Kaiser-Permanente, Los Angeles Medical Center, Los Angeles, CA, California, United States
Background/Case Studies: The hospital is a 560 licensed bed facility, providing regional cardiovascular services, including 1,200 open heart surgeries annually. The blood bank was purposely located next to CV OR, separate from other laboratories, to minimize transport time. Due to availability constraints the hospital experienced treating bleeding patients with cryo AHF, an alternative solution, Pathogen Reduced Cryoprecipitated Fibrinogen Complex (PR Cryo, Cerus Corporation) was implemented. PR-cryo has the same benefits in treating coagulopathy as cryo AHF, but minimizes order to ready time as it can be stored, thawed, at room temperature, for 5 days and reduces the risk of transfusion transmitted infection because it is pathogen reduced. The increased shelf life also minimizes wastage risk and enhances supply stability. On July 1, 2021, the hospital incorporated PR Cryo into the blood bank inventory, and on August 16, 2021, the hospital transfused their first patient with the product. 20 months post-implementation, after 576 patients were transfused with 949 PR Cryo 4-pool units, the institution reviewed a portion of the product experience and found that PR Cryo reduces waste, provides supply stability, and reduces order to dispense time. Additionally, all previous issues with supply stability due to the pandemic blood shortages and general national seasonal product shortages are no longer occurring.
Study
Design/Methods: The hospital Blood Bank reviewed records for the cryoprecipitated AHF units issued from September 2019 through February 2020, just prior to the pandemic, and separately Blood Bank reviewed PR Cryo and cryo AHF orders from September 2022 through February 2023, to provide an analogous time of year segment as close to the end of the pandemic as possible. Wastage and time from order to ready for pick up at blood bank data were recorded.
Results/Findings: Before implementation of IFC, and potential pandemic influence (Sept 2019 – Feb 2020), cryo AHF wastage was 6.1%. After IFC implementation, during the analogous months post-pandemic (Sept 2022-Feb 2023), the wastage rate of cryo AHF and IFC (dual inventory, PR Cryo ~60%) dropped to 1.6%, a 74% reduction in waste. Order to ready time dropped 70%, from a median of 30 minutes to 9 minutes. Conclusions: The reduction preparation time, reduction in waste, and reduction risk of transfusion transmitted infection, and supply stability that PR cryo has provided LAMC align with the hospital's goals for excellence in patient care.
Importance of research: This abstract contains the first analysis of clinical data from the use of PR cryo at the hopsital. Data include the positive impact having PR cryo, with a 5-day post-thaw shelf life, provides in reducing product wastage rates, and preparation time at the blood bank.
