Optimal Blood Ordering for Elective Surgery

THE 21-day shelf-life of donated blood, stored at 4 to 6 C obligates blood bank directors and other physicians to manage this important resource carefully. Because frozen blood is expensive, most patients requiring hemotherapy receive units stored at 4 to 6 C. Appropriate crossmatch ordering is necessary for effective utilization of this blood. A unit of blood that has been crossmatched for a particular patient is reserved for that patient (24 to 48 hours in most institutions) and is thus unavailable for use elsewhere. Therefore, if it is not actually transfused into that patient, there is an increased likelihood of its becoming outdated. Several institutions have tried to circumvent this problem by crossmatching and reserving one unit for two or more patients simultaneously. This procedure is an expediency with inherent risks. We have studied the use of blood in elective surgery at our institution to develop guidelines for the surgical