Praiseldy Langi Sasongko

12 Chapter 1 1.3 Brief History of Trends in the Demand of Red Blood Cells and Immunoglobulins Red blood cells Red blood cells (RBCs) have been blood banks’ staple product, its “bread and butter” for decades due to the historical need for large quantities for transfusions. However, in the past 25-30 years, this has shifted due to singular and cumulative advances within society, medical practices, and technologies.7 First, the HIV infections of the 1980s-1990s changed the public’s perceptions to how blood could be “bad”—very bad, in fact, due to the accidents and scandals and subsequent legal actions and governmental measures that occurred.1,7,8 In subsequent years, a focus on blood safety, costs, utilization, and management generated substantial data that supported using conservative transfusion triggers.1,9 This was also complimented by the adoption of Patient Blood Management (PBM), a multifaceted, multidisciplinary approach to limit the need and use of blood transfusions in surgical and non-surgical patients.10,11 Furthermore, the rise of medical innovations (e.g., laparoscopic surgery) and pharmaceutical products have dramatically decreased blood loss.7,11–13 Hence, many Western countries have seen the demand for RBCs steadily decrease.11,13–15 In the Netherlands, there has been a 47% decline from 1998-2023 (see Figure 1.2). Figure 1.2 Demand of red blood cells in the Netherlands from 1998-2023 200.000 300.000 400.000 500.000 600.000 700.000 800.000 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 Number of units supplied Year

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