Annals of Laboratory Medicine

Korean Society for Laboratory Medicine (대한진단검사의학회)
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Common Data Model-based Analysis of Selective Leukoreduction Protocol Compliance at Three Hospitals

  • Sooin Choi (Department of Laboratory Medicine and Genetics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine) ;
  • Soo Jeong Choi (Division of Nephrology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine) ;
  • Jeong Won Shin (Department of Laboratory Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine) ;
  • Young Ahn Yoon (Department of Laboratory Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine)
  • Received : 2022.04.22
  • Accepted : 2022.09.19
  • Published : 2023.03.01
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Abstract

Background: The selective leukoreduction protocol (SLP) is limited in that patients who require it can be overlooked. We estimated SLP compliance (SLPC) using the Observational Medical Outcomes Partnership common data model (CDM). Methods: Patients were classified into eight groups: pre- and post-hematology disease (A and B), pre- and post-solid organ transplantation (C and D), solid cancer (E), immunodeficiency (F), anticancer therapy (G), and cardiovascular surgery (H). We examined the red blood cell (RBC) transfusion history from three hospital datasets comprising approximately three million patients over 20 years using CDM-based analysis. SLPC was calculated as the percentage of patients who received only leukoreduced RBCs in total patients transfused RBCs. Results: In total, 166,641 patients from three hospitals were enrolled in this study. From 2001 to 2021, SLPC in all groups, except H, tended to increase, although there were differences among the hospitals. Based on the most recent values (2017-2021), the SLPC in groups A, B, D, and G was maintained at ≥75% until 1,095 days before or after diagnosis or treatment. Groups E, F, and H had < 50% SLPC one day after diagnosis and treatment. Conclusions: CDM analysis supports the review of large datasets for SLPC evaluation. Although SLPC tended to improve in most patient groups, additional education and monitoring are needed for groups that continue to show low SLPC.

Keywords

Acknowledgement

This study was funded by the Soonchunhyang University Research Fund.

References

  1. Ratko TA, Cummings JP, Oberman HA, Crookston KP, DeChristopher PJ, Eastlund DT, et al. Evidence‐based recommendations for the use of WBC‐reduced cellular blood components. Transfusion 2001;41:1310-9. https://doi.org/10.1046/j.1537-2995.2001.41101310.x
  2. Bassuni WY, Blajchman MA, Al-Moshary MA. Why implement universal leukoreduction? Hematol. Oncol Stem Cell Ther 2008;1:106-23. https://doi.org/10.1016/S1658-3876(08)50042-2
  3. Choi SJ, Kim S, Kim HO, Kwon JR, Lee SW, Shin YH. The status of use of leukoreduced blood products in Korean hospitals. Lab Med Online 2012;2:204-8. https://doi.org/10.3343/lmo.2012.2.4.204
  4. Whitaker BI and Hinkins S. The 2011 national blood collection and utilization survey report. United States Department of Health and Human Services, 2011:1-88.
  5. Trial to Reduce Alloimmunization to Platelets Study Group. Leukocyte reduction and ultraviolet B irradiation of platelets to prevent alloimmunization and refractoriness to platelet transfusions. N Engl J Med 1997; 337:1861-9. https://doi.org/10.1056/NEJM199712253372601
  6. Choi S, Choi SJ, Kim JK, Nam KC, Lee S, Kim JH, et al. Preliminary feasibility assessment of CDM-based active surveillance using current status of medical device data in medical records and OMOP-CDM. Sci Rep 2021;11:24070. https://doi.org/10.1038/s41598-021-03332-6
  7. Hripcsak G, Duke JD, Shah NH, Reich CG, Huser V, Schuemie MJ, et al. Observational Health Data Sciences and Informatics (OHDSI): opportunities for observational researchers. Stud Health Technol Inform 2015;216:574-8.
  8. Park RW. The distributed research network, observational health data sciences and informatics, and the South Korean research network. Korean J Med 2019;94:309-14. https://doi.org/10.3904/kjm.2019.94.4.309
  9. Seong Y, You SC, Ostropolets A, Rho Y, Park J, Cho J, et al. Incorporation of Korean electronic data interchange vocabulary into observational medical outcomes partnership vocabulary. Healthc Inform Res 2021;27: 29-38. https://doi.org/10.4258/hir.2021.27.1.29
  10. Koo BN, Kwon MA, Kim SH, Kim JY, Moon YJ, Park SY, et al. Korean clinical practice guideline for perioperative red blood cell transfusion from Korean Society of Anesthesiologists. Korean J Anesthesiol 2019; 72:91-118. https://doi.org/10.4097/kja.d.18.00322
  11. National organ tissue blood management agency. Korean national transfusion guideline. 5th ed. Seoul: National organ tissue blood management agency, 2022:56-8.
  12. Choi S, Hyun J, Yu H, Cho D. ABO-incompatible transfusion events reported in written judgments and in the Korean hemovigilance system. Ann Lab Med 2021;41:493-8. https://doi.org/10.3343/alm.2021.41.5.493
  13. Sarkar S and Seshadri D. Conducting record review studies in clinical practice. J Clin Diagn Res 2014;8:JG01-04. https://doi.org/10.7860/JCDR/2014/8301.4806
  14. Song MJ, Kim S, Boo D, Park C, Yoo S, Yoon HI, et al. Comparison of proton pump inhibitors and histamine 2 receptor antagonists for stress ulcer prophylaxis in the intensive care unit. Sci Rep 2021;11:18467. https://doi.org/10.1038/s41598-021-98069-7
  15. Josephson CD, Glynn S, Mathew S, Birch R, Bakkour S, Baumann Kreuziger L, et al. The Recipient Epidemiology and Donor Evaluation Study‐ IV‐Pediatric (REDS‐IV‐P): a research program striving to improve blood donor safety and optimize transfusion outcomes across the lifespan. Transfusion 2022;62:982-99. https://doi.org/10.1111/trf.16869
  16. Leffell MS, Kim D, Vega RM, Zachary AA, Petersen J, Hart JM, et al. Red blood cell transfusions and the risk of allosensitization in patients awaiting primary kidney transplantation. Transplantation 2014;97:525-33. https://doi.org/10.1097/01.tp.0000437435.19980.8f
  17. Choi S, Lee KW, Park JB, Kim K, Jang HR, Huh W, et al. C3d-positive preformed DSAs tend to persist and result in a higher risk of AMR after kidney transplants. J Clin Med 2020;9:375. https://doi.org/10.3390/jcm9020375
  18. Wallis JP, Chapman CE, Orr KE, Clark SC, Forty JR. Effect of WBC reduction of transfused RBCs on postoperative infection rates in cardiac surgery. Transfusion 2002;42:1127-34. https://doi.org/10.1046/j.1537-2995.2002.00181.x
  19. Gu YJ, devries AJ, Boonstra PW, van Oeveren W. Clinical performance of a high-efficiency rapid flow leucocyte removal filter for leucocyte depletion of heparinized cardiopulmonary bypass perfusate. Perfusion 1995;10:425-30. https://doi.org/10.1177/026765919501000606
  20. Kim HI, Yoon JY, Kwak MS, Cha JM. Real-world use of colonoscopy in an older population: A nationwide standard cohort study using a common data model. Dig Dis Sci 2021;66:2227-34. https://doi.org/10.1007/s10620-020-06494-x
  21. Yoon JY, Kwak MS, Kim HI, Cha JM. Seasonal variations in the diagnosis of the top 10 cancers in Korea: a nationwide population‐based study using a common data model. J Gastroenterol Hepatol 2021;36:3371-80. https://doi.org/10.1111/jgh.15634