Blood Safety

WORLD HEALTH ORGANIZATION
Blood Safety
AIDE-MEMOIRE
for National Blood Programmes
Checklist
Blood transfusion service
A well-organized blood transfusion service (BTS), with quality
Government commitment and support
systems in all areas, is a prerequisite for the safe and effective use
National blood policy/plan
of blood and blood products.
Legislation/regulation
Organization with responsibility and
The HIV/AIDS pandemic has focused particular attention on the
authority for the BTS
importance of preventing transfusion-transmitted infections (TTIs).
BTS management committee
Between 5% and 10% of HIV infections worldwide are transmitted
BTS medical director
through the transfusion of contaminated blood and blood
BTS quality manager
products. Many more recipients of blood products are infected by
Specialist BTS advisory groups
hepatitis B and C viruses, syphilis and other infectious agents, such
Trained BTS administrative and
as Chagas disease.
technical staff
Adequate budget
The global burden of disease due to unsafe blood transfusion can
National quality system
be eliminated or substantially reduced through an integrated
strategy for blood safety which includes:
Blood donors
National blood donor programme officer
Establishment of a nationally-coordinated blood transfusion
Blood donor unit
service
Blood donor recruitment officer
Collection of blood only from voluntary non-remunerated blood
Standard operating procedures
donors from low-risk populations
Training of staff in blood donor unit
Testing of all donated blood, including screening for transfusion-
Low-risk donor populations
transmissible infections, blood grouping and compatibility testing
Educational materials
Register of voluntary non-remunerated
Reduction in unnecessary transfusions through the effective
blood donors
clinical use of blood, including the use of simple alternatives to
Donor selection, deferral, care and
transfusion (crystalloids and colloids), wherever possible.
confidentiality
Donor notification and referral
Monitoring of TTIs
Testing of donated blood
Words of advice
Technical officer
Screening strategies and protocols
Secure government commitment and support for the
Training of laboratory technical staff
national blood programme
Screening of all donated blood for TTIs
Establish a blood transfusion service as a separate unit
Blood grouping and compatibility testing
with responsibility and authority, an adequate budget, a
Good laboratory practice, including
management team and trained staff
standard operating procedures (SOPs)
Educate, motivate, recruit and retain voluntary non-
Continuity in testing
remunerated blood donors from low-risk populations
Effective blood cold chain
Ensure good laboratory practice in screening for
Clinical use of blood
transfusion-transmissible infections, blood grouping,
National policy and guidelines on the
compatibility testing, blood component production and
clinical use of blood
the storage and transportation of blood products
Training of clinicians and BTS staff
Reduce unnecessary transfusions through the effective
Prevention, early diagnosis and treatment
clinical use of blood, including alternatives to transfusion
Alternatives to transfusion (crystalloids
Establish a quality system for the BTS
and colloids)
Train all BTS and clinical staff to ensure the provision of
Effective clinical use of blood
safe blood and its effective clinical use
Monitoring and evaluation
© World Health Organization 2002. All rights reserved. WHO/BCT/02.03. Printed July 2002

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Key elements
Establish a blood transfusion service
It is the responsibility of governments
Formalization of government
Appointment, when necessary, of
to ensure a safe and adequate supply
commitment and support
specialist BTS advisory groups
of blood. This responsibility may be
Development of a national blood
Appointment and training of staff
delegated to a non-profit non-
policy and plan
experienced in each key aspect of
governmental organization, but the
the BTS
BTS should be developed within the
Development of necessary
Development and implementation
framework of the country’s health
legislation/regulation for the BTS
of a budgeting and finance system
care infrastructure.
Formation of an organization with
to ensure a sustainable blood
The BTS requires government
responsibility and authority for the
programme through cost recovery
commitment and support and
BTS
and/or annual budget allocation
recognition as a separate unit with an
Formation of a BTS management
Establishment of national quality
adequate budget, management team
committee
system, including guidelines,
and trained staff.
standard operating procedures,
Appointment of a medical director
Important activities in establishing a
accurate records, monitoring and
blood transfusion service include:
Appointment of a quality manager
evaluation.
Educate, motivate, recruit and
Donor notification and referral for
Reduce unnecessary transfusions
counselling
retain low-risk blood donors
by effective clinical use of blood
Monitoring of TTIs in the donor
High priority should be given to the
population.
Blood transfusion has the potential for
elimination of family/replacement
acute or delayed complications and
and paid blood donor systems, which
the transmission of infection. The risks
Test all donated blood
are associated with a significantly
associated with transfusion can be
higher prevalence of TTIs.
reduced by minimizing unnecessary
The BTS should develop and maintain
transfusions through the effective
Voluntary non-remunerated blood
a national strategy for the testing of all
clinical use of blood and blood
donors from low-risk populations
donated blood and blood products,
products and the appropriate use of
who give blood regularly are the
using the most appropriate and
simple alternatives to transfusion
foundation of a safe and adequate
effective tests, and for good laboratory
which are safer and more cost-
blood supply.
practice.
effective.
Important activities include:
Important activities include:
Important activities include:
Appointment of a designated
Appointment of an officer
technical officer
Development of a national policy
responsible for the national blood
and guidelines on the clinical use of
donor programme
Development of protocols for the
blood
testing, selection and evaluation of
Establishment of a BTS unit
appropriate screening assays to be
Training in the clinical use of blood
responsible for donor education,
used at each site
for all clinicians involved in the
motivation, recruitment and
transfusion process and for BTS
retention
Training of BTS laboratory
staff
technical staff
Appointment of a designated
Commitment to the prevention,
Screening of all donated blood for
blood donor recruitment officer
early diagnosis and treatment of
TTIs, including HIV, hepatitis
conditions that could result in the
Preparation of SOPs in accordance
viruses, syphilis and other
need for transfusion (obstetrical
with BTS guidelines
infectious agents, such as Chagas
complications, trauma and other
disease
Training of staff in the blood donor
causes of anaemia)
unit
Blood grouping and compatibility
testing
Availability of intravenous
Identification of donor populations
replacement fluids (crystalloids
at low risk for TTIs
Good laboratory practice, with
and colloids) for the correction of
effective documentation, including
hypovolaemia
Development of educational
standard operating procedures
materials
Availability of pharmaceuticals
Procurement, supply, central
and devices to minimize the need
Establishment of a register of
storage and distribution of reagents
for blood
voluntary non-remunerated blood
and materials to ensure continuity
donors
in testing at all sites
Effective clinical use of blood and
Assurance of safe blood collection
Maintenance of an effective blood
blood products in accordance with
procedures, including donor
cold chain for the storage and
national guidelines
selection and deferral, donor care
transportation of blood and blood
Monitoring and evaluation of the
and confidentiality
products.
clinical use of blood.
Department of Blood Safety and Clinical Technology
World Health Organization
1211 Geneva 27, Switzerland
Fax: +41 22 791 4836 bloodsafety@who.int www.who.int/bct

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