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

1987 to the mid 1990s, cryoprecipitatevirally inactivated at 60° for62 hours was used for the treatmentof haemophiliacs. Thisexplains the relatively low rate ofHIV infections in this population(2%), which is attributed to thenon-inactivated factor VIIIconcentrates imported at thattime.Solidarity in adversityStrangely enough, it was theHomeland War in the 1990s thatgave blood donation a big boost: inone year, the number of blooddonors increased by over 20%,ending the blood componentshortages at the time. People justcame and offered their blood as agesture of goodwill and support totheir fellow citizens in times ofconflict. The fact that—evenduring war times—no bloodproduct is transfused withouttesting for viral markers, is agreat achievement of the bloodtransfusion services, and theCroatian health system in general.TestingBlood transfusion safety hasalways been a priority for the RedCross and transfusion services aswitnessed by mandatory testing inthe country. Testing for syphiliswas introduced at the end of the1940s, for hepatitis B in 1972,HIV in 1987 and hepatitis C in1992. And by the end of 1998,small-pool RNA-HCV NAT testingbecame mandatory. Only testsapproved by the Paul EhrlichInstitute or the Agence françaisedu Sang are authorized in Croatia.Quality controlThe fast growth of the transfusionservices in the 1990s ledspecialists to focus on the settingof standards and quality control.External Quality Control was theninitiated for immunohaematologyand viral serology. A reorganizationof the blood transfusionservices will also allow greaterquality and safety controlmeasures, through more centralizedproduction and testingfacilities. Implementation of thisdecision, however, has beendelayed due to a lack of financingand a concern over the implicationsof such restructuring,particularly for blood transfusionpersonnel. Nonetheless, it ishoped that the reorganization willbe completed within five years.Challenges facing thetransfusion servicesFor a population of around fourand a half million, Croatia has fourregional Blood TransfusionCentres and 20 hospital-basedblood banks. In 1999, an averageblood bank collected 7,000 unitsof whole blood and prepared15,000 blood components. Thedisproportionate number of bloodbanks in Croatia performinglaboratory donor screening andproducing relatively smallquantities of blood means that it isdifficult and expensive tointroduce a new test and tocomply with current GMP.One of Croatia’s many blood donors on World Health Day66 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME