Future of Red Blood Cell Transfusion
Red blood cell transfusions by hospitals in the United States decreased 5% between 2008 and 2011. During the recent economic recession, hospitals reported a 6% decrease in elective procedures. Historically, hospitals were thought to be immune to recession, but this no longer appears to be true.
Demographic factors may increase the demand for red blood cell transfusions in the future, but very slowly. The main drivers for increased rates of transfusion include population growth and aging of population. Today, 45% of RBCs are transfused to patients 65 years and older. Individuals 65 years of age and older will increase from 40 million to 72 million by the year 2030 and to 80 million by 2050. The cultural shift towards violence may lead to more penetrating trauma, increasing the need for massive transfusion. Increased population and traffic could lead to more motor vehicle accidents. Introduction of smart cars could potentially offset this factor.
Many other factors could decrease future demand for red blood cell transfusions. Mitigators of transfusion include the significant expansion of blood management programs largely due to the steadily increasing evidence that blood transfusion has negative effects on morbidity & mortality. Health care reform is adversely affecting hospital budgets, causing hospital administrators to fully support blood management initiatives.
Technological advances are also decreasing the need for blood transfusion. Examples include:
- Minimally invasive surgery
- Endovascular repair of aneurysms & valves
- Safer oral anticoagulants and antiplatelet drugs
- Targeted, less toxic, chemotherapy
- More effective hemostatic sealants
Altogether, these trends suggest that future demand for red blood cell transfusions will be anemic, at best.
