DR.P.K.RATH MD(PATH)

GURU BRAHMA GURU VISHNUGURU DEVOMAHESWARAHAGURU SHATHSHATHPRA BRAMMAMDHASMAISREE GURUVE NAMAHA

QUALITY ASSURANCE IN BLOOD BANKING

Aravindakshan. MURALIDHARANDoctors Blood Bank & Research Centre

Trichy

INTRODUCTION

WHO defines the term QUALITY as, “ The consistent and reliable performance of Services or product in conformity with specified standards”

QUALITY ASSURANCE is vital for the successful operations of any blood transfusion services.

The All Important - Blood Donor - OUR DEMIGOD

Donor Motivation

Donor Awareness

Donor Incentive

Donor Selection

The Single most important factor towards Our Final Goal

SAFE BLOOD

Donor Experience

Donor Retention

Adherence to the SOPs

Blood Collection

Blood Bank policy regarding the blood usageChoice of Bags : Quality of bag/ Type of Bag,

Examination of Bags.Good phlebotomy proceduresBlood Donor recovery and refreshment

Blood Component Preparation :-SOPs as per NABH, DGHS Guidelines for

the preparation of Red Cells, FFP, Platelets & Cryo.

Instrument calibration and validation

Storage

Calibration and validation of various

equipments involved in storage such as BBRs, Deep Freezers, Platelet incubator and agitator etc.

Q A in Screening of BloodGrouping : Manual / Automated

TTI Screening : Manual / Automated Quality control in this with positive control,

negative controls, L J chart in this will help.

QC of Blood Component Preparation

Whole blood :Volume : 350mls excluding anticoagulantHCT : 40±5%pH > 6.5K < 27mmol/LSterility : no growth

Red Cell Concentrates

The expected values

Volume : 280ml ± 50ml, frequency of control 1% of all units

HCT : 65- 75 %pH > 6.5K < 78 mmol/LSterility : no growth

Platelet Concentrates :Volume > 30mlpH : 6.8-7.4Plt count : at least 5.5 x 1010 /bag in at least 75% of

the units tested at the end of the storage.By apheresis : minimum 3 x 1011/bag platelets in at

least 75% units testedWBC contamination: < 2 x 103/bag.RBC contamination: minimal Macroscopic appearance : no visible platelets

aggregatesSterility : no growth

Fresh frozen plasmaQuality Control

Volume: 175 - 250ml Should contain necessary units of factor VIII,

factor IX, vWF and other plasma clotting factors

Macroscopic Examination: no abnormal color or visible clots

Cryo precipitateQuality Control :

Volume : 10- 15 mlFactor VIII : 80 – 100 units/ Conc.Fibrinogen : 150 – 250mg/ Conc.von-Willebrand factor :40–70% of the originalFibronectin : 55 mgFactor XIII: 20-30% of the originalSterility: no growth

References : Compendium of Transfusion Medicine – Dr. Makroo

Issue of Blood Products:

SOPs for issue of individual products

Thawing procedures and calibration for thawing bath

Packing and transportation of the products

QC FOR EQUIPMENT

Trouble shooting of untoward incidences

Reporting and recording of untoward incidences

Recall of components and rechecking (separate SOP for this should maintain)

Changes in SOP for prevention of such incidences

TO CONCLUDEDonor Selection and RetentionInstrument calibrationTest ValidationMaintanence of periodic QC of various blood

productsStrict adherence to SOPsGood Laboratory Practices - GLP

Quality Assurance is the right of every patient and it is the Duty of Every Blood Centre.

References:Compendium of Transfusion Medicine

by Dr. R.N, Makroo MBBS, DIBT, MD Second Edition 2009.

Transfusion Medicine Technical Manual by Director General of Health Services, INDIA - Second Edition 2003

Thank you