Blood Component Utilization and Discard Patterns in Telangana, India: A Three-Year Retrospective Study.

Background Blood transfusion services play a central role in emergency and routine clinical care, making the optimal utilization of blood components essential for healthcare efficiency. The present study aimed to evaluate statewide patterns of requisition, utilization, and discard of blood components across licensed blood banks in Telangana over a three-year period, and to identify component-specific and system-level factors contributing to wastage. Methodology This retrospective, observational study analyzed records from 50 licensed blood banks across Telangana between January 2022 and December 2024. Data on requisition, cross-matching, issue, transfusion, return, and discarding of packed red cells (PRCs), fresh frozen plasma (FFP), and platelet concentrates (PCs) were collected using a standardized protocol. Key indicators such as crossmatch-to-transfusion ratio (C/T), transfusion probability (%T), transfusion index (TI), utilization ratio, and discard ratio were calculated. Descriptive analyses were performed. Results Across the three-year period, approximately 51,063 units were issued, with an overall utilization ratio of 87.7% and a discard ratio of 12.3%. The annual discard ratio increased from 11.7% (2022) to 13.3% (2024). Component-wise, PRCs had the highest utilization (92.1%) and lowest discard (7.9%), whereas FFP and PCs showed lower utilization (~83%) and higher discard ratios (16.9% and 17.0%, respectively). Expiry was the leading cause of waste, rising from 1,068 units (2022) to 1,373 units (2024). The mean C/T ratio was 1.5, %T was 66.1%, and TI was 0.82, although there was notable interfacility variability. Intensive care and surgical units demonstrated the highest utilization, while oncology and pediatrics showed suboptimal performance. Conclusions Although red cell utilization in Telangana blood banks is efficient, the persistently high wastage of platelets and plasma and the increasing expiry-related discard trend highlight the need for improved inventory management, redistribution systems, and statewide patient blood management strategies.