Identifying predictors of transfusion burden after haematopoietic stem cell transplants has reduced wastage and workload for ward and laboratory staff, Australian haematologists say.

The single-centre 8-year retrospective audit of blood use after allogeneic HSCT published in the Internal Medicine Journal found that male recipients, intermediate or advanced disease at transplant, use of cord blood stem cells and minor or major ABO incompatibility were independently associated with an increased red cell transfusion burden during the first 30 days post-transplant.

The overall observed transfusion burden was low, with a median 4 units of red cells and platelets used by day 30, and a median 6 units of each transfused by day 365. The median time to transfusion independence for red cells was 12 days and 50% of patients did not require further transfusion after day 30.

“The study has given us an understanding of our current red cell and platelet transfusion burden following allogeneic HSCT,” lead author Annette Le Viellez from the Fiona Stanley Hospital in Perth told the limbic.

“This will allow us to inform future patients of their likely requirements for transfusion and to help improve inventory planning and efficiency in the transfusion laboratory”.

The results of the study have already been used to reduce the workload for both ward and laboratory staff at Fiona Stanley Hospital and to virtually eliminate wastage of irradiated red cells and achieve a level of platelet waste that is below the national average.

Identifying the determinants of increased transfusion use has also led to changes in clinical practice, says Ms Le Viellez.

“We may be able to reduce the red cell transfusion burden further as we are now more frequently using a single unit per transfusion instead of 2 units as we approach the expected time point of transfusion independence,” she said.