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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