Monitoring wastage

Blood product wastage refers to blood components or plasma-derivative products discarded instead of being transfused to a patient. Some wastage is inevitable, particularly when maintaining adequate inventory levels to ensure the timely availability of products for patients.  

It’s important that laboratories and hospitals actively track and document all instances of wastage, including expired and discarded products.  

Wastage rates should be monitored against national benchmarks to ensure that appropriate inventory levels are maintained, thereby minimising wastage.  

Reviewing wastage data may identify aspects of inventory management which could be improved.  

For example:

• High expiry rates may indicate that excess blood product stocks are being held; or  
• High discard rates may indicate inappropriate practices, for example within hospital wards, which may need to be investigated. 
   
  All blood product usage and wastage data should be entered into the National Blood Authority’s (NBA) BloodNet system. BloodNet provides reporting tools to support monitoring and benchmarking at the group, state, and national levels.  

The NBA sets wastage targets, which are accessible through BloodNet reports. These targets help guide facilities in evaluating their performance. 

While some Australian laboratories and hospitals achieve wastage rates below 1%, this may be more challenging in regional settings due to delivery schedules, inventory constraints, and logistical factors. 

Hospitals and laboratories can implement strategies like the ones below to reduce wastage of blood products. 

Refrigeration failure plan

Refrigeration failure can result in the loss of large quantities or even entire stocks of blood products. This not only compromises a laboratory or hospital’s ability to respond to emergency blood requests but also results in the wastage of valuable donations.

To prevent product loss and ensure continuity of care, every facility should have a refrigeration failure plan, which includes:

• Monitoring of alarms, especially outside normal working hours.
• Immediate actions to take when an alarm is triggered.
• Notification process for who to contact, when, and how (including contact numbers).
• How long the temperature is maintained after failure.
• Availability of backup storage such as an alternative fridge or Lifeblood shippers.
• Procedures for relocating blood components and plasma-derived products.

Transfer of components nearing expiry to another laboratory

To minimise wastage, consider transferring products nearing expiry or excess stock to a larger laboratory within your network, especially O RhD negative red cells. It’s essential to allow sufficient time for the receiving site to use the product before expiry. 

The National Blood Authority (NBA) inventory management guidelines recommend the following minimum shelf lives when deciding to transfer blood and blood products:

• red cells: 7 - 14 days before expiry
• irradiated red cells: >5 days before expiry
• platelets: 24 hours before expiry, or as short as agreed to with the receiving site
• plasma derivative products: 1-3 months before expiry.

When transferring blood products, ensure appropriate storage and transport conditions are maintained. Products are transferred in BloodNet to maintain traceability and ensure accurate national inventory data.

Correct handling

Blood products must be kept at the relevant temperature, in temperature-controlled storage equipment or facilities. Time spent outside the specified temperature range should be minimised to preserve product integrity and ensure patient safety

For red cells, the time out of temperature-controlled storage should, where possible, be kept to less than 30 minutes. If transfusion hasn’t started within 30 minutes or is not expected soon after, the red cells must be returned to the laboratory. They may be put back into the inventory to be available for use again, but this is at the discretion of the Transfusion Service Provider.

To ensure the safe return of unused blood components, both the time of issue and the time of return to the laboratory should be recorded.

If red cells have been out of temperature-controlled storage for more than 30 minutes, they should either be:

• transfused, if this can be completed within 4 hours from the time of original issue; or
• returned to the laboratory, or to remote storage, where the Transfusion Service Provider will decide the appropriate action in accordance with local policies or national guidelines.  

Maintain an ‘ideal’ inventory level

The ideal inventory of blood components balances the need to have an appropriate quantity of each component and the right mix of blood groups to meet clinical demand, while minimising wastage due to expiry and the cost of excessive deliveries  

The ideal inventory level will vary between organisations and depends on several key factors, including the number, type and complexity of activities undertaken in the hospital:

• time to resupply in an emergency  
• distance from the blood supplier and delivery frequency
• predictability of usage e.g. level 1 trauma centre vs. thalassaemia treatment centre
• the number, type and complexity of activities undertaken in the hospital e.g. trauma, obstetrics, surgery
• the number and type of components issued by the laboratory

In many cases, inventory levels may have evolved without regular, evidence-based review. It is recommended that inventory levels be evaluated annually to reflect institutional changes that may affect blood component usage.

For support in reviewing or adjusting inventory levels, contact your state or territory Lifeblood Transfusion Scientist, who can provide tailored advice and benchmarking data.  

Updated September 2025