Organizational models of blood transfusion systems

Treviso, 21 OctoberKarin Magnussen

Donors outside the Blood Bank

/Centre

Donors in the Blood Bank

/Centre

Blood products Blood Group serology

The Patients

Quality ControlHemovigilance

Blood managementEthics etc.

Recruitment Donor interests

◦ Insurance in case of donor injury◦ Complaints◦ Legal and other advice

Information Ethics

Donors out side the blood bank

Booking of the donation Evaluation of the donor The donation

◦ Whole blood◦ Apheresis◦ Stem Cells

Information Deferral rules Testing

◦ Haemoglobin, and possibly more tests

Donors in the blood bank

Testing◦ Blood group, Infectious disease screening and

more Fractionation Storage Distribution Quality control Issuing the blood for the patients

Blood products

Blood grouping◦ Donors and patients

Antibody screen◦ Donors and patients

Antibody identification◦ Mainly patients

X-match◦ Electronic◦ Serological

Blood group serology Laboratory

Decision to prescribe a transfusion Giving the transfusion Monitor the transfusion Treat and report adverse events Develop guidelines for transfusion

The patients, departments

Donors outside the blood Bank

/Centre

Donors in the Blood Bank

/Centre

Blood products Blood Group serology

The PatientsQuality ControlHemovigilance

Blood managementEthics etc.

Blood centres are separate from hospitals and patients

Separate economies A problem that donation centres may

implement expensive procedures and increase the cost, regardless of hospital end patient best interests

Communication is a challenge

USA and Estonia

Donors outside the Blood Bank

/Centre

Donors in the Blood Bank

/Centre

Blood products Blood Group serology

The PatientsQuality ControlHemovigilance

Blood managementEthics etc.

Blood centres separate from hospital where serology laboratory and patient departments are separate

Separate economies Communication challenge These Blood Centres are not the most

interesting place to work for most physicians

UK and Malta

Donors outside the blood Bank

/Centre

Donors in the Blood Bank

/Centre

Blood products Blood Group serology

The PatientsQuality ControlHemovigilance

Blood managementEthics etc.

The blood centre is within the department of haematology and the physicians are specialists in haematology

The more experienced physicians tend to care mainly about advanced patient related analysis and treatment of patients

Less prestige is given to care of donors and blood products

Southern Europe

Donors outside the blood Bank

/Centre

Donors in the Blood Bank

/Centre

Blood products Blood Group Serology

The PatientsQuality ControlHemovigilance

Blood managementEthics etc.

A blood donor organization recruits donors and take care of donor interests

The hospital based department of blood donation and transfusion covers all from blood donation to issuing blood for the patients. Also has advisory capacity regarding blood transfusion to patients

This works very well, provided close contact and communication between the Blood bank and both the donor organization and the clinical departments

Scandinavia and a new medical speciality in the Nederlands

The organization of blood donation and transfusion differs throughout Europe and the world.

Regardless of organization, what is important is cooperation, communication, care and safety for donors and patients

The organization has an impact on recruitment of medical doctors, recruitment of voluntary non-remunerate donors and the ethics regarding donor and patient safety

Conclusion

Thank You for your attention