Approvisionnement des blocs opératoires en concentrés érythrocytaires : une démarche collective d’amélioration des pratiques

[Immuno-haematology and blood bank inventory and issue management]

Blood bank management must ensure the correct blood product issuance in the right time. For this purpose, patient clinical and immuno-haematological data have to be taken into consideration. Inventory composition, by blood group and phenotype, blood product providing possibilities and transport delays are determining factors. Finally, a good management relies also on the use of consensually written procedures and the monitoring of pertinent indicators.

[Immunological blood transfusion safety and selection of red blood cells issued from hospital blood banks]

Allogeneic red blood cells transfusion is always an immunological challenge and the choice of the blood products is crucial for the patient safety. But this choice may be hampered by the quality or the quantity of the available supply. In the end, the lack of transfusion may be more harmful than transfusion. The balance between patients' needs and blood centres supplying is always delicate. The conditions are not the same for all blood groups. Things are easier for the KEL1 phenotype, where the supply must ensure only 92.5% of KEL: -1 red blood cells instead of the 91% expected. More complicated is the situation for group O red blood cells with 47 versus 43%. But the major problem concerns RH: -1 red blood cells, for which the needs reach 20.1 versus 15%. These challenges require a lot of efforts from blood centres staffs to influence blood donors' recruitment and appointments. A justified and carefully selected blood products issuing may be of great help, especially for group O RH: -1 red blood cells. Therefore, hospital blood banks must have ad hoc procedures and a trained staff to put them into practice.