AABB2025: Advancing Patient Care Through Out-of-Hospital Transfusions

Out-of-hospital transfusions can expand the benefits of blood transfusion to more patients, through convenience and increased access, particularly for underserved populations, according to Fatima Aldarweesh, MD, QIA, from the University of Chicago. Aldarweesh spoke about her experiences with implementing and expanding an out-of-hospital transfusion program in the Chicago area during Monday morning’s “Expanding Access, Ensuring Safety: Best Practices in Out-of-Hospital Transfusion” session.

"Out-of-hospital transfusion refers to the administration of blood products in environments outside of traditional hospital settings,” Aldarweesh said, adding that potential settings included dialysis centers, ambulatory centers and patient homes.

Aldarweesh said it is thanks to recent advancements in medical technology that out-of-hospital transfusion protocols are becoming a reality. “Portable monitoring systems and improved blood storage capabilities make off-site transfusions more feasible than ever before,” she said. Additionally, she noted that many health care systems are now “prioritizing flexible care delivery models that meet patients where they are most comfortable.”

She stressed that certain steps need to be taken to maintain quality assurance and ensure that patients transfused outside of a hospital receive the same level of optimal care as those transfused in a hospital. “Maintaining proper blood storage temperatures, handling protocols and product integrity outside of controlled hospital blood banks requires vigilant oversight,” she said. She noted specialized transport containers and monitoring systems are now available that are able to ensure blood products maintain optimal storage conditions throughout the transfusion process.

Aldarweesh said staff training is of the utmost importance when developing out-of-hospital transfusion protocols. “Health care teams must receive extensive certification in transfusion medicine, emergency response protocols and adverse reaction management,” she said.

Aldarweesh also discussed various challenges associated with out-of-hospital programs, including resource management, implementation gaps, staff compliance and standardization. However, she stressed that such challenges can be addressed and emphasized that, ultimately, out-of-hospital programs can be beneficial, particularly for certain patient populations.

To set up an out-of-hospital transfusion program, Aldarweesh advised a three-step approach, which involves developing comprehensive protocols, ensuring optimal technology integration and, finally, continuous training. She also noted that adhering to FDA regulations, as well as any state or local licensing guidelines, is essential. Finally, she recommended AABB’s recently published Standards for Emergency Prehospital and Scheduled Out-of-Hospital Transfusions to guide development of a new system, and encouraged facilities to seek AABB accreditation when ready.

Aldarweesh concluded by saying that her experiences the University of Chicago system proved that “safe, high-quality transfusion care can be given outside of hospital walls.”