Background/Case Studies: Regular red cell transfusion is essential to both prevent and treat complications in those patients who have severe forms of the inherited haemoglobinopathies including sickle cell disease (SCD) and thalassaemia. Over the past 25 years, the number of patients with haemoglobinopathies in Ireland has risen at least 30-fold, with over 700 patients now being treated nationwide.
Study
Design/Methods: This is a collaborative retrospective study carried out by the National Blood Transfusion Service and a large hospital treating the majority of adult patients with haemoglobinopathies in the Republic of Ireland. This study assesses the impact of this growing service by quantifying the change in red cell usage by the Adult Haemoglobinopathy Service. This change is compared with red cell usage in other departments in the hospital and with national blood usage. Retrospective data on red cell usage over an eight-year period (January 2015 – December 2022) was collected by the hospital transfusion laboratory. The National Blood Service reviewed all red cell requests from the hospital during this period and compared these with nationwide red cell issues.
Results/Findings: The number of patients attending the Adult Haemoglobinopathy Service in the hospital increased by 234% over 8 years, from 112 to 262 patients. 242 have SCD and 20 have thalassaemia. In total, 114 patients were transfused and 42 were on a regular transfusion programme by 2022. In 2015, the Haematology/Oncology & Stem Cell Transplant Unit had the highest red cell usage (37.3%) followed by Surgery (35.7%), Medicine (25.4%) and the Adult Haemoglobinopathy Service (1.6%). In 2022, the Haematology/Oncology service remained the chief red cell user (30.4%) and the Adult Haemoglobinopathy Service had become the service with the second highest use in the hospital (28.9%). Table One shows these red cell usage trends. Conclusions: This data illuminates the impact of changing population demographics and the challenges of introducing a new service. The National Blood Service is introducing a variety of measures to achieve a more ethnically diverse donor pool. This will help provide the requisite antigen matched blood for the haemoglobinopathy patient population and to conserve the national O RhD negative supply. Wider availability of curative treatments in the future may reduce dependency on red cell transfusion within this patient population.
Importance of research: This data demonstrates the significant impact of changing population demographics on both a major hospital and a national blood service. This retrospective research is essential in helping to plan for future services both on a local and national level. It reinforces the importance of achieving an ethnically diverse donor pool to help provide the requisite antigen matched blood for the haemoglobinopathy patient population and additionally to safeguard the national O RhD negative supply.
