(P-TS-35) Directed Red Blood Cell Donations - Is it Worth Continuing to Offer the Option?

Background/Case Studies: Canadian Blood Services recently discontinued its Directed Donor Program, as they had not had a directed donor blood product collection since 2019, and only parents and legal guardians were allowed to donate for their child. It is well known that there are directed donation (DD) risks to both the donor and the recipient, and current Canadian guidelines do not recommend the practice.¹ However, within the United States, therre has been a recent rise in DD requests - specifically for certain donor characteristics. These actions prompted us to evaluate our pediatric institution's utilization of DD red blood cells.

Study

Design/Methods: The laboratory's electronic database was examined for DD red blood cells from 2006 through 2023. The most common indication for DD requests at our institution is for either a planned surgical procedure with anticipated blood use or chronic RBC transfusion. Standard Operating Procedure (SOP) stated that DD RBCs will be tagged for the intended recipient, and if the units are not used by the anticipated patient within 35 days they would be released into general inventory for homologous use.

Results/Findings: During those 17 years we received 2063 DD red cell units, ranging from 257 to 27 units per year, with a wastage rate of 2.37%. Fifty eight percent (58.4%; 1205/ 2063 units) of the intended recipients received their DD RBC units, white 39% (795/ 2063 units) of the units were used by the general pediatric in-patient population. On-site irradiation was available and no known adverse events were related to these transfusions.

Conclusions: Blood transfusion is a common therapeutic intervention during hospitalization, with more than 15 million blood components transfused in the US annually.² Many parents have a sense of fiduciary responsibility to their child, especially in the setting of the need for blood products. Despite the evidence of marked decline of the number of DD units received at our facility annually over those 17 years, the wastage of the products has remained stable over time. With heightened awareness of being good stewards of the dwindling blood supply, the option of directed donation continues to be an integral, but limited, component of transfusion medicine.