Background: Blood is the most common organ donation that can be done by an ordinary healthy person. It plays an important role in saving human life. Since there is no blood substitute available till date, blood so collected during voluntary (blood donation camps) and replacement donations, should be used in a proper and judicious manner. The aim of all the blood banks should be to have discarded rate/wastage of zero or to keep it to a minimum level.

Aim: The aim of the present study was to know about the causes of blood wastage, calculate the discard rate and to plan or formulate the strategy to reduce the wastage of blood at the district hospital.

Materials and Methods: It is a retrospective study carried out over a period of 5 years (1^st January 2015 to 31^st 2019) at a blood bank in a district hospital of Himachal Pradesh. The data was collected and analysed.

Results: A total of 7306 units of blood were collected over the period of 5 years with 6824 (93.3%) units through voluntary donations and majority (n=6911, 94.6%) of them being males. One hundred and two (1.39%) units of blood were discarded due to the various reasons with seropositivity for transfusion transmitted infection (TTIs) (70.6%) being the most common. Under collection (20.5%), expiry date (4.6%) lipemia plasma, hemolysis of blood and blood clots in the bag were the other rare causes for discarding blood.

Conclusion: To reduce the discard rate and have minimal wastage of blood, it is important to do proper and strict donor selection as per the WHO guidelines and   to have trained pheblolists, experienced and  motivated staff in the blood bank. There should be proper coordination between the clinicians and the blood bank staff.

Keywords: Transmission transmitted infection (TTIs), blood donors, seropositivity, discard rate.

1. Press, World Health Organization. Towards 100%Voluntary Blood Donation: A Global Framework For Action 2010. Available at http://www.who.into/bloodsafety/publication/9789241599696/en/
2. National AIDS Control Organization. Standards for Blood Banks and Blood Transfusion Services. New Delhi. Minstry of Health and Family Welfare, Government of India.2007.
3. Blood Transfusion Safety. Available at URL:http://www.who.int/blood safety/en/Blood Transfusion safety.pdf. Accessed on June 16,2015.
4. Sharma N, Kaushik S, Kumar R, Azad Z, Acharya S, Kudesia S. Causes of wastage of blood and blood components: A retrospective study. IOSR J Dent Med Sci 2015;13:59-61.
5. Saxena S, Weiner JM, Rabinowitz A, Fridey J, Shulman IA, Carmel R. Transfusion practice in medical patients. Arch Intern Med. 1993;153:2575-80.
6. Kumar A, Sharma SM, Ingole NS, Gangane N. Analysis of reasons for disarding blood and blood components in a blood bank of tertiary care hospital in central India. A prospective study. Int J Med Public Health.2014;4:72-4.
7. World Health Organization. Recommendations. Developing a national policy and guidelines on the clinical use of Blood Geneva:WHO.2009.
8. Dobariya GH, Raja KA, Unagar CA, Pandya AN, Patel JN, Jarag MA et al. Prevalance and trends of transfusion transmitted infections among blood donors of blood bank attached to government hospitals of South Gujrat, India.Int J Res Med Sci 2016;4:4123-7.
9. Kanani AN, Vachhani JH, Dholakiya SK, Upadhyay SB. Analysis on discard of blood and its products with suggested possible strategies to reduce its occurrence in a blood bank of tertiary care hospital in Western India. Glob J Transfus Med. 2017;2:130-6.
10. Kaur P,Kaur R, Masih V, Jindal A. Incidence and Causes of Wastage of Blood and Blood components in a Blood Bank of Tertiary Care Hospital. A Retrospective Study. IOSR J Dent Med Sci.2016;15 (9):108-110.
11. Mahapatra S, Sahoo BB, Ray GK, Mishra D, Panigrahi H and Panda P. Discard of blood and blood components with the study of causes. A Good manufacture practice .wipmr.2017;3(2):172-175.
12. Patil P, Bhake A, Hiwala K. Analysis of discard of whole blood and its components with suggested possible strategies to reduce it. Int J Res Med Sci 2016;4:477-80.
13. Arora I, Singh S, Singh S. Int J Community Med Public Health.2018 Jul;5(7):3016-3019
14. Suresh B, Sreedhar Babu KR, Arun R, Chandramouli P, Jyothibai DS. Reasons for discarding whole blood and its components in a tertiary care hospital blood bank in South India. J Clin Sci Res 2015;4:213-9.
15. Lakum NR, Makwana H, Agnihotri A. A analytical study of discarded units of whole blood and its components in a blood bank at a tertiary care hospital in Zalawad region of Saurastra. Int J Med Sci Public Health 2016;5:318-321.
16. Thakare MM, Dixit JV, Goel NK. Reasons for discarding blood from blood bank of government medical college, Aurangabad. Asian J Transfus Sci. 2011;5: 59–60. doi: 10.4103/0973-6247.76009.
17. Gauravi D, Agravat A, Kurpal MP. Seroprevalance of HIV, HBV, HCV and syphilis in blood donors Saurastra region of Gujrat: Decling trends over a period of 3.5 years. Online J Health Allied Sci 2012.11:5.
18. Duarah B, Duara L, Sharma A, Saikia P. Reasons of discarding blood and blood components in the State of Art Model Blood Bank in a tertiary care teaching hospital. International Journal Of Scientific Research.2016;5(9):39-40.
19. Mukherjee G, Ghosh S, Haider S, Mondal S. Study of discard Rate of Whole Human Blood; Useful Blood Center Quality Indicator. J Sci Soc (serial online) 2018(cited 2020 Sep19);45:116-118.
20. Goel NM, Sudhakar DD. An analysis on blood product usage and wastage in arural tertiary care hospital, Konkan belt of Maharashtra, India. MedPulse International Journal of Pathology. March 2019;9(3):144-149.                       
21. Chanderakar SA, Amnokar GP, Desai HM, Valvi N, Puranik GV. Seroprevalance of transfusion infections in healthy blood donors: A five year Tertiary Care Hospital experience. J Lab Physicians2017;9:283-7.
22. Kaur G, Basu S, Kaur R, Garg S. Patients of infections among blood donors in a tertiary care centre: a retrospective study. Natl Med J India.2010;23(3):147-9.
23. Liang WB, Guo HH, Fan EY, et al. Erythrocyte concentrates recovered from under collected whole blood: experimental and clinical results. PLoS-one. 2015.
24. Chavan SK. Determination of rate and analysis of reasons for discarding blood and blood components in a blood bank of tertiary care hospital: a retrospective study. Int J Res Med Sci 2017;5:1111-5.
25. Janathpour KA, Puglieroni TG, Crocker VL, Dubois DJ, Holland PV. Visual assessment of haemolysis in red cell units and segment can be deceptive. Transfusion. 2014;44:984-989.
26. Jariwala K, Mishra K, Patel G, Seliya R, Shukla R, Ghosh K. Reasons for discarding of whole blood /red cell units in a Regional blood transfusion centre in Western India. Indian J Hematol blood transfus. 2018;34(3):501-505.
27. World Health Organization WHO. Quality Systems for Blood Safety: Introductory Module Guidelines and Principles for Safe Blood Transfusion Practice Geneva; 2002:65-75.

Dr Digvijay Singh Dattal

Senior Resident, Department of Pathology, IGMC Shimla & Ex Medical officer (Blood bank incharge) District Hospital, Solan, Himachal Pradesh, India