Using simulation to study the impact of racial demographics on blood transfusion allocation policies

Managing the supply and demand of blood for transfusions is a complicated problem that many hospitals encounter since the blood supply is dependent on donations while the demand is not. Moreover, recent research also shows that transfusing older blood into patients may lead to increased mortality. This raises the issue of whether transfusing fresher blood can be achieved without jeopardizing blood availability. In this paper, we build a simulation model to study the impact of racial and ethnic diversity in combination with a blood allocation threshold. We show that for many diverse cities like New York City that the increased diversity of the population can lead to a large mismatch between blood supply and demand.

[1]  Jamol Pender,et al.  Diffusion limits for the (MAPt/Pht/∞)N queueing network , 2017, Oper. Res. Lett..

[2]  J. Vincent,et al.  Association between duration of storage of transfused red blood cells and morbidity and mortality in adult patients: myth or reality? , 2009, Transfusion.

[3]  C. Hillyer,et al.  Demographic patterns of blood donors and donations in a large metropolitan area. , 2011, Journal of the National Medical Association.

[4]  C. Wade,et al.  Duration of red blood cell storage is associated with increased incidence of deep vein thrombosis and in hospital mortality in patients with traumatic injuries , 2009, Critical care.

[5]  W. Dzik Fresh blood for everyone? Balancing availability and quality of stored RBCs , 2008, Transfusion medicine.

[6]  H. Ullum,et al.  Duration of red blood cell storage and survival of transfused patients (CME) , 2010, Transfusion.

[7]  Richard H. Rand,et al.  Queues with Choice via Delay Differential Equations , 2017, Int. J. Bifurc. Chaos.

[8]  M. Tweeddale,et al.  Association of mortality with age of blood transfused in septic ICU patients , 1997, Canadian journal of anaesthesia = Journal canadien d'anesthesie.

[9]  Richard A Forshee,et al.  A stock‐and‐flow simulation model of the US blood supply , 2014, Transfusion.

[10]  Jamol Pender,et al.  Gram Charlier Expansion for Time Varying Multiserver Queues with Abandonment , 2014, SIAM J. Appl. Math..

[11]  G. Gravlee Duration of Red-Cell Storage and Complications after Cardiac Surgery , 2009 .

[12]  Richard H. Rand,et al.  Delayed Information , 2018 .

[13]  E. Moore,et al.  Age of transfused blood is an independent risk factor for postinjury multiple organ failure. , 1999, American journal of surgery.

[14]  H. Nielsen,et al.  Storage time of transfused blood and disease recurrence after colorectal cancer surgery , 2001, Diseases of the colon and rectum.

[15]  Lawrence M Wein,et al.  A novel allocation strategy for blood transfusions: investigating the tradeoff between the age and availability of transfused blood , 2012, Transfusion.

[16]  D. Gerber Duration of red cell storage before transfusion and in-hospital mortality , 2011 .

[17]  B. D. Proctor,et al.  Current Population Reports, P60-235, Income, Poverty, and Health Insurance Coverage in the United States: 2007 , 2008 .

[18]  E. Moore,et al.  Increased rate of infection associated with transfusion of old blood after severe injury. , 2002, Archives of surgery.

[19]  S. Anderson,et al.  Modeling the potential impact on the US blood supply of transfusing critically ill patients with fresher stored red blood cells , 2017, PloS one.

[20]  C. Hillyer,et al.  Blood donation and blood transfusion: special considerations for African Americans. , 2008, Transfusion medicine reviews.

[21]  A. Shander,et al.  Clinical consequences of iron overload from chronic red blood cell transfusions, its diagnosis, and its management by chelation therapy , 2010, Transfusion.

[22]  D. Fergusson,et al.  Clinical consequences of red cell storage in the critically ill , 2006, Transfusion.

[23]  Jamol Pender,et al.  Gaussian skewness approximation for dynamic rate multi-server queues with abandonment , 2013, Queueing Syst. Theory Appl..

[24]  A. Eder,et al.  Hispanic ethnicity, race and blood donation in the United States , 2008, Transfusion medicine.

[25]  Stefan Engblom,et al.  Approximations for the Moments of Nonstationary and State Dependent Birth-Death Queues , 2014, ArXiv.

[26]  Jamol Pender NONSTATIONARY LOSS QUEUES VIA CUMULANT MOMENT APPROXIMATIONS , 2014, Probability in the Engineering and Informational Sciences.