Background/Case Studies: BSG currently uses top-bottom collection bags for 450ml whole blood (WB) collection. In some cases, blood may not be collected to the intended volume of the blood bag due to discontinuation of donation resulting from donor’s reactions and slow flow of donation exceeding 15 minutes. WB collected in 450ml blood bag with a volume between 300ml to 404ml is processed into low volume RBC. The processing of low volume RBC is more time and cost consuming compared to normal volume RBC as it involves additional procedures and resources due to the top-bottom blood bag orientation. Low volume RBC that is less than 180ml is rejected as Quantity Not Sufficient (QNS). This study aims to examine the rejection and usable rates of low volume RBC and to determine the effectiveness and efficiency of processing low volume RBC in BSG.
Study
Design/Methods: Retrospective data for all low volume RBC units processed between year 2018 to 2022 were analyzed. Their corresponding WB volumes were analyzed for the correlation against the rejection and usable rate. The low volume RBC were broken down into 4 groups and split equally according to their WB volume. The total rejections and rejection type were analyzed within each group.
Results/Findings: Of the 554,883 units of 450ml WB collected within this period, 6,270 (1%) of low volume RBC were processed. 39% of these low volume RBC were good for use. 61% were rejected; of which, 57% were rejected for Clot in Container or QNS and 4% for other reasons such as infectious diseases reactive, medical rejects, donor call backs etc. The breakdown of low volume RBC with rejection details by WB volume is tabulated in Table 1. It was observed that rejection rate is inversely related to WB volume while usable rate is proportionally related to WB volume. Conclusions: The low volume RBC processing is both ineffective and inefficient as the production has a low yield rate of 39% and high wastage of 61%. Due to the nature of these WB collections, high occurrences of clot and QNS in low volume RBC were unavoidable, hence contributed to the low yield, making the processing ineffective. High rejection rate also translates to high wastage of manpower and resources, which lead to processing inefficiency. The inefficiency is more evident at a lower volume WB with rejection rate as high as 87%. A recommendation to improve efficiency would be to raise the WB volume range to process low volume RBC. Alternatively, to stop processing low volume RBC, which would result in a maximum RBC supply loss of 1%. Further studies can be done with our blood collection team to look into reducing the number of low volume WB collected.
Importance of research: Studying the effectiveness and efficiency of processing low volume RBC is essential due to its high rejection rate. It is crucial in minimizing product and consumables wastage. The analysis serves as an important platform for further studies on the processing procedures, cost and manpower involved in the processing of low volume RBC.
