Inventory management; how to provide units with short supplies?

CP is a limited resource. The blood centre and the transfusion service are ultimately guardians of the blood supply, distributing or issuing components, respectfully, following common principles of patient care, transfusion medicine best practice, distribution guidance by national regulatory agencies and/or dosing regimens by study protocols and peer‐reviewed literature. One must always be consistent in ‘not treating physician’s anxiety but treating patient’s needs’.

Some places will triage CP inventory with a limited number of transfusion specialists especially when inventory is low. Others will provide CCP only within the context of a clinical trial or after ethics committee approval to maximize the effectiveness signal and minimize demand. Others – especially where compassionate use is high – will try to ensure as many patients as possible have access to at least one unit of CCP. Each solution has its pros and cons. Concerns about restricting access to minority groups should be considered, regardless of which method is used. Good communication between expert prescribing and BTS physicians is key to developing and updating clinical guidelines and order sets.

Exclusive use of group AB CP for all patients is not possible; therefore, ABO isogroup units should be the first choice for transfusion. When ABO compatible CP is unavailable and transfusion is recommended, consider using units with low titre ABO isoagglutinins (≤64–≤100) or that are ‘least incompatible’ (i.e. B plasma to an AB patient).