Abstract
Transfusion demand in sub‐Saharan Africa is increasing. Establishment of large national blood services seems to be challenging. Hospital blood services maintain the basic supply. However, they lack effective communication networks. Cell phones/internet provides the infrastructure for establishing such networks and could help in establishing haemovigilance systems. Voluntary non‐remunerated donors are the minority of donors (<20%). It seems more appropriate to develop strategies to increase the safety of replacement donor blood instead of insisting on copying Western‐world models. Red cell serology is usually restricted to ABO/Rh‐D and at best Coombs crossmatch. Introduction of antibody differentiation and additional typing for C,c,E,e and K would prevent 60–70% of delayed haemolytic transfusion reactions. One of the most frequent indications for blood transfusion is major haemorrhage. Why is component therapy still recommended for resource‐limited regions, while whole blood is reintroduced in Europe/US for exactly the same indications? Plasma thawed due to electricity failures is usually discarded anyway. Leuco‐depleted products would be beneficial (multitransfused sickle‐cell patients/neonates/AIDS). An ideal blood product could be whole blood, in‐line leuco reduced by gravity filtration, treated by user‐friendly pathogen‐reduction not requiring irradiation/illumination. The transfusion medicine community should form an alliance to develop an affordable, pathogen‐reduced blood product, to train regional auditors and to bring in external expertise to aid knowledge transfer. However, standards to be reached should be defined by the respective national experts who understand the culture and needs of their country. In respectful collaboration, we could learn from each other to finally improve transfusion in resource‐limited regions.
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