Conserving Red Cell Use for Good Stewardship and Patient Safety

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As a resource, the need for allogeneic red cell has never been more in demand than it is today. Escalating elective surgery, an ageing population, periodic shortages arising from a fall in supply, old and emerging threat of transfusion –transmissible infections and spiralling costs due to various safety introductions have all conspired to ensure that allogeneic red cell remains very much a vital but limited asset in healthcare delivery. Conserving blood makes sense. Effective stewardship of our red cell stock is important for economic, supply/ demand reasons and to protect the national inventory at times of national blood shortage. There is the need for all stakeholders to think seriously and innovatively about how best to attract and retain new donors as well as sourcing for alternatives to allogeneic red cell transfusion. A successful and sustainable future demands exemplary stewardship from all players in the careful management of both red cell supply and demand issues. We have a significant challenge to reduce unnecessary demand through world class management of this precious product by applying the best available evidenced-based medical practices. To improve outcomes, red cell usage must be optimized and expenditures controlled so that resources may be channelled toward other diagnostic, therapeutic, and technological initiatives. Health professionals involved in the care of anaemic patients has a real and pressing obligation to fulfil their responsibilities, in terms of accountability for the human, financial, clinical and other resources associated with managing blood donations. There is need to reduce the growth in demand for allogeneic red cell transfusion. We must accept the challenge that growth cannot continue at the present rate and take real steps to ensure that any growth reflects real evidence-based clinical need and is not driven by historical practice. Wastage of this precious gift is an unacceptable failure in the stewardship of blood products.