(P-PB-5) Analysis of Wastage, Savings, and Maternal and Pediatric Outcomes for Pooled Pathogen Reduced Cryoprecipitate versus Conventional Cryoprecipitate

Sunday, October 20, 2024

12:00 PM - 1:00 PM

Presenting Author(s)

GH

Georgia Huffman, MD

Baylor College of Medicine
Houston, Texas, United States

Background/Case Studies: Hypofibrinogenemia is a significant cause of mortality in bleeding pediatric and obstetric patients. Cryoprecipitate is commonly used for replacement of fibrinogen in these patients. Conventional cryoprecipitate (CRYO, 5-unit pool) wastage is a common issue in hospitals due to its 6-hour shelf life. Pathogen-reduced cryoprecipitate (PRC, 4-unit pool), with a 5-day shelf-life, may reduce waste. The aim of this study was to evaluate wastage, safety, and efficacy in our pediatric and obstetric populations.

Study

Design/Methods: The blood bank LIS was reviewed to identify transfusion and wastage data for cryoprecipitate. Baseline wastage data was collected from January 2022 to September 2022. The study period, in which both CRYO and PRC were in use, was from October 2022 to December 2023. For CRYO wastage, all pools were reviewed to determine likelihood of usage if shelf-life had been 5 days. We determined p</span>ools were “highly likely” to have been used if >3 pools were issued in 5 days and “likely” to be used if 1-2 pools were issued in 5 days. We retrospectively reviewed the electronic medical record to collect age, weight, number of units, fibrinogen increment, and presence of transfusion reactions for pediatric (< 18 years) and obstetric patients receiving CRYO and PRC. Statistical analysis was performed using SPSS version 27 (IBM, NY).

Results/Findings: Baseline wastage was 13.3%. For the study period, total waste for CRYO and PRC was 10.2%. When separated, there was 13.0% wastage for CRYO and 3.0% wastage for PRC. The total cost of wasted units was $24,096 (CRYO: $19,096; PRC: $5,000). For CRYO pools, 40 were “highly likely” and 11 were “likely” to have been transfused with 5-day outdating similar to PRC, resulting in a possible savings of $13,640-$17,391 and yielding an adjusted total wastage 1.6-4.5%. The efficacy and safety data for pediatric and obstetric patients are listed in Table 1. There were no significant differences identified in patient demographics or fibrinogen response between the CRYO and PRC patients. One transfusion reaction occurred in the CRYO group.

Conclusions: Use of a dual inventory of cryoprecipitate did not result in reduced wastage as compared to institutional baseline. However, utilization of PRC is associated with decreased waste as compared to CRYO in our tertiary pediatric and obstetric hospital. No significant differences were identified regarding safety or efficacy in our pediatric or obstetric populations.