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Gazzetta Medica Italiana - Archivio per le Scienze Mediche 2022 April;181(4):234-8

DOI: 10.23736/S0393-3660.20.04475-7


language: Italian

Palliative medicine and tranfusion therapy: the "Serenissima" experience

Francesca POLESE 1, Carla ROSSI 1, Giovanni POLES 2, Nevia ARREGHINI 1, Gianluca GESSONI 1

1 Transfusion Medicine ULSS 3 “Serenissima”, Venice, Italy; 2 Palliative Care ULSS 3 “Serenissima”, Venice, Italy

BACKGROUND: In Western Countries, health systems are obliged to take into consideration the needs of a population characterized by an increase incidence of older not self sufficient subjects, patients with cancer, hematological malignancies or other life limiting illness. These epidemiological challenges suggest the opportunity to plan a transfusional support program alternative to hospitalization. Italian legislation allows to perform blood transfusion in settings such as elderly nursing home (ENH), outpatients settings (OPS), patients home in a settings of oncologic palliative care (OPC). We report our experience of ten years in blood transfusion in an extra hospital setting in Venice and Mestre.
METHODS: Were considered digital registrations for years from 2010 to 2019 with particular consideration to transfusion performed in the patients’ home setting, in the elderly nursing home and in our outpatients facilities.
RESULTS: In the considered period in the outpatients facility the number of red cells unit transfuse raised from 280 to 1347 for Mestre and from 121 to 405 for Venice; raised from 174 to 259 for Home transfusion setting. Considering the NHS the number of packed red cells (PRC) unit transfused raised from 53 in 2010 to 404 in 2019, moreover structures performing blood transfusion raised from 5 in 2010 to 16 in 2019.
CONCLUSIONS: Results obtained, although considered largely positive, cannot be considered fully satisfactory since only half of the ENHs present in our area carry out transfusions to guests who need them. Furthermore, home transfusion therapy is currently only possible in cancer patients. To improve and extend this therapeutic alternative, it will be necessary to be able to count on a wider involvement of territorial medicine and general practitioners.

KEY WORDS: Homes for the aged; Palliative care; Blood transfusion

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