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The available shelf life of a unit of red cells decreases each time the red cell unit is held or crossmatched for a patient who does not use it.
When more blood is crossmatched and set aside for a patient than is required, it is unavailable for other patients and increases the chance that the blood will expire before it is used.
Providing guidelines such as a policy to use 'group and hold' wherever possible, a maximum blood order schedule (MBOS) and monitoring crossmatch-to-transfusion (C/T) ratios is helpful in preventing blood expiring unnecessarily.
The MBOS defines the number of units required to meet the needs of 80% to 90% of patients undergoing a specific procedure and assists in ordering blood.
The hospital transfusion laboratory, however, must give special consideration to patients with a positive antibody screen.
The ANZSBT guidelines contain a suggested maximum blood order schedule.(1) However, institutions should also take into consideration their own particular circumstances, including patient demographics (which may have special requirements) and local surgical practice and experience.