Safe Blood Starts with Me - libdoc.who.int - World Health Organization

ANNEX 3. BLOOD TRANSFUSION SAFETYInformation for National Blood ProgrammesWHO strategy forblood safetyThe HIV/AIDS pandemic hasfocused particular attention onthe importance of preventingtransfusion-transmitted infection.WHO estimates that between 5% and10% of HIV infections worldwide aretransmitted through the transfusionof infected blood and blood products,while many thousands morerecipients of blood products areinfected with hepatitis B and Cviruses, syphilis and other infectiousagents, such as Chagas disease andmalaria.In the past, strategies to promoteblood safety tended to focus primarilyon screening donated blood fortransfusion-transmissible infections(TTIs). However, while systematicscreening is essential, it isinsufficient in itself to ensure thesafety of the blood supply.Evidence from all regions of the worldindicates that the absence of anationally-coordinated bloodprogramme, lack of safe blood donorsand the unnecessary clinical use oftransfusion are equally importantcontributory factors to thetransmission of infection bytransfusion.The WHO strategy for blood safetyemphasizes an integrated four-foldapproach. Effective quality assuranceshould form an essential part of thisapproach.1. The establishment of acoordinated blood transfusionservice that can provide adequateand timely supplies of safe bloodfor all patients in need.2. The collection of blood only fromvoluntary non-remunerated blooddonors from low-risk populationsand the use of stringent donorselection procedures.3. The screening of all donated bloodfor transfusion-transmissibleinfections, including HIV, hepatitisviruses, syphilis and otherinfectious agents, and bloodgrouping, compatibility testingand processing of blood.4. A reduction in unnecessarytransfusions through theappropriate clinical use of blood,including the use of intravenousreplacement fluids and othersimple alternatives to transfusion,wherever possible.Blood transfusion serviceA coordinated blood transfusionservice (BTS) is a prerequisite for anadequate supply of safe blood. Thenational health authority maydelegate responsibility for the bloodsupply to a non-profit nongovernmentalorganization, but theBTS should be developed within theframework of the country’s healthcare infrastructure.The BTS should be established inaccordance with an agreed nationalblood policy and plan and within alegislative framework. It should beresponsible for establishing andmaintaining a national quality system,including the development ofguidelines and standard operatingprocedures, staff training, aninformation management system anda system for monitoring andevaluation.The BTS requires formal governmentcommitment, support and recognitionas a separate, identifiable programmewith a budgeting and finance systemthat can ensure a sustainable bloodprogramme through cost recoveryand/or annual budget allocation. TheBTS should be managed by anExecutive Committee and assisted,where necessary, by specialistadvisory groups. BTS personnelshould include a medical director, aquality manager and staff who havebeen adequately trained in all aspectsof management, quality systems,blood donor recruitment, bloodcollection, screening, processing andthe storage and distribution of bloodand blood products.Low-risk blood donorsThe safer the source of donated blood,the safer the final product is likely tobe.122 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME