Management Of Blood Transfusion Services Research Articles

Management of blood transfusion services in low-resource countries.

Enabling universal access to safe blood components should be a key component of every country's national healthcare strategy. This study aimed to assess the current status of infrastructure and resources of blood transfusion services (BTS) in low- and middle-income countries. A cross-sectional survey was designed to gather information on blood donations, components, redistribution, testing resources and quality management systems (QMSs). The survey was distributed to the International Society of Blood Transfusion members between October 2021 and November 2021. A total of 54 respondents from 20 countries responded to the survey. This included hospital-based BTS/blood centres (46%), national blood centres (11%)and national and regional blood services (11%). Voluntary non-remunerated, replacement and paid donors accounted for 94.2%, 84.6% and 21.1% of donations, respectively. Apheresis donation was available in 59.6% of institutions. National/regional criteria for redistribution of blood components were reported by 75.9% of respondents. Blood components incurred payment charges in 81.5% of respondents' institutions, and payments were borne by patients in 50% of them. Testing methods, such as manual (83%), semi-automated (68%) or fully automated (36.2%), were used either alone or in combination. QMSs were reported in 17 institutions, while accreditation and haemovigilance were reported in 12 and 8 countries, respectively. QMS was implemented in most of the countries despite the common use of paid donations and the lack of advanced testing. Efforts to overcome persistent challenges and wider implementation of patient blood management programmes are required.

Do we meet up with the standard blood demand, usage, and availability levels in State Specialist Hospital, Akure, Ondo State, Nigeria?

Aim: The aim of this study is to determine the extent of blood usage during blood transfusion procedures with evaluation of blood transfusion prescription practices in view of optimal and efficient utilization of blood transfusion services (BTSs). Materials and Methods: We prospectively analyzed all the blood orders between May 2015 and April 2017 from the Blood Bank of Hematology Laboratory in State Specialist Hospital, Akure, Ondo State, Nigeria. The indices used were in compliance with the international blood transfusion clinical practice guidelines. Results: Out of 1536 blood units ordered and crossmatched in this study, 62.57% units were transfused to patients and 37.43% were not transfused. This indicates judicious blood usage during transfusion procedure to saving lives. The overall blood transfusion indices for crossmatch-to-transfusion ratio (C/T), transfusion probability (%T), and transfusion index (TI) were 1.60, 62.57, and 1.00, respectively. This implied that blood at the point of utilization within the hospital, enjoyed a favorable status of blood prescription practice compare to the standard reference values (that is, C/T ratio ≤2.5, %T ≥30, and TI ≥0.5) in most of the departments under study. Departments such as Obstetrics and Gynecology (CT = 2.45, %T = 25.45, TI = 0.41) and General Theater (C/T = 3.8, %T = 16.44, TI = 0.26) exhibited inappropriate order of excessive crossmatched blood by junior medical officers which may be subsequently canceled by senior colleagues on later review of the patients were common. Conclusion: This study showed a reliable and efficient clinical practice in the management of BTSs from the point of order to the point of need which amount to a more appropriate, prudent, and conserved utilization of blood products, resources, and services.

Prevalence and Distribution of ABO and Rh-D Antigens along with Its Subgroups & Rare Types in Greater Gwalior Region

Among a total of 29 blood group systems and over 600 different blood group antigens discovered so far, ABO and Rhesus are the most important blood group systems. The most significance rhesus antigen is Rh-D because of its immunogenicity. The sound knowledge of ABO and Rh-D antigens and its distribution in population is essential for the effective management of blood transfusion services, in population genetic studies, in resolving medico-legal issues and more importantly in compatibility test in blood transfusion practice. Study is aimed to provide data on ABO and Rh-D distribution in Gwalior region (Madhya Pradesh) and its comparison with related studies in India and abroad. Total 90,000 samples in 4 years from January 2004 to December 2007 were grouped for ABO, Rh-D and their subgroups at Blood Bank of Gajra Raja Medical College, along with Emergency Blood Bank, Gwalior, Madhya Pradesh, India. Blood group distribution among these samples showed phenotypes A, B, AB and O as 22.7%, 37.5%, 9% and 30.8% respectively. A2 and A2B were 8.0% and 8.6% respectively. The Rh-D negative phenotype was found 8.9% and DU variants/weaker D was 0.036% among the sample tested. In cord blood samples, the incidence of A2 and A2B were 18.6% and 20.2% respectively.

Whole blood and component use in resource poor settings

Data on blood collection, testing and component preparation has improved worldwide; however, there is limited information on blood utilization from the developing countries. Blood requirement in the Southeast Asia region is 15 million units against a collection of 9.3 million. There is huge diversity in the management of blood transfusion services, the voluntary blood collection (range 40–100%) and proportion of blood separated into components (10–95%). The major indications for transfusion are for emergency obstetric care, surgery, pediatric and trauma patients. The prevalence of thalassemia in this region is high and in India alone 2 million units of packed red cells are required for transfusion to these patients. The Blood Safety Program in India has developed as a component of the National Aids Control Program and has lead to infrastructure development, blood component separation facilities and formulation of a National Blood Policy. In order to facilitate emergency obstetric care nearer home, blood storage centers are being established at primary health care centers. Emerging infectious threats like dengue hemorrhagic fever necessitate platelet transfusion therapy. A few centers in India issue NAT screened blood. It is envisaged to establish a nationally co-ordinated transfusion service for cost-effective quality blood/components for appropriate clinical use.

Levels of quality management of blood transfusion services in Europe

The European blood legislation has defined several key quality elements to achieve Good Manufacturing Practice (GMP) in the field of blood transfusion. During the recent years, the blood legislation is in the process of implementation throughout its member states. Following the Directive 2002/98/EC, Directive 2005/62/EC has given further requirements for quality‐management systems to be fulfilled by blood establishments. In addition, GMP/Good Laboratory Practice (GLP) and ISO standards are used inter alia by blood establishments. In order to support the implementation of the blood legislation, the European Public Health Work Plan (2005/2007) has cofunded two projects, led by the German Red Cross and supported by the European Blood Alliance, delivering a common European Standard Operating Procedure (SOP) methodology (EU‐Q‐Blood‐SOP) and criteria and standards for the inspection of blood establishments (EUBIS). The EU‐SOP manual will assist blood establishments in preparing for the inspection of their services related to the implementation of quality relevant elements required by the EU Directive 2002/98/EC and its technical annexes. The standards and criteria for inspection of blood establishments will cross‐reference existing quality standards to the directive requirements and define requirements for the structure of quality‐management systems based on the directive 2002/98/EC and its technical annexes. Based on these requirements, inspection standards and criteria are developed to assist in the independent assessment of quality systems established by individual blood establishments. These assessments are done in relation to the requirements defined by the European Union legislation on blood, in order to safeguard the quality of blood and to achieve continuous improvement of its quality throughout Europe.

Book Review: Management of Blood Transfusion Services

Book Review: Management of Blood Transfusion Services

Management of Blood Transfusion Services

Management of Blood Transfusion Services

Book Reviews : Management of Blood Transfusion Services, by S.R. Hollan, W. Wagstaff, J. Leikola and F. Lothe. Published by World Health Organisation, Geneva, Distributed by HMSO in UK, 1990. £16.50 Paperback. Pp 229. ISBN 92 4 154406 9

Book Reviews : Management of Blood Transfusion Services, by S.R. Hollan, W. Wagstaff, J. Leikola and F. Lothe. Published by World Health Organisation, Geneva, Distributed by HMSO in UK, 1990. £16.50 Paperback. Pp 229. ISBN 92 4 154406 9