ibto research center1. 2 iranian blood transfusion organization
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IBTO Research Center 1
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Iranian Blood Transfusion Organization
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بهازايجمعيت درصداهدا
0 0.5 1 1.5 2 2.5 3
آذربايجان
پاكستان
تركيه
ازبكستان
قرقيزستان
ايران
مصر
اردن
كويت
مراكش
عمان
قطر
عربستان
سودان
سوريه
امارات
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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 in this hospital.
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
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1955: Establishment of the First Center for preparation of Blood Derivatives
1955: Establishment of the First Provincial Blood Transfusion Center
1962: Establishment of the First Independent Iran Red
Lion and Sun society (Red Crescent) Blood Transfusion Center.
1974: Establishment of National Blood Transfusion Organization
1978: Iran Blood Transfusion Organization & Islamic Revolution
1979:The Blood Transfusion Organization was assigned to the Ministry of Health and Welfare.
History of blood transfusion in Iran (con’t)
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History of blood transfusion in Iran (con’t)
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 responsible of the Supplying Blood and Blood Products in Iran
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 2007: Achievement the 100% voluntary
nonremmunerated blood donation
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Ministry of Health & Medical Education
IBTO's High Council
Managing Director
Department of Legal Affairs
Department of Public Relation &
International Affairs
Security Office Office of Activity Evaluation & Complaints
Managing Director Office
Deputy of Management Expansion & Improvement
Deputy of Technical & Quality Assurance
Deputy of Research &
Development
Technical Department
Quality Assurance Department
Blood Donors Education & Recruitment Department
Occupational Safety & Health Department
Department of Research
Department of Education
Research Center
Director of Renovation & Administrative Improvement
Department of Administrative Affairs
Department of Financial Affairs
Department of Supply, Maintenance & Services for Medical Equipments
Provincial Blood Centers
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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 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
10IBTO Research Center 10
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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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3.promoting the network of providing blood supply and transporting system
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Blood Centers
Arak Isfahan
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Blood Centers
Qom Rasht
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Blood Donation Center
Karaj Zabol
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The Iranian Blood Transfusion Organization
Major equipments and consumables are approved and procurement nationallyExamples: Blood Bags Test Kits Refrigerated Centrifuges ELISA Processors Blood Bank Refrigerators Hemoglobin Color Scale strips
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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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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
Technical & QA Deputy acts as National Regulatory Authority
Same 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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Trend of Blood Donation in Iran (1974-2007)
1735000
12,354
1,183,630
1,448,149
746,868
0
200000
400000
600000
800000
1000000
1200000
1400000
1600000
1800000
2000000
Un
its
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64
10092
95 95 96 9799
79807777
0
20
40
60
80
100
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
Per
cen
tTrend of Transition to 100%
Voluntary Blood Donation in Iran (1996-2007)
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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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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 2007Total donation 1735000
Donations fromFamily Replace
ment donors
Paid donor
s
Autologous donors
New donors
Lapsed donors
Regular donors
39%21%40%0.0%0.0%Per request
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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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Education & Research Deputy of Research and Development is
responsible for National & International Educational programs
32 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
Blood Centers conduct seminars, and educational/ technical training classes & in-services to provide updates and continuing education for technologists, nurses and physicians involved in collection, preparation and transfusion of blood and components
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Education & Research An educational program leading to a master
degree is offered by educational department for 7 students holding B.S. degree and 4 phD annually
Publication and translation of technical & scientific books & literatures are provided by Educational department
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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0% 20% 40% 60% 80% 100%
افغانستان
قزاقستان
جيبوتي
مصر
اردن
كويت
ازبكستان
قرقيزستان
مراكش
ايران
پاكستان
قطر
عربستان
سودان
سوريه
تونس
اماراتمتحدهعربي
يمن
درصدانواعاهدا
داوطلبانه
جايگزين
پولي
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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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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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IBTO – Red crescent cooperation in blood donor
recruitment
0
10000
20000
30000
40000
50000
60000
70000
1385 1386
RCS donors
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The Iranian Blood Supply system
1200000
1300000
1400000
1500000
1600000
1700000
1800000
2000 2001 2002 2003 2004 2005 2006 2007
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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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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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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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changes in process
Total Laboratory Automation has been implemented in regional IBTO Blood Center in order to centralize the testing of the donated blood.
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changes in process
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Extraction-Automation
IBTO Research Center 48
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Production-Blast Freezer
IBTO Research Center 49
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On the Road to ISBT 128 Conversion
Internationally recognized Barcode System ISBT128 was replaced 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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