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

Voluntary non-remunerated blooddonors from low-risk populations whogive blood regularly are thefoundation of a safe and adequatesupply of blood.In all regions of the world, a higherincidence and prevalence oftransfusion-transmissible infectionsare reported among family/replacement donors and, inparticular, paid donors. Furthermore,the use of family/replacement donorsmay constitute a hidden system ofpaid donation. These donors may notreliably respond to questionsregarding risk behaviour and theirsuitability as blood donors.A system of voluntary, regular nonremunerateddonation is thereforenot only safer than the use of family/replacement donors or paid donors. Italso enables more cost-effective useto be made of limited resources byreducing the volume of donated bloodthat has to be discarded because ofevidence of infectious diseasemarkers.Worldwide, more than 75 millionunits of blood are collected annually.In developed countries, the bloodsupply comes from voluntary nonremuneratedblood donors. Globally,developing countries contribute only16% of the voluntary nonremuneratedblood donors whichshows that the blood supply dependson a very high proportion of family/replacement/paid donors in thesecountries. High priority shouldtherefore be given to eliminating theuse of paid blood donors, convertingreplacement donors to voluntary nonremunerateddonors and motivatingthem to donate regularly.Many countries have introducedlegislation requiring blood donationonly by voluntary non-remunerateddonors. In practice, this can only beachieved through the establishment ofan effective programme of blooddonor recruitment and retention,staffed by trained personnel, with anefficient donor information, educationand motivation programme.It also requires strict criteria fordonor selection and screening toidentify donors for deferral orexclusion, and efficient blood donorrecord systems. The identification ofdonor populations at low risk fortransfusion-transmissible infectionsand the monitoring of transfusiontransmissibleinfections in both thegeneral population and the donorpopulation are also key elements of astrategy for blood safety.The screening andprocessing of bloodWHO recommends that, beforetransfusion, all donated blood shouldbe tested for:• HIV• Hepatitis B• SyphilisWHO also recommends that, wherepossible and appropriate, donatedblood should be tested for otherinfectious agents, including hepatitisC, Chagas disease and malaria.Nevertheless, each year, more than13 million units of donated blood arenot tested for all transfusiontransmissibleinfections. Testing isalso sometimes unreliable,particularly when performed byinadequately trained staff or whenthere are shortages of suitableequipment or erratic supplies of testkits.Each country should thereforedevelop a national policy and strategyto ensure the systematic and effectivescreening of blood for transfusiontransmissibleinfections. Thisrequires:— the development of protocols forthe testing, selection andevaluation of the most appropriateand effective screening assays tobe used at each site— the development of qualitysystems for screening, bloodgrouping, compatibility testingand component preparation— the training, updating andcontinuing education of laboratorytechnical staff in BTSs andhospital blood banks— the central procurement, storageand distribution of reagents andmaterials to ensure continuity inscreening at all sites— an adequate budget.All donated blood units should also beroutinely tested for ABO and Rh (D)blood grouping and red cell antibodyscreening.Good laboratory practice usingstandard operating procedures andthe maintenance of an effective bloodcold chain for the storage andtransportation of blood and bloodproducts is equally important.Reducing unnecessarytransfusionsThe primary responsibility forensuring the appropriate clinical useof blood lies with clinicians. However,the BTS has a key role in promoting123 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME