title: Implementation of a redistribution system for near-outdate red blood cell units.
abstract: BACKGROUND
  Many remote hospitals keep small on-site stocks of red blood cell (RBC) units for emergency use and to support patient care programs. In Canada, the blood supplier does not accept returned units into inventory. Discard rates can, therefore, be high.
  
  
  OBJECTIVE
  To transport near-outdate RBC units to a high-usage hospital site, which would reduce overall discard rates, thereby increasing overall stock levels available in the blood system.
  
  
  METHODS
  A blood transportation system was developed and validated. The validation was presented to a high-usage site that agreed to accept near-outdate RBC units transported by this system. Stocks at the remote hospitals were optimized without increasing system-wide discard rates. The redistribution program was implemented in 4 remote sites in northern Alberta, Canada. The final disposition of each transported unit was tracked. Data from the first 2 years were analyzed.
  
  
  RESULTS
  Between April 1, 2003, and March 31, 2005, 106 RBC units were successfully transported to and transfused at the high-usage site. The majority of the units were group O. None of the transfused units were involved in any reported transfusion reactions. The success rate of the transportation system varied among the sites (59%-78% successfully transported and transfused). Changes to the transport system were implemented as problems were discovered. The use of a temperature monitor in each shipment allowed for concurrent revalidation after each change.
  
  
  CONCLUSIONS
  Redistribution systems can be an effective way to reduce RBC unit discard rates. Even simple transportation systems have many factors affecting the RBC unit temperature. Novel temperature stabilizing materials may make future transportation of RBC units more reliable.
authors.affiliation: Dynacare Kasper Medical Laboratories, Regional Services, Edmonton, Alberta, Canada. lisa.denesiuk@dkml.com
authors.forename: Lisa
authors.initials: L
authors.lastname: Denesiuk
authors.forename: Trevor
authors.initials: T
authors.lastname: Richardson
authors.forename: Susan
authors.initials: S
authors.lastname: Nahirniak
authors.forename: Gwen
authors.initials: G
authors.lastname: Clarke
mesh_terms: D001771:Blood Banks / Q000458:organization & administration*; D001793:Blood Preservation; D004905:Erythrocyte Aging; D017707:Erythrocyte Transfusion / Q000191:economics*; D006750:Hospital Distribution Systems / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D007445:Inventories, Hospital / Q000191:economics / Q000379:methods; D011786:Quality Control; D014186:Transportation