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The comparison of MSBOS data in Severance hospital through 1989 to 2013
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Citations
... They created an artificial intelligence model to predict the appropriate amount of preoperative RBC demand, using several preoperative analysis parameters, such as portal hypertension, age, hemoglobin, diagnosis, direct bilirubin, activated partial thromboplastin time, globulin, aspartate aminotransferase, and alanine aminotransferase (30) According to Park et al.'s study in South Korea and the MSBOS comparisons conducted regarding 1989,1999,2007, and 2013 tables demonstrated a significant declining trend. Therefore updating MSBOS tables in each blood transfusion service can improve blood transfusion management (31). ...
Background & Objective
Unnecessary pre-operative ordering of red blood cells (RBCs) in elective surgeries increases costs and waste of blood inventory. Maximum surgical blood order schedule (MSBOS) is a helpful strategy in the estimation of blood units needed for surgery and the prevention of overconsumption. In this study, an MSBOS for pediatric cardiac surgeries is designed.
Methods
In this cross-sectional study, we included all pediatric patients who underwent elective cardiac surgery in Children’s Medical Center in Tehran, Iran, from March 21, 2019, to September 22, 2019. Data consisted of the type of surgery and the number of blood units transfused and units cross-matched, based on which cross-match to transfusion ratio (CTR), the transfusion index (TI), and transfusion probability (T%) were calculated.
Results
Overall 205 pediatric patients were included in the study. Four hundred and ten RBCs units were cross-matched, and 262 were transfused. The overall results of the CTR, T%, and TI for all the eight types of cardiac surgery were 1.56 (410/262), 76% (157/205), and 1.28 (262/205), respectively. The raw MSBOS for cardiac surgeries included ventricular septal defect, tetralogy of fallot, dextro-transposition of the great arteries, atrial septal defect, aortic coarctation, patent ductus arteriosus, pulmonary stenosis, and pacemaker insertion, which were 1.58, 1.03, 1.54, 1.66, 0.77, 0, 1.25, and 0 unit, respectively, and the figures were rounded up.
Conclusion
Accurate MSBOS protocols reduce cross-match workload in laboratories, lead to the appropriate use of blood stocks with less wastage, save human and economic resources, and eventually, promote patient safety.
... In our study, a total of 10 units of red blood cell products were transfused intraoperatively into four patients, with the mean transfusion units per patient being 2.5. According to a previous study by Park et al. [18] in Korea, the number of patients receiving transfusions during kidney transplantation was 0.8%, with the mean units per transfused patient being 2.0. Consequently, the MSBOS for kidney transplantation was set at 2.0 [18]. ...
... According to a previous study by Park et al. [18] in Korea, the number of patients receiving transfusions during kidney transplantation was 0.8%, with the mean units per transfused patient being 2.0. Consequently, the MSBOS for kidney transplantation was set at 2.0 [18]. Another study on MSBOS setting in the United States recommended that the number of crossmatching units prepared before kidney transplantation surgery should be set at 2.0 red blood cell units. ...
Background
Accurately predicting the demand for blood transfusions is crucial for blood banks. Given the potential for emergency situations, it is imperative that blood banks maintain a sufficient inventory of blood products. In this study, we examined the use of perioperative transfusions in patients undergoing elective kidney transplants.
Methods
Data on all complement-dependent cytotoxicity-crossmatched assays between 2013 and 2022 were collected. We excluded repeated assays and patients who did not undergo kidney transplantation. Transfusion records and transfusion adverse reactions were reviewed retrospectively.
Results
In total, 30 patients underwent elective kidney transplantation from 2013 to 2022. The mean age of the patients was 48.1±9.7 years. The male-to-female ratio was 1.51. Four patients received transfusions intraoperatively, whereas eight patients were transfused postoperatively. The postoperative hemoglobin level of the transfusion group (n=9, 8.9±1.3) was significantly lower than that of the nontransfusion group (n=21, 10.4±1.2). The most commonly transfused blood product intraoperatively was leuko-reduced filtered red blood cells, followed by fresh frozen plasma. When the study period was divided into two halves based on the time of operation, the first half showed a higher number of significant transfusions.
Conclusions
In most elective kidney transplant cases, surgery was conducted without the need for blood transfusion. The timing of transfusion, when necessary, shifted from during the operation to after the operation. The implementation of patient blood management, coupled with advancements in surgical techniques, appears to have impacted the pattern of perioperative transfusion.
... The need for adequate blood transfusion for surgical procedures has led to the development of the maximum surgical blood order schedule (MSBOS), which is a list of surgical procedures with their corresponding recommended number of blood units. MSBOS was first introduced in 1976 [1] and was established in South Korean hospitals starting from the 1980s [2][3][4][5][6][7][8][9]. Adopting the MSBOS can decrease the unnecessary blood release, minimize wastage due to outdating, and reduce the workload of blood banks by providing guidelines with simplified methods, such as applying the type and screen (T&S) method for procedures with low MSBOS [10,11]. ...
... Several factors have been proposed for deriving the MSBOS. The average of the actual transfused RBC units per surgery, i.e., the transfusion index, is one of the most commonly adopted factors [13][14][15][16][17], which is used widely in blood banks in South Korea [2][3][4][5][6][7][8][9]. Many studies recommended and adopted the type and screen for cases with TI＜0.5 [16,18,19]. ...
... 3 It is necessary to study the transfusion data of individual hospitals to prepare a stable supply of blood products. Organ transplant surgery is known to require a high volume of blood transfusions, 4 but only a few studies have reported on transfusions or the MSBOS of transplants. [3][4][5] In this study, we investigated blood transfusion volumes that were transfused preoperatively, intraoperatively, and postoperatively in heart and lung transplants. ...
... Organ transplant surgery is known to require a high volume of blood transfusions, 4 but only a few studies have reported on transfusions or the MSBOS of transplants. [3][4][5] In this study, we investigated blood transfusion volumes that were transfused preoperatively, intraoperatively, and postoperatively in heart and lung transplants. This study was conducted to evaluate the changes in transfusion requirements and predict transfusion patterns during transplantation of both these organs. ...
... 11 Two studies on LT in other Korean medical institutions reported an average RBC transfusion of 11 units. 4 One study conducted 2192 heart transplantations for 1 year and transfused on average 2 to 4 units of RBC, 1.6 units of FFP, and 1 unit of platelets during surgery. 12 The average number of blood products used for 514 lung transplants at a university hospital in the Netherlands were RBC, 4 units; FFP, 2 units; and platelets, zero units. ...
Objective:
Transplantations may require massive transfusion of blood products. Therefore, blood banks need to predict, prepare, and supply the required amount of blood products.
Methods:
We measured the volume of transfused blood components as red blood cells, fresh frozen plasma, platelets, and cryoprecipitate in 54 and 89 patients who received heart and lung transplantation, respectively, in our hospital between January 2012 and December 2019.
Results:
Platelets were the most frequently transfused blood component. Transfusion volumes during heart and lung transplantation surgeries differed: red blood cells, 7.83 units vs 14.84 units; fresh frozen plasma, 2.67 units vs 12.29 units; platelets, 13.13 units vs 23.63 units; and cryoprecipitate, 1.74 units vs 2.57 units; respectively. The average transfusion volume of transplants was different each year.
Conclusion:
Periodic evaluation of transfusion requirements will facilitate the efficient management of blood products at the time of transplantation and help blood banks predict changes in blood requirements.
