Authors
Pokhabov D.S., Shestakov E.A., SHalygin L.D., Zhiburt E.B.
Pirogov National Medical and Surgical Center, Moscow
Abstract
Rationale: the work of the blood service of the Pirogov Center is based on three pillars: 1) evidence-based guidelines for prescribing blood components, evolving due to the emergence of new knowledge and technologies; 2) patient blood management, in which all employees participate; 3) the best, selective, most effective and safe blood components.
Objective: to assess the evolution of the transfusiological practice of the Pirogov Center.
Methods: the reports on blood transfusion at the Pirogov Center in 2003-2022 were studied. Quantitative records of recipients of blood components have been conducted since 2007. The data were examined using descriptive and inductive statistics at a significance level of 0.05.
Results: in 2003–2022 in the Pirogov Center, 521,439 people received specialized inpatient treatment, including transfusion of 38,584 units of donor erythrocytes and 19,394 doses of plasma. In 2007–2022 the number of inpatients increased by 163%. The share of recipients of blood components among them decreased: erythrocytes — by 73% (p<0.001), plasma — by 96% (p<0.001). In 2022, patients received 1,650 units of erythrocytes and 188 units of plasma. During the observation period, the maximum consumption (number of units per 1000 patients) was recorded: a) erythrocytes: in 2006 — 170 units, b) plasma — in 2005 — 278 units. Compared to these indicators, in 2022, the consumption of erythrocytes decreased by 4.6 times, and plasma consumption — by 65.8 times. Haemovigilance and prospective audit of blood transfusions made it possible to avoid transfusion reactions during the entire follow-up period. The principles of the blood service have proven to be effective in providing a hospital with COVID-19.
Conclusion: the management of the patient’s blood changes the structure of the need for allogeneic blood components both qualitatively and quantitatively. The reduction in the volume of transfusions is accompanied by an increase in the quality of blood transfusion media. On the agenda: a) improving the quality and reducing the cost of platelet concentrates: pooling single donor doses, b) introducing pooled pathogen-reduced cryoprecipitate. The blood service ensures the high efficiency of the clinical work of the Pirogov Center, is aimed at introducing the advanced achievements of transfusiological science.
Keywords: blood transfusion, recipient, red blood cells, platelets, plasma, cryoprecipitate, guidelines, evidence-based medicine.
References
1. Shevchenko YL, Karpov OE, Zhiburt EB. Blood transfusion: history and modernity (on the 100th anniversary of blood transfusion in Russia). Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2019; 14(4): 4-11. (In Russ.) doi: 10.25881/BPNMSC.2020.29.78.001.
2. Zhiburt EB. Pirogov center blood service: yesterday, today, tomorrow. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2006; 1(1): 55-57. (In Russ.)
3. Shevchenko YL, Zhiburt EB, Shestakov EA. Implementation of the guidelines for the transfusion of blood components in clinical practice. Vestnik hirurgii imeni I.I. Grekova. 2008; 4: 85-89. (In Russ.)
4. Zhiburt EB, Gubanova MN, Shestakov EA, Ismailov HG. The clinic’s need for blood components is changing. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2008; 3(1): 60-67. (In Russ.)
5. Zhiburt EB, Shestakov EA, Vergopulo AA. First experience with fresh frozen plasma transfusion audit. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2009; 4(1): 20-23. (In Russ.)
6. Zhiburt EB, Shestakov EA, Likhonin DA, Karavaev AV. Women’s plasma transfusion damages recipient’s lungs. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2011; 6(2): 109-111. (In Russ.)
7. Zhiburt EB, Shestakov EA, Karavaev AV. Efficiency of blood transfusion: the role of the organization of the process. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2011; 6(4): 69-71. (In Russ.)
8. Zhiburt EB. Patient blood management for critical bleeding and massive transfusion. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2013; 8(4): 71-77. (In Russ.)
9. Gubanova MN, Mamadaliev DM, Shestakov EA. et al. Evolution of blood transfusion in the branches of the Pirogov Center. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2014; 9(3): 71-74. (In Russ.)
10. Protopopova EB, Madzaev SR, Sultanbaev US, et al. New in evidence-based erythrocyte transfusion. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2015; 10(1): 56-58. (In Russ.)
11. Zhiburt EB, Filina NG, Gubanova MN. Virusinactivation of plasma. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2007; 2(1): 105-110. (In Russ.)
12. Zarubin MV, Gubanova MN, Gaponova TV. Ensuring the efficiency and safety of platelet transfusion. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2016; 11(3): 118-125. (In Russ.)
13. Tankaeva KhS, Shestakov EA, Melnichenko VYa, Zhiburt EB. Implementation of pathogen-reduced platelet transfusion in a multidisciplinary clinic. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2020; 15(1): 78-83. (In Russ.) doi: 10.25881/BPNMSC.2020.84.31.015.
14. Orlov AM, Popkova NG, Galimov ML, et al. The first experience of anticovid plasma transfusion. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2020; 15(4): 61-62. (In Russ.) doi: 10.25881/BPNMSC.2020.74.41.012.
15. Khamitov RG, Ayupova RF, Zhiburt EB. Implementation of collection and transfusion of anticovid plasma. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2022; 17(1): 75-77. (In Russ.) doi: 10.25881/20728255_2022_17_1_73.
16. Ayupova RF, Sultanbaev US, Zhiburt EB, Zhernosenko AO. Efficiency of transfusion of pathogen-reduced platelets in adult patients. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2017; 12(2): 72-74. (In Russ.) doi: 10.25881/BPNMSC.2020.84.31.015.
17. Chemodanov IG, Gorelikova LG, Zhiburt EB. Status of blood donation and its components in the Republic of Crimea. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2018; 13(3): 79-81. (In Russ.) doi: 10.25881/BPNMSC.2018.49.66.017.
18. Zhiburt EB, Shestakov EA, Sidorov SK. The formation of the blood service of the Pirogov Center. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2017; 12(4-1): 72-76. (In Russ.)
19. Gubanova MN, Serba IK, Shestakov EA, et al. Evolution of blood transfusion in the Pirogov Center. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2017; 12(4-2): 90-92. (In Russ.)
20. Chemodanov IG, Shestakov EA, Mamadaliev DM, Zhiburt EB. Relationship of blood type with blood transfusions and mortality in a multidisciplinary clinic. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2018; 13(4): 91-92. (In Russ.) doi: 10.25881/BPNMSC.2018.49.46.017.
21. Zhiburt EB, Madzaev SR, Shestakov EA. Medical and cost-effectiveness of a restrictive blood transfusion strategy. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2015; 10(1): 100-102. (In Russ.)
22. Zhiburt EB, Shestakov EA, Vasilashko VV. Evolution of erythrocyte transfusion tactics in thoracic and cardiovascular surgery. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2009; 4(2): 47-49. (In Russ.)
23. Zhiburt EB, Madzaev SR, Gubanova MN, Burkitbaev ZhK. Results of the study of indications for blood transfusion in elderly surgical patients. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2012; 7(3): 75-76. (In Russ.)
24. Madzaev SR, Gubanova MN, Burkitbaev ZhK. New in evidence-based platelets transfusion. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2013; 8(4): 57-58. (In Russ.)
25. Chemodanov IG, Shestakov EA, Zhiburt EB. The value of prothrombin complex concentrate in the prevention and correction of coagulopathy. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2019; 14(3): 87-89. (In Russ.) doi: 10.25881/BPNMSC.2019.19.25.018.
26. Zhiburt EB, Shestakov EA, Kodenev AT, et al. Efficiency of introducing audit of erythrocyte transfusions into clinical practice. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2009; 4(2): 74-78. (In Russ.)
27. Madzaev SR, Shestakov EA, Kozhevnikov AS, et al. Polymorphism of blood transfusion in the branches of the Pirogov Center. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2009; 4(2): 74-78. (In Russ.)
28. Zhiburt EB, Maksimov VA, Ismailov HG, Vergopulo AA. Postoperative blood salvage in joint arthroplasty. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2008; 3(2):12-14. (In Russ.)
29. Mamadaliyev DM, Farkhutdinov FF, Shestakov EA, et al. Influence of blood phenotype on the risk of erythrocyte transfusion during cardiac surgery. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2015; 10(2): 32-35. (In Russ.)
30. Protopopova EB, Mochkin NE, Madzaev SR, et al. Platelet Transfusion in Autologous Stem Cell Transplantation. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2015; 10(2): 84-85. (In Russ.)
31. Shikhmirzaev TA, Chemodanov IG, Shestakov EA, et al. Pharmacoprophylaxis of transfusion reactions. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2018; 13(2): 95-99. (In Russ.)
32. Zhiburt EB, Shestakov EA, Kuznetsov SI. Hemolytic transfusion reactions. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2019; 14(4): 105-111. (In Russ.) doi: 10.25881/BPNMSC.2020.17.22.020.
33. Chemodanov IG, Gorelikova LG, Ljackovskij AI et al. Transfusion Circulatory Overload Prevention Tool. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2018; 13(4): 93-95. (In Russ.)
34. Kozhemyako OV, Bakulina AYu, Zeiler EI., Zhiburt EB. Transfusion reaction in a remote hospital. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2017; 17(4-2): 147-149. (In Russ.)
35. Zhiburt EB, Shestakov EA, Karavaev AV. et al. Prerequisite for post-transfusion complication. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2010; 5(1): 84-88. (In Russ.)
36. Shestakov EA., Sukhorukova II., Klyueva EA., Zhiburt EB. Wrong blood groyp in a donor container. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2010; 5(1): 109-112. (In Russ.)
37. Gubanova MN, Kopchenko TG, Karavaev AV, et al. The system of prevention of post-transfusion complications in the subject of the Russian Federation. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2010; 5(2): 97-102. (In Russ.)
38. Zhiburt EB, Maksimov VA, Vecherko AV. et al. Improvement of infectious safety and organization of the blood service. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2007; 2(2): 63-67. (In Russ.)
39. Zhiburt EB, Karavaev AV, Glazov KN, Shestakov EA. Errors in the primary determination of the blood group by the attending physician. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2012; 7(3): 113-115. (In Russ.)
40. Kuznetsov SI, Shestakov EA, Gusarov VG, et al. Blood transfusion in a COVID-19 hospital. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2021; 16(4): 74-77. (In Russ.) doi: 10.25881/20728255_2021_16_4_74.
41. Macedonskaya OG, Eikhler OV, Zhiburt EB. Vaccinated — a new category of anti-covid plasma donors. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2020; 15(3-2): 77-79 (In Russ.) doi: 10.25881/BPNMSC.2020.95.33.014.
42. Shestakov EA, Gudymovich VG, Zhiburt EB. The shelf life of blood does not affect the effectiveness of the treatment of transfusion recipients in a cardiac surgery clinic. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2012; 7(4): 80-84. (In Russ.)
43. Protopopova EB, Burkitbaev ZhK, Kuzmin NS. et al. The shelf life of donor erythrocytes does not affect the efficiency of their transfusion. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2012; 7(4): 80-84. (In Russ.)
44. Pokhabov DS, Averyanov EG, Shestakov EA, Zhiburt EB. Peculiarities of national accounting for the collection of donor erythrocytes and plasma. Menedzher zdravookhraneniya. 2022; 9: 14-24. (In Russ.) doi: 10.21045/1811-0185-2022-9-14-24.
45. Zhiburt EB, Kuznetsov SI. 2019 Nobel Prize in Medicine discovery — new alternative to blood transfusion. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2019; 14(4): 121-122. (In Russ.) doi: 10.25881/BPNMSC.2020.55.86.022.
46. Chemodanov IG, Shestakov EA, Kamelskikh DV., Zhiburt EB. Assessment of knowledge and skills of clinical residents in transfusiology. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2018; 13(1): 124-126. (In Russ.)
47. Zhiburt EB, Madzaev SR, Kuzmin NS, Vergopulo AA. Hemotransmissible infections in the population and blood donors. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2016; 11(1): 88-90. (In Russ.)
48. Shevchenko YL, Zhiburt EB, Shestakov EA. The implementation of a blood-saving ideology in the practice of the Pirogov Center. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I.Pirogova. 2008; 3(1): 14-21. (In Russ).
49. Zhiburt EB. Yuri Leonidovich Shevchenko and blood transfusion. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I.Pirogova. 2022; 17(4-1): 121-124. (In Russ). doi: 10.25881/20728255_2022_17_4_1_121.
