Our Blood Institute Oklahoma City, Oklahoma, United States
Background/Case Studies: Red blood cell units collected from therapeutic phlebotomy (TP) procedures can boost blood inventories significantly, offering a viable sourcing option for blood centers facing chronic donor recruitment challenges. The Food and Drug Administration (FDA) created a regulatory path in 2001 enabling US blood operators to qualify blood draws from hemochromatosis patients for allogeneic transfusions. In 2013, a new variance expanded permissible collections to include patients on androgen therapy to raise testosterone levels. Despite these allowances, many blood collectors do not use them to augment standard phlebotomy operations. Barriers to adoption include implementing specialized donor qualifications, operating procedures, staff training, outcome tracking, appointment scheduling, fee collection, etc. In contrast and to positive effect, our blood center assiduously pursued a free-of-charge TP program, steadily adding resources and sophistication over the last decade.
Study
Design/Methods: We reviewed our center’s TPs from January 2015 through December 2024. Whole blood collections qualifying for allogeneic transfusion are tracked by our blood establishment computer system (BECS) separately from those that must be discarded. Conversion % denotes the relative number of usable units yielded from the total number of medically prescribed procedures. We do not use apheresis machines for these collections and there is no sizable competitor offering TPs in our operational area. For sustainability calculations, we factored revenues from the distributed products, including plasma co-components, derived from successful collections. Expense figures included costing for the burden of discarded TP draws and selected overhead allocations.
Results/Findings: As shown in Figure 1, from 2015 to 2024 we saw uninterrupted growth in the annual totals of usable draws. Over that span our conversion percentage has increased three-fold (46.4/15.3 = 3.03) and our per annum productivity is 8,545 units higher (from 726 to 9,271) representing 1277% growth. In 2024, the therapeutic RBC harvest represented 3.0% of our center’s total red cell draw of 306,072. Our total TP revenues, exceeding $2 million, covered all assigned operational and infrastructure costs, with a surplus of several hundreds of thousands of dollars.
Conclusions: In 2024, our blood center leveraged its free therapeutic phlebotomies to increase its red cell supplies by more than 9,000 units and did so in a financially sustainable fashion. Without this community health program, a large donor pool would have been excluded from contributing usable, allogeneic blood units. Continuing investment over a decade has grown both the percentage of converted collections and overall useful TPs, which now contribute meaningfully to our blood inventories.
