LAUSR

Dear Sir, Out-of-hospital transfusions (OHTs) of red blood cells (RBCs), platelets or plasma occur in non-traditional settings, such as the patient’s home, a hospice or nurse home, through the delivery of these blood products from the hospital blood-issuing points (HBIPs) to home care agencies (HCAs). OHT is very convenient for non-ambulatory patients. However, because of an increased distance from emergency medical care, OHT must be carefully assessed to ensure that the added risk is minimal and acceptable in the light of the advantages to the patient. OHT is usually indicated for housebound immobile, severely ill or debilitated patients who cannot easily be transported to the hospital. For these patients, transfusions at home contribute to their independency, dignity and quality of life as OHTs prevent energyand time-consuming hospital visits for these patients as well for their relatives (Craig et al., 1999; Madgwick & Yardumian, 1999; Ademokun et al., 2005). Many aspects and risks of OHT services must be taken into account before starting OHT services and during OHT practice by transfusionists (Evans, 1997; Fridey, 1997). On the other hand, there are many examples showing that with adequate protocols and good education, OHTs can be conducted safely (Craig et al., 1999; Madgwick & Yardumian, 1999; Ademokun et al., 2005). We performed a nationwide survey in the Netherlands to collect information on OHT practices, to define differences and to postulate best practice recommendations that may be used for harmonisation or qualification demands to accomplish a safe OHT effectuation and to overcome barriers to implement OHT service.