Cost-effectiveness of a limited-donor blood program for neonatal red cell transfusions

• Published in: Transfusion (Philadelphia, Pa.) Vol. 39; no. 9; pp. 938 - 943
• Main Authors: HILSENRATH, P, NEMECHEK, J, WIDNESS, J. A, CORDLE, D. G, STRAUSS, R. G
• Format: Journal Article
• Language: English
• Published: Oxford Blackwell Publishing 01.09.1999
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Donors; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Cost-Benefit Analysis; Erythrocyte Transfusion - economics; Erythrocyte Transfusion - methods; Humans; Infant; Infant, Low Birth Weight - blood; Infant, Newborn; Medical sciences; Sensitivity and Specificity; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Human; Premature; Sanitary program; Transfusion; Pregnancy disorders; Red blood cell; Method; Long term; Infection; Very low birthweight; Blood cell; Newborn diseases; Newborn; Blood donation; Health economy; Limitation; Comparative study; Cost efficiency analysis; Blood donor
• ISSN: 0041-1132; 1537-2995
• DOI: 10.1046/j.1537-2995.1999.39090938.x

Very-low-birthweight infants have typically been given fresh red cells (RBCs), a practice in which aliquots of RBCs for several infants were issued each day from a single unit. Recently, to limit donor exposures, large volumes of RBCs are reserved for the long-term transfusion support of individual infants. Medical records were examined retrospectively to assess the costs of a limited-donor program for providing RBC transfusions to very-low-birthweight infants. Costs of multiple- and limited-donor programs were compared by using two samples of 30 consecutive infants treated at The University of Iowa Hospitals and Clinics in 1993 and 1997. Effectiveness was evaluated with respect to the number of donor exposures per infant. The cost, in 1997 dollars, of preparing each small-volume transfusion in the multiple-donor program was $27.86 per transfusion, while that in the limited-donor program was $34.83. This difference was largely attributable to use of white cell reduction in association with the limited-donor program in 1997. Eliminating the costs associated with white cell reduction rendered the costs of the limited- and multiple-donor transfusions comparable. The limited-donor program had donor exposures of 2.0 per infant, while the multiple-donor program had 3.6 exposures per infant (p<0.002). The limited-donor blood program reduces donor exposure without adversely affecting costs.