Blood transfusion services play an essential role in modern healthcare systems and are integral to the management of  trauma, major surgeries, obstetric emergencies, hematological disorders, and critically ill patients. Blood and its components are unique therapeutic resources that cannot be synthetically manufactured and rely entirely on voluntary human donation. Because of this limited and valuable supply, efficient utilization of collected blood is essential to maintain adequate availability while minimizing wastage [1]. 
 
With advancements in transfusion medicine, whole blood is rarely transfused as a single entity. Instead, blood is separated into different components including packed red blood cells, platelet concentrates, fresh frozen plasma, and cryoprecipitate. This component therapy allows optimal utilization of each donated unit by enabling multiple patients to benefit from a single donation. However, despite these improvements, a proportion of collected blood components are discarded due to various reasons such as seropositivity for transfusion-transmitted infections, expiry, leakage, breakage, or technical errors during processing and storage [2]. 
 
Blood component discard represents an important indicator of the efficiency of blood bank management. High discard rates not only reflect operational inefficiencies but also result in financial losses and reduced availability of blood components for patients in need. In particular, platelet concentrates are known to have higher How to Cite: N Nigam, L Khan, J Ram, “A 4-year Retrospective Analysis of the discard of Blood Components in the Blood Center of a Tertiary level Hospital in North India, "CME J Ger Med, Vol. 18, No. 3, 2026, pp. 61-65. discard rates because of their short shelf life, typically limited to five days under standard storage conditions [3]. Demand fluctuations, inadequate inventory management, and logistical challenges often contribute to platelet wastage in many blood centers. Serological screening of donated blood for transfusion transmitted infections such as human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis, and malaria is mandatory to ensure transfusion safety. Units testing positive for these infections must be discarded to prevent transmission of 
disease. The prevalence of these infections among donors therefore contributes significantly to the total number of discarded blood units in transfusion services [4]. Monitoring and analyzing discard patterns through periodic audits is essential for identifying causes of wastage and implementing corrective measures. Such analyses help in improving donor selection criteria, 
optimizing inventory management, and strengthening quality control processes within blood banks. Several studies have reported that regular audits of blood component utilization can significantly reduce discard rates and improve transfusion service efficiency [5]. In high-volume blood centers with large annual collections, even a small percentage of wastage can translate into a substantial number of discarded units. Therefore, understanding the causes and patterns of blood component discard is important for designing strategies aimed at reducing wastage and improving resource utilization [6-10]. The present study was conducted to evaluate the magnitude and causes of blood component discard in a tertiary care blood center over a four-year period from 2022 to 2025. The study aimed to assess the relative contribution of different factors responsible for blood component wastage and to provide insights that may help improve inventory management and transfusion practices. 

Study Design

A retrospective observational study was conducted to evaluate blood component discard patterns in a tertiary care blood center for over a period of four years.

Study Setting

The study was carried out in the Department of Immunohematology and Blood Transfusion, GSVM Medical College, Kanpur, U.P which functions as a high-volume blood center with an annual collection of approximately 32,000 blood units.

Study Duration

Data were collected for the period January 2022 to December 2025.

Data Sources

Information was retrieved from blood bank records including:

• Blood collection registers
• Component preparation registers
• Discard registers
• Serological screening records

All records were reviewed systematically to obtain information on the number of blood units processed and the reasons for component discard.

Blood Component Preparation

Whole blood collected from voluntary and replacement donors was processed into components using standard blood component separation techniques. The components prepared included:

• Packed red blood cells (PRBC)
• Platelet concentrates
• Fresh frozen plasma (FFP)

All procedures were carried out according to National Blood Transfusion guidelines.

Screening for Transfusion-Transmitted Infections

All donated blood units were tested (both by ELISA & NAT) for mandatory transfusion-transmitted infections, including:

• Human immunodeficiency virus (HIV)
• Hepatitis B virus (HBV)
• Hepatitis C virus (HCV)
• Syphilis
• Malaria

Units found reactive for any of these infections were discarded according to standard biosafety guidelines.

Causes of Blood Component Discard

The reasons for discard were categorized as follows:

1. Seropositivity for transfusion-transmitted infections
2. Expiry of platelet concentrates
3. Handling or storage damage
4. Leakage or breakage of blood bags
5. Other technical or processing errors

Statistical Analysis

Data were entered into Microsoft Excel and analyzed using descriptive statistics. The total number of blood components processed and the number discarded for various reasons were calculated. The discard rate was determined using the formula:

Discard Rate (%) =

(Number of discarded units / Total number of processed units) × 100

Results were presented as frequencies and percentages.

During the four-year study period, a total of 119,147 blood units were processed into various components. A proportion of these components were discarded due to different causes including seropositivity, expiry, and handling damage.

Table 1: Distribution of Blood Components Processed

During the four-year study period, a total of 1,19,147 blood units were processed into various blood components. Among these, packed red blood cells constituted the largest proportion (1,19,147 units), accounting for 100% of the total components prepared. Platelet concentrates represented 99,890 units (83.8%), while fresh frozen plasma accounted for 1,19,136units (99.9%). This distribution reflects the routine component separation practices in the blood center, where whole blood donations are fractionated into multiple therapeutic products to maximize utilization

Table 2: Causes of Blood Component Discard

Analysis of discarded blood components revealed that platelet expiry was the most common cause of discard, accounting for 3,840 units (61.8%) of the total discarded components. Seropositivity for transfusion-transmitted infections was the second most common cause, responsible for 2,336 discarded units (37.6%). Discards due to handling or storage damage were minimal (27 units; 0.4%), while other technical causes contributed to only 12 units (0.2%). These findings indicate that the short shelf life of platelet concentrates remains the major contributor to blood component wastage

Table 3: Year-wise Distribution of Blood Units Processed and Discarded

Year-wise analysis showed a gradual increase in the total number of blood components processed during the study period. In 2022, units processed were 26,223, which increased to 30,048 units in 2023, 31,853 units in 2024, and 31,023 units in 2025. A corresponding increase in the number of discarded units was also observed, ranging from 1,420 units in 2022 to 1,665 units in 2025. Despite this increase in absolute numbers, the discard rate remained relatively stable when considered as a proportion of total processed units.

Table 4: Distribution of Transfusion-Transmitted Infections in Discarded Units

Among the 2,336 seropositive discarded units, hepatitis B infection accounted for the highest proportion (1,587 units), followed by hepatitis C infection (517 units). Human immunodeficiency virus was detected in 131 units, while syphilis accounted for 43 units and malaria for 58 units. The predominance of hepatitis B among seropositive donors highlights the continued public health burden of this infection and underscores the importance of stringent donor screening and preventive strategies in transfusion services.

Table 1. Distribution of Blood Components Processed

Packed red blood cells constituted the largest proportion of processed components, followed by fresh frozen plasma and platelet concentrates.

Table 2. Causes of Blood Component Discard

Platelet expiry was identified as the most common cause of blood component

Table 3. Year-wise Distribution of Blood Units Processed and Discarded

A gradual increase in blood component processing was observed over the study period.

Table 4. Distribution of Transfusion-Transmitted Infections in Discarded Units

Hepatitis B accounted for the largest proportion of seropositive discarded

Blood component discard is an important quality indicator for evaluating the efficiency of transfusion services. Effective management of blood inventories is necessary to ensure optimal utilization of donated blood and minimize wastage. The present study analyzed patterns and causes of blood component discard in a high-volume tertiary care blood center over a four-year period.

The overall discard pattern observed in the present study indicates that platelet expiry remains the most significant contributor to blood component wastage. Platelets have a limited shelf life of approximately five days when stored under standard conditions, which makes them particularly susceptible to expiry if demand fluctuates or if inventory management is suboptimal [7]. Several studies have reported that platelet concentrates account for the highest discard rates among blood components due to their short storage duration [8].

The high proportion of platelet expiry observed in this study highlights the need for improved inventory management practices within blood banks. Implementing strategies such as demand forecasting, inter-hospital component sharing, and optimized stock management may help reduce platelet wastage. Regular communication between clinical departments and transfusion services can also help ensure better utilization of platelet components [9].

Seropositivity for transfusion-transmitted infections represented the second most common cause of blood component discard in the present study. Screening of donated blood for infections such as HIV, hepatitis B, hepatitis C, syphilis, and malaria is mandatory to ensure transfusion safety. Units testing positive for these infections must be discarded to prevent disease transmission. The prevalence of seropositive units among donors therefore plays a significant role in determining discard rates [10].

Among the transfusion-transmitted infections identified in this study, hepatitis B was the most common, followed by hepatitis C and HIV. This distribution is consistent with epidemiological data indicating that hepatitis B infection remains relatively prevalent in many developing countries. Strict donor screening protocols and promotion of voluntary blood donation may help reduce the number of seropositive donations [11].

Handling and storage damage accounted for a very small proportion of discarded units in the present study. These types of losses usually occur due to technical errors during blood collection, processing, or storage. Breakage of blood bags, improper centrifugation, or temperature fluctuations during storage may lead to such losses [12]. Maintaining strict quality control measures and providing adequate training for blood bank personnel can help minimize these preventable causes of wastage.

The year-wise trend analysis in this study showed a gradual increase in the total number of processed blood units over the study period. This increase reflects the expanding demand for transfusion services in tertiary care hospitals. Although the number of discarded units also increased slightly during this period, the discard rate remained relatively stable when considered as a proportion of total processed units [13].

Regular audits of blood component utilization are essential for identifying inefficiencies in transfusion services and implementing corrective actions. Audits help in understanding patterns of wastage and enable blood banks to develop targeted strategies for improving inventory management. Such measures may include improved donor recruitment strategies, better coordination with hospital departments, and implementation of computerized inventory tracking systems [14].

In addition to operational improvements, public health interventions aimed at reducing the prevalence of transfusion-transmitted infections can also contribute to lowering discard rates. Increasing awareness about safe blood donation and encouraging voluntary non-remunerated donors may help reduce the number of seropositive donations [15-20].

The findings of the present study emphasize the importance of continuous monitoring of blood component utilization and discard patterns in high-volume blood centers. Reducing wastage not only improves the efficiency of transfusion services but also ensures that valuable blood components are available for patients who need them [21-25].

This study exposes a critical AI knowledge deficit among Southern Punjab nurses, rooted in systemic gaps in education and Blood component discard remains an unavoidable but important aspect of transfusion service management. In the present study, platelet expiry and seropositivity were identified as the major causes of blood component wastage in a high-volume tertiary care blood center. Although handling damage contributed minimally to the overall discard rate, improvements in inventory management and donor screening could significantly reduce wastage. Regular audits of blood component utilization, better coordination between clinical departments and blood banks, and adoption of efficient inventory control strategies are essential for optimizing the use of donated blood. Strengthening these measures can enhance the overall efficiency of transfusion services and ensure better availability of safe blood components for patient care.

1. World Health Organization. Global status report on blood safety and availability 2021. Geneva: World Health Organization; 2022.
2. Klein HG, Anstee DJ. Mollison’s blood transfusion in clinical medicine. 12th ed. Oxford: Wiley-Blackwell; 2014.
3. Murphy MF, Pamphilon DH, Heddle NM. Practical transfusion medicine. 5th ed. Oxford: Wiley-Blackwell; 2017.
4. Stanworth SJ, Estcourt LJ, Powter G, Kahan BC, Dyer C, Choo L, et al. A no-prophylaxis platelet-transfusion strategy for hematologic cancers. N Engl J Med. 2013;368(19):1771-80. doi:10.1056/NEJMoa1212772.
5. Ellingson KD, Sapiano MRP, Haass KA, Savinkina AA, Baker ML, Chung KW, et al. Continued decline in blood collection and transfusion in the United States—2015. Transfusion. 2017;57(S2):1588-98. doi:10.1111/trf.14155.
6. Heddle NM, Cook RJ, Arnold DM, Liu Y, Barty R, Crowther MA, et al. Effect of platelet dose on bleeding outcomes in thrombocytopenic patients. Blood. 2016;127(7):819-28. doi:10.1182/blood-2015-11-636613.
7. Slichter SJ. Platelet transfusion therapy. Hematology Am SocHematolEduc Program. 2007;2007(1):172-8. doi:10.1182/asheducation-2007.1.172.
8. Karp JK, King KE, Ness PM. Transfusion medicine in the United States: a review of practice trends. Transfusion. 2018;58(4):1106-14. doi:10.1111/trf.14474.
9. Yazer MH, Jackson B, Beckman N, Hillyer CD. Changes in blood product utilization and wastage in a large tertiary hospital. Transfusion. 2016;56(2):453-61. doi:10.1111/trf.13381.
10. Whitaker BI, Hinkins S, Rajbhandary S, Schreiber GB, Kamili S, Dodd RY. Trends in United States blood collection and transfusion. Transfusion. 2016;56(9):2175-83. doi:10.1111/trf.13764.
11. Allain JP. Moving on from voluntary non-remunerated donors: who is the best blood donor? Br J Haematol. 2011;154(6):763-9. doi:10.1111/j.1365-2141.2011.08708.x.
12. Williamson LM, Devine DV. Challenges in the management of the blood supply. Vox Sang. 2013;105(2):83-92. doi:10.1111/vox.12038.
13. Carson JL, Guyatt G, Heddle NM, Grossman BJ, Cohn CS, Fung MK, et al. Clinical practice guidelines from the AABB: red blood cell transfusion thresholds and storage. Lancet. 2016;388(10039):1439-46. doi:10.1016/S0140-6736(16)30963-6.
14. Lozano M, Cid J, Pereira A, Villamor N, Esteve J, Ordinas A. Platelet transfusion: current status and future directions. Vox Sang. 2019;114(6):560-8. doi:10.1111/vox.12788.
15. Dhingra N, Bloch EM. Global blood safety and availability. Vox Sang. 2013;105(1):1-3. doi:10.1111/vox.12042.
16. Patel EU, Bloch EM, Grabowski MK, Goel R, Lokhandwala PM, Tobian AAR. Temporal trends in blood donation and transfusion practices. Transfusion. 2019;59(7):2261-70. doi:10.1111/trf.15269.
17. Sapiano MRP, Savinkina AA, Ellingson KD, Haass KA, Baker ML, Henry RA, et al. Supplemental findings from the National Blood Collection and Utilization Survey. Transfusion. 2019;59(10):3225-33. doi:10.1111/trf.15427.
18. Schweitzer A, Horn J, Mikolajczyk RT, Krause G, Ott JJ. Estimations of worldwide prevalence of chronic hepatitis B virus infection. Lancet. 2015;386(10003):1546-55. doi:10.1016/S0140-6736(15)61412-X.
19. Stanworth SJ, New HV, Apelseth TO, Brunskill S, Cardigan R, Doree C, et al. Effects of platelet transfusions in patients with thrombocytopenia. Blood. 2015;125(9):1473-81. doi:10.1182/blood-2014-09-569541.
20. World Health Organization. WHO global database on blood safety: summary report 2021. Geneva: World Health Organization; 2021.
21. Chappidi C, Buma SB. Clinical impact of orthodontic treatment on gingival health. Int J Res Health Allied Sci. 2023;9(3):125–128.
22. Chappidi C, Buma SB. Assessing postoperative pain in teeth with asymptomatic irreversible pulpitis: a comparative study of manual and rotary instrumentation. J Adv Med Dent Sci Res. 2023;11(9):27–29. doi:10.21276/jamdsr.
23. Gehlot PM, Rajkumar DS, Mariswamy AB, Reddy UNN, Chappidi C. Nonsurgical Endodontic Management of Nonperforating Internal Root Resorption in a Maxillary Central Incisor: A Case Report with a 4-Year Follow-Up. J Pharm Bioallied Sci. 2024 Jul;16(Suppl 3):S3005-S3008. doi: 10.4103/jpbs.jpbs_444_24. Epub 2024 Jul 31. PMID: 39346441; PMCID: PMC11426693.
24. Kohli AS, Goyal JD, Jamatia K, Kaur GP, Syed Afroz K, Anoosha M, Tiwari R. Clinical and radiographic evaluation of different techniques for impacted canine exposure. Journal of Pharmacy and Bioallied Sciences. 2025. doi:10.4103/jpbs.jpbs_1462_24.
25. Reddy KH, Syed AK, Alivelu D, Danda H, Alla R. A randomized split mouth clinical trial of the application of the desensitizer agents for tooth sensitivity. International Journal of Research in Medical Sciences. 2021;9:2430-4.