The safe supply of blood products is an important part of the healthcare system. The Paul-Ehrlich-Institut, the Federal Institute for Vaccines and Biomedicines, is responsible for the monitoring of blood and blood products in Germany. A recent analysis of selected data on the production and consumption of blood products from 2009 to 2021, which was reported to the Paul-Ehrlich-Institut in accordance with the Transfusion Act, shows an annual decline in the production of blood components. However, it has been possible to maintain a sufficient national supply of erythrocyte concentrates thus far. Erythrocyte concentrates contain red blood cells (erythrocytes). In Germany, up to 70% or more of the concentrates are produced from whole blood donations. In order to better assess the supply situation, a one-year pilot study was carried out by experts from the Paul-Ehrlich-Institut together with several blood donation services. The study was focused on the weekly reporting of available erythrocyte concentrates. Transfusion Medicine and Hemotherapy reports on the analysis in its online edition from 18 January 2023.
According to section 21 of the Transfusion Act, blood donation facilities and the pharmaceutical companies that produce blood products are obliged to provide annual reports to the Paul-Ehrlich-Institut with figures on the production and consumption of blood products. They must also report on the amount of blood products and plasma proteins that go lost, expire, are placed on the market, imported, and exported. In its reports on the data collected in accordance with section 21 of the Transfusion Act, the Paul-Ehrlich-Institut compares the production and consumption of blood products and thus makes supply and demand transparent.
Experts at the Paul-Ehrlich-Institut analysed the data from 2009 to 2021. There was a steady decline in whole blood donations and thus also a decrease in the number of erythrocyte concentrates produced therefrom. One factor to which this decline can be attributed is the shift in demographics. There has been a simultaneous decrease in the consumption of erythrocyte concentrates thanks to the use of tissue-protecting surgical techniques and the patient blood management concept. The medical concept of patient blood management serves to increase patient safety by increasing the use of the body's own blood reserves.
From 2009 to 2021, the annual number of erythrocyte concentrates produced decreased from 4.68 million to 3.43 million, which corresponds to a decrease from 58 to 41 erythrocyte concentrates per 1,000 inhabitants and is approaching the level of consumption in other EU Member States. The ratio of erythrocyte concentrates produced to those consumed did not change significantly even during the COVID-19 pandemic.
In the pilot study, the supply of erythrocyte concentrates reported weekly in Germany from November 2021 to November 2022 was documented and compared to actual demand. The data was obtained by the Paul-Ehrlich-Institut from the participating blood donation services, whose activities cover 77% of blood donations in Germany. During the one-year period of observation, relevant fluctuations occurred, in particular in the availability of the erythrocyte concentrates of the blood group 0 Rhesus positive. The supply for this blood group is particularly sensitive to fluctuations. Temporary supply shortages arose, the causes of which included school or national holidays, medical staff illnesses, or a relevant number of blood donors.
Weekly reporting on the blood supply thus provides valuable information about the current erythrocyte concentrate supply situation. As a result, it is possible for blood donation facilities to initiate appropriate promotional campaigns and calls for donations in a timely manner and to receive faster support from other blood donation services that still have sufficient amounts of erythrocyte concentrates.
Updated: 06.03.2023
