5 42q0 24 16 40.5t40 16.5t40 -16.5t16 -40.5q0 -26 -16 -42t-41 -16z" /></g><g transform="matrix(.017,-0,0,-.017,59.447,11.363)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,67.606,11.363)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,75.766,11.363)"><use xlink:href="#x32"/></g><g transform="matrix(.017,-0,0,-.017,83.925,11.363)"><path id="x31" d="M384 0h-275v27q67 5 81.5 18.5t14.5 68.5v385q0 38 -7.5 47.5t-40.5 10.5l-48 2v24q85 15 178 52v-521q0 -55 14.5 -68.5t82.5 -18.5v-27z" /></g>

		
	
</svg>&#x2009;mmHg). A preliminary small-scale study about the application of the present method resulted in reduced hemolysis, decreased vesiculation, and limited alterations to the red blood cell morphology, as gleaned from flow cytometry and scanning electron microscopic analyses. Further in-depth and larger-scale investigations are encouraged.

Lello Zolla

Angelo D'Alessandro

An Efficient Apparatus for Rapid Deoxygenation of Erythrocyte Concentrates for Alternative Banking Strategies

About this journal

Journal profile

Meet the editorial board

Editor spotlight

Submit your proposal

Do you think there is an emerging area of research that really needs to be highlighted? Or an existing research area that has been overlooked or would benefit from deeper investigation? Raise the profile of a research area by leading a Special Issue.

Journal of Blood Transfusion