(P-TS-45) Dual Benefits of Mobile Refrigerator Implementation for Liver Transplant Surgery to or Team and Blood Bank Team

Background/Case Studies: As our hospital campus expanded, the distance between Blood Bank and OR would be doubled. Liver transplant surgeries routinely need blood transfusion and the transplant team was concerned with the increased transportation time for blood products. To meet this challenge we evaluated and implemented a mobile refrigerators (MF) program. Prior to MF use, pre-op ordered and crossmatched RBC and FFP units for liver transplant surgery were stored in a small temperature monitored refrigerator in the OR hallway. During the surgery when additional blood products were needed, products would be prepared by the Blood Bank team, then picked up by OR team.

Each MF unit has two separate temperature controlled, refrigerated compartments on a wheeled cart with 24 hour battery life. For each liver transplant case 12 units of crossmatch RBCs and 12 units of thawed plasma are to be issued and stored in each compartment in the MF in the OR. Per internal audit the average liver transplant case uses 8 units of RBC and 8 units of FFP.

Study

Design/Methods: Following implementation, our Blood Bank sought to review the impact of MF on the Blood Bank workload in supporting liver transplant. We reviewed 1 year data on the blood product orders placed during the surgery while using MF and compared this data to the year prior MF implementation.

Results/Findings: The first year of MF use there were 289 liver transplant cases, 152/289 (52.6%) cases did not need additional orders for blood products, and 137/289 (47.4%) of cases needed additional blood products. The year prior MF implementation there were 282 liver transplant cases, 50/282 (17.7%) cases did not need additional orders and 232/282(82.3%) of cases needed additional orders for blood products. In one year the need for additional orders dropped from 83% to 47.4% of cases (Figure 1)



Conclusions: MF usage in OR resulted in time savings in OR for the Anesthesia team and time savings for the Blood Bank team. The goal with the initial implementation was for the liver transplant team to have product needed for the case readily available and minimize the number of trips to the BB for additional RC and FFP products.