In Focus
Supply Chain Challenges
The impact of non-donor related resource constraints
Blood components and plasma protein products are critical components to patient management in wide variety of disease states and clinical procedures. However, the adequacy of the blood supply can be compromised by several external threats.
Background
Historically, blood contingency planning has focused on endemic disease outbreaks, natural disasters, labor disruptions and mass casualty/ trauma events that create potential for demand surges at the same time as decreased supply (see Figure 1)1.
Figure 1. Causes of blood contingencies. Table excerpted from Canada’s blood shortage plan.
However, since the COVID-19 pandemic blood suppliers and transfusion services are struggling with supply chain disruptions that impact the ability to produce and administer blood to those in need. The blood supply chain is defined as a sequence of interconnected processes that includes donor recruitment and collection; testing and processing; storage and inventory management; distribution; and patient testing and transfusion. A disruption in any one point along the supply chain can lead to delayed medical care, wastage of blood products, ineffective distribution, staff dissatisfaction and high financial costs.
The Supply Chain Subgroup of ISBT’s Blood Supply Management Working Party is attempting to further define the impact of non-donor related resource constraints affecting the blood supply chain internationally.
The primary areas of investigation will be focused on:
1. Medical equipment and testing supply constraints - Resource limitations are disproportionately common in rural, remote and lower income areas but reports of medical equipment shortages or reagent back orders are prevalent in most clinical laboratory environments2, as well as for the manufacturing of other biologic therapeutics like vaccines3 and radioisotopes. Major contributing causes are thought to be the lack of redundancy with the shrinking number of medical equipment and reagent manufacturers; increased reliance on disposable items; lack of raw materials; higher quality requirements for reagents increasing time for production and instability of chemicals or reagents required for testing. Any breakdown in our ability to source validated blood bags, phlebotomy supplies, personal protective equipment, testing reagents, and cold chain transport coolers can halt blood collection clinics and blood processing capacity. This may result in limited effectiveness of blood donor recruitment campaigns propagating shortages through yet another aspect of the blood supply chain.
2. Transportation and Logistics - The blood supply chain is highly reliant on effective distribution of blood between donor clinics, processing facilities and hospital transfusion services. Fuel shortages, natural disasters, weather disturbances, border closures, flight delays or political conflicts can create challenges for delivery of blood inventory but also can contribute to the shortages in equipment and reagents mentioned above.
3. Workforce Challenges - No longer limited to short term labor disruptions, the chronic inability to recruit and retain qualified healthcare professionals is being felt globally across the entire healthcare spectrum. One source claims a deficiency in the United States of one technologist for every 1000 US citizens 2 but the impact on medium to low-income countries with limited training programs is likely much higher. Adequate staffing is crucial in the production of blood products as well as generating accurate timely patient testing and safe issuing of blood. The American Society of Clinical Pathology (ASCP) identified that the lack of appropriate supplies requiring staff to validate alternate equipment or reagents on an emergency basis while continuing to maintain the same quality of patient testing led to disruptive workflows, stress and burnout of staff4 further contributing to poor retention.
Understanding these supply chain challenges will help the ISBT’s Blood Supply Management Working Party generate guidance on potential mitigation strategies that the transfusion medicine community can adopt to preserve the integrity of our blood supply.
We look forward to your participation in the upcoming survey.
References
1. Nahirniak S, Shih A, Prokopchuk-Gauk O, Stuart K, Tinmouth A, LaFrense J, et al. The National Plan for Management of Shortages of Labile Blood Components [Internet]. Ottawa: National Advisory Committee on Blood and Blood Products; July 27, 2009 [updated July 2025; cited July 5th, 2025].
2. Moore N. Our lab testing capacity is getting dangerously low. MedPage Today. April 26, 2022.
3. Vivani L, Vandeputte J, Smith D, Coppens E, Mahmood K, Goel S, et al. Global Availability of Critical Reagents for Biologics Testing – Current status, challenges and possible solutions. Biologicals 90 )2025) 101821.
4. Hilborne L, Garcia E, Kundu I. Laboratory Supply Chain Shortage Effects on Laboratory Workforce and Effective Test Utilization. [Internet] Critical Values. May 10, 2022 [cited July 5th, 2025]
