Implementation of a blood conservation program in the private hospital setting in South Africa

• Main Author: Du Preez, Monique
• Other Authors: Pepper, Michael Sean
• Published: University of Pretoria 2013
• Subjects: Infectious diseases; Patients; South africa; Allogeneic blood transfusions; Immunomodulatory reactions; Private hospitals; UCTD
• Online Access: http://hdl.handle.net/2263/24886; Du Preez, M 2011, Implementation of a blood conservation program in the private hospital setting in South Africa, MSc dissertation, University of Pretoria, Pretoria, viewed yymmdd < http://hdl.handle.net/2263/24886 >; http://upetd.up.ac.za/thesis/available/etd-05222012-181130/

Although blood products are a great deal safer these days than in the past, patients receiving allogeneic blood transfusions are still exposed to potential hazards such as infectious diseases and immunomodulatory reactions. Therefore it is important to consider alternatives to allogeneic blood use. This can be done by means of blood conservation alternatives. A successful blood conservation program consists of three integrated phases, namely pre-operative, intra-operative and post-operative stages of patient care. The main objective of this study was to create a transfusion medicine database in order to evaluate the effect of a blood conservation program on the length of hospital stay of patients and the costs incurred in such a program. Five pilot hospitals who had implemented a blood conservation program were compared to five non-pilot hospitals (no blood conservation program). The results show that the average cost related to allogeneic blood usage in pilot hospitals amounted to R 473 274.13, compared to R 777 646.22 for the non-pilot hospitals. Length of hospital stay was also significantly lower in patients receiving blood conservation alternatives compared to patients receiving allogeneic blood. The total costs related to patients of blood conservation was lower, although not significantly, than the total costs of patients using allogeneic blood or both. In this study it was seen that the outcomes were positively associated with the implementation of blood conservation techniques. The efficacy of two leukodepletion methods for allogeneic blood products namely pre-storage and post-storage filtration, were evaluated. The results revealed that the mean leukocyte count of pre-storage leukodepleted blood samples (n = 30) was 0.12 cells/μl. The mean leukocyte count of the post-storage filtered blood samples (n = 20) was 0.05 cells/μl. Both methods were shown to be successful in the efficient removal of leukocytes. Copyright === Dissertation (MSc)--University of Pretoria, 2011. === Immunology === unrestricted