Читать книгу Transfusion Medicine - Jeffrey McCullough - Страница 38

Certain areas of the United States are chronically unable to collect enough blood to meet their local transfusion needs. This occurs mostly in metropolitan areas that serve large trauma, tertiary, and transplantation centers. This can cause several difficulties, including possible unavailability of blood or components when needed, complex inventory management, technical disparities, emergency appeal‐type donor recruitment, higher costs, decreased independence, and higher‐risk management costs. As the nature of blood supply organizations has changed (see earlier US Blood Supply section), local and regional relationships have weakened, and each organization manages to collect and distribute their products in the most cost‐efficient and revenue‐generating way possible.

This process of moving blood considerable distances is increasing as hospitals contract with blood suppliers based on cost and availability, breaking long‐time regional or local relationships. This has converted most blood supply organizations into a national perspective.

Despite the fact that there is not a unified blood banking system or a single national inventory or blood resource–sharing system in the United States, blood suppliers have made major efforts to use blood from areas where it is available in excess. Since 1953, the American Association of Blood Banks (AABB) has operated the National Blood Exchange that coordinates the distribution of many units of blood and components annually. These blood‐sharing systems have become less important as the supply organizations have consolidated and become part of larger organizations that manage their own inventory on a national basis.

One of the major issues in blood inventory management is the attitude of blood donors. In the only study focused on donors’ attitudes about being asked to donate more blood than is needed by their local community [31], donors to several American Red Cross blood centers indicated a willingness to donate for patients in other areas of the United States as long as their local blood needs were being met.