1 iranian blood transfusion organization f acts and figures
TRANSCRIPT
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Iranian Blood Transfusion Organization Facts and Figures
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Table of Contents History of blood transfusion IBTO Organizational Chart IBTO as a Centralized National Blood Program The Iranian Blood Supply System Regulation, Standardization and Certification Recruitment of Blood Donors Medical Assessment of Whole Blood Donors Laboratory Testing of Donated Blood Preparation and Storage of Components Clinical Uses of Blood Components Quality Assurance System Safety Education and Research Iranian Plasma Collection and Manufacturing
Organization
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History of blood transfusion in Iran
The first hospital of National Iranian oil company was established in Masjed Soleiman in 1924 and the blood transfusion was first carried out by the British Doctors in this hospital.
Despite that the establishment of blood transfusion centers was not mentioned in the Constitution of the year 1948 of Iran Red Lion and Sun society (Red Crescent), regarding the goals set by the general director of the Group, including:
1- corpsmen, 2- the youth, 3- nurse training, 4- blood transfusion, this Group determined to establish blood transfusion center.
From 1940s onward, blood transfusion has been sporadically done in various hospitals. Sina Hospital was one of the most significant centers of blood transfusion in Iran.
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1948: Establishment of the First Private Blood Transfusion in Iran as Dr. Motamed blood transfusion center
1949: Publication of the First Notice to Call for Blood Donation 1950s: Hospitals started to use replacement blood 1952: Establishment of Army’s Blood Transfusion Center 1954: Establishment of the First Iran Red Lion and Sun society
(Red Crescent) blood Transfusion Center 1955: Establishment of the First Center for preparation of
Blood Derivatives 1955: Establishment of the First Provincial Blood Transfusion
Center 1960s: The decade of 1960, conduced to valuable
accomplishments for the activists of the blood transfusion medicine field in Iran.
1962: Establishment of the First Independent Iran Red Lion and Sun society (Red Crescent) Blood Transfusion Center.
History of blood transfusion in Iran (con’t)
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History of blood transfusion in Iran (con’t)
1974: Establishment of National Blood Transfusion Organization
1976: Establishment of the First Provincial Blood Transfusion of Iran Blood Transfusion Organization
1978: Iran Blood Transfusion Organization & Islamic Revolution
1979:the Blood Transfusion Organization was assigned to the Ministry of Health and Welfare.
1980: Iran Blood Transfusion Organization & Imposing War Supply of blood and blood products required by the thousands of wounded soldiers
1984: Introduction of the Organization as the Sole Supervisor of the Supplying Blood and Blood Products in Iran
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Screening tests
1974: HBs Ag Screening test 1987: HIV-Ab Screening Test 1997: HCV screening test 2005: Implementing HIV-Ab, HIV-Ag
screening test 2006: Development of Iran Blood
Transfusion Network 2006: Commencement of technical and
software automation of Iran blood transfusion stations
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The Iranian Blood Transfusion Organization
Total number of Blood Centers/ Blood Donation Centers
288
Blood Donation Centers206
Blood Collection & Preparation Centers17
Blood Centers65
Provincial Centers 30 Regional & Educational Centers 9
Blood donation center: Responsible for the collection of blood and associated activities for donor recruitment and recall, assessment of donor suitability and donor care.Blood Collection & Preparation Centers: Responsible for recruitment, blood collection, processing, storage & distribution.
Blood center: Carries out donor recruitment, blood collection (whole blood and in some cases, apheresis), testing for transfusion- transmissible infections and blood groups, processing in to blood components, storage, distribution to other blood centers and hospital blood banks within a defined region, the clinical use of blood and surveillance of adverse transfusion events.
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The Iranian Blood Transfusion Organization
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The Iranian Blood Supply system
Whole blood is collected Only in IBTO blood centers
Fixed centers Mobile (Factories, Offices, Universities)
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The Iranian Blood Supply system
Blood centers are nonprofit and governed by a director appointed by the IBTO’s Managing Director
Major function is to provide the community’s blood supply and hospitals within the blood collection area and hospitals in other areas as well
Area covered is determined by Historical factors An overall plan by Central Technical & QA
Department
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The Iranian Blood Supply system
Blood is provided to hospitals free of chargeNo charges or fees are requested for the cost of collecting, testing, processing, storing and shipping the blood
Central Immunohematology Reference Laboratory provides advance techniques for serological investigations on donors / patients
Produces home made panel cells to be used by the Blood Centers
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The Iranian Blood Supply system
Type of Blood collected annually
Volunteer Whole Blood100 %
AutologousPer- request
Replacement0
Directed0
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The Iranian Blood Supply system
1.80 % average growth rate of Whole Blood collection (2000-2007)
1200000
1300000
1400000
1500000
1600000
1700000
1800000
2000 2001 2002 2003 2004 2005 2006 2007
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The Iranian Blood Supply system
Per capita rate Blood Collection 24/1000 (06- 07) Collection rate age- eligible donors (18+) 36/1000
(05- 06)
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Regulation, Standardization and Certification
IBTO constitution adopted in 1974 revised in 1984 is approved by the I.R of Iran’s Parliament
The 2nd version of IBTO standards titled »Iranian National Standards for Blood Transfusion «was published in 2005 and went in to effect in Sep. 2005
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Regulation, Standardization and Certification
Registrations/ Certifications
ISO 9001-20004 blood centers 2004Obtained
ISO 15189-2003
IBTO Diagnostic Reference Laboratory 2004
Obtained
ISO 9001-2000Remaining BCs 2006-2008In process
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Regulation, Standardization and Certification
Technical & QA Deputy acts as National Regulatory Authority
Standard Operating Procedures (SOPs) are in use in all Blood Centers
Establishment of all Blood Centers/ Blood Donation Centers is required to be approved by IBTO’s Higher Council. Licenses are issued by Central Technical & QA Department before any facilities are operative renewed annually.
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Recruitment of Blood Donors
A national recruitment department Director of recruitment department
leads the related activities Lectures, media printed/ visual,
community social activities etc. A system of pre-donation counseling
of blood donors exist
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Recruitment of Blood Donors
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Recruitment of Blood Donors
Demographic characteristics of Blood Donors 2006 Gender
Total Whole Blood Donors
Women; 8.1
Men; 91.9
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Recruitment of Blood Donors
Demographic characteristics of Blood Donors 2006
Age
41- 50 yrs 18.8
51-60 yrs 7.2
> 60 yrs 0.8
< 20 yrs 7.2
21- 30 yrs36.9
31-40 yrs 29.1
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Recruitment of Blood Donors
Demographic characteristics of Blood Donors 2006 Education
High school not completed; 34.7
High School Diploma; 38.7
Higher Education; 2.2
Illiterate; 2.6
Associate Degree; 8.5
B.S Degree; 13.3
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Recruitment of Blood Donors
Demographic characteristics of Blood Donors 2006
Employment
Unemployed 3
Farmer 1.8
Factory employee 4.8
Civil employee 4.5
Service Personnel 3
Government employee
26.6
High school Student
2.7
Home maker 5.7
Self employed 41.6
College student 6.5
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Recruitment of Blood Donors
Demographic characteristics of Blood Donors 2006
Marital Status
Marital Status
Unmarried; 28.2
Married; 71.8
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Amount of Blood Collected
Number of Units of Blood Collected by IBTO1974 - 2005
0
300000
600000
900000
1200000
1500000
1800000
1974
1976
1978
1980
1982
1984
1986
1988
1990
1992
1994
1996
1998
2000
2002
2004
Year
Un
it
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Future changes in process
Total Laboratory Automation will be implemented in regional IBTO Blood Center in order to centralize the testing of the donated blood.
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Future changes in process
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On the Road to ISBT 128 Conversion
Internationally recognized Barcode System ISBT128 will replace the old system. Tracking of specimens, test results and individual components is done by computers using these labels.
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On the Road to ISBT 128 Conversion
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Implementing new software system
IBTO is in the process of implementing the use of a single Organizational Wide Software System “MAK System” in all its blood centers through out the country.
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Tracing Blood Electronically
Recipient Tracing
There is a process of recipient tracing (Look-
Back) in IBTO by making sure that records
(Manual & semi- manual) are carefully
reviewed, in order to identify the patients who
have received seronegative blood from a donor
later found to be infected by blood borne
pathogens.
The Use of a single National Computer Network
System is an effort to make sure that, the
current look back process work more efficiently.
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Cord Blood and other cellular therapies
Establishment of a National Public Cord Blood Bank based on National & International standards and to be
accredited internationally (Net Cord) is in process
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Disaster preparedness
Is promoted by establishing IBTO Disaster Task Force to prepare policies and guidelines on blood needs during disasters.Readiness between IBTO and otherrelevant government organizations at the time of disaster is the aim.
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Medical Assessment of whole Blood Donors
Blood containers Blood is collected in to FDA or CE licensed
container (450±10% plus 63 ml CPDA)
Number of Whole Blood collected in 2006Total donation 1667412
Donations fromFamily Replace
ment donors
Paid donor
s
Autologous donors
New donors
Lapsed donors
Regular donors
41.86%19.92%38.22%1%0.0%Per request
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Laboratory Testing of Donated Blood
Each unit of whole blood undergoes a standard battery of tests
Required tests
Blood Grouping testsTotal Units Tested
ABO Grouping100%
RhD Typing100%
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Laboratory Testing of Donated Blood
Transmissible Disease TestingTotal Units
Tested
Hepatitis B surface antigen (HBsAg)100%
Hepatitis C antibody (anti-HCV)100%
HIV 1 & 2 antibody-antigen (HIV Ab/Ag)100%
HTLV I, II antibody (anti- HTLV I, II)8%
Syphilis (RPR)100%
Malaria0.5%
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Laboratory Testing of Donated Blood
Prevalence of marker of infection in blood donations in 2007
Type of InfectionPercentage
HIV0.004%
HBV0.41%
HCV0.12%
Syphilis0.04%
Malaria0.0%
HTLV0.02%
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Quality Control of Laboratory Testing
External controls WHO BBI Lab Quality Finland Acro-Metrix The Netherlands, NRL Australia
EQAS collaboration Run Control Samples (go- no-go samples)
IBTO Central QC laboratory sends samples to provincial Blood Centers
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Quality Control of Laboratory Testing
National Internal Controls Central Quality Control Laboratory Blood group serology Positive and Negative controls
Supplemental TestsHIV (Western Blot) or Line Immuno Blot / HIV P24 Ag / HIV-1 Ag
confirmHTLV (Western Blot)HCV (Riba) HBsAg (Neutralization)/ (HBcAb)RPR (FTA- ABS)
There are specific and clear Strategies (Algorithms) set by Technical and QA department to be used by laboratories for all screening test results
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Preparation and storage of components
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Preparation and storage of components
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Clinical Uses of Blood Components
Establishment of Hospital Transfusion Committees in all medical centers that administer blood is in process
Complications of transfusionDocumentation, follow up and reports of infectious and noninfectious complications of blood transfusion needs to be improved
Biovigilance Efforts are underway to establish a
national biovigilance system to collect and analyze data regarding transfusion related adverse events
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Clinical Uses of Blood Components
Blood Issued in 2007
Total 2826194
Percentage
Whole Blood1.45
Red Blood Cells52.9
FFP20.2
Platelets (Random)19.25
Cryoprecipitated AHF
4.09
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Quality Assurance System
A Quality Assurance management system has been implemented in IBTO
Standards from ISO 9001- 2000, AABB Quality System Essentials, European Council and WHO Quality Recommendations are used as guidelines
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Quality Assurance System The goals of the IBTO quality assurance system program
are to: Decrease errors Obtain credible results consistently Improve product safety Improve product quality
A QC department exist in each Blood Center with a QC officer in charge
QC department monitors all processes that take place in IBTO, from donor recruitment, donor selection, blood collection, distribution of blood and blood components, donor testing, labeling, storage, compatibility testing etc.
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Quality Assurance System Hospital blood banks
All hospital blood banks are monitored by IBTO’s Blood Center QC department and hospital inspector, periodically.
A comprehensive Quality Directive for hospital blood banks in cooperation with the Ministry of Health and Medical Education is in place
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Safety New Occupational Safety & Health Unit was established
in 2000IBTO’s policy is to emphasize on a safe workplace for the safety of the employees, donors, patient and visitors
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Education & Research Deputy of Research and Development is
responsible for National & International Educational programs
34 Faculty members of the Research Center provide teaching and training including basic scientific research in the field of transfusion medicine in cooperation with other IBTO scientific investigators in the country
An educational program leading to a master degree is offered by educational department for 7 students holding B.S. degree annually
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Education & Research IBTO’s technical & scientific materials in
transfusion services have been provided for neighboring Persian speaking countries through collaboration with WHO office in Cairo EMRO
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IBTO Research Center 2003
IBTO-Research Centre has published more than 70 specialized educational pamphlets and 20 books about blood transfusion, blood safety, and transfusion sciences in Farsi language in last 4 years.
IBTO-Research Centre embarked on publishing its
specialized quarterly entitled “Khoon” (Blood) that is indexed by IMEMR and Index Copernicus.
We forward copies of all our pamphlets, books, and journals to WHO and EMRO so as to be used in Farsi-speaking communities (such as Afghanistan). IBTO hopefully won the status of being a WHO Collaborating Center.
Iranian blood transfusion organization-Research centreIranian blood transfusion organization-Research centre
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Iranian Plasma Collection & Manufacturing
Organization There is a national strategy for the
provision of plasma derived products Iranian Blood Research and
Fractionation Center a public/ not for profit fractionation center has been built in Tehran which is being upgraded
At present, Plasma derivative products are imported from abroad as contract fractionation (Octapharma Austria and Biotest Germany, Kedrion Italy)
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Iranian Plasma Collection & Manufacturing
Organization
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