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Country Report Iranian Blood Transfusion Organization F acts and Figures. Table of Contents. Iran- Country Profile IBTO Organizational Chart IBTO as a Centralized National Blood Program The Iranian Blood Supply System Regulation, Standardization and Certification
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Country Report Iranian Blood Transfusion Organization Facts and Figures
Table of Contents • Iran- Country Profile • IBTO Organizational Chart • IBTO as a Centralized National Blood Program • The Iranian Blood Supply System • Regulation, Standardization and Certification • Recruitment of Blood Donors • Medical Assessment of Whole Blood Donors • Laboratory Testing of Donated Blood • Preparation and Storage of Components • Clinical Uses of Blood Components • Quality Assurance System • Safety • Education and Research • Iranian Plasma Collection and Manufacturing Organization
Iran Country ProfileHealth Expenditure, Human and Physical Resources Indicators Total Health expenditure per capita: $ 131 Physician per 10,000 population: 8.9 (2005) Nursing and Midwifery personnel per 10,000 population: 14.1 (2005) Hospital beds per 10,000 population: 17.2 (2005) Population with access to local health services(%): Urban/ Rural 100 (2005)
Ministry of Health & Medical Education IBTO's High Council Managing Director Department of Legal Affairs Department of Public Relation & International Affairs Security Office RecruitmentDepartment Office of Activity Evaluation & Complaints Managing Director Office Deputy of Research & Education Deputy of Financial & Administration Deputy of Technical & Quality Assurance Provincial BloodCenters Organizational Chart
Blood Centers Isfahan Zabol
Blood Centers Qom Rasht
The Iranian Blood Transfusion Organization • Major equipments and consumables are approved and procurement nationally Examples: • Blood Bags • Test Kits • Refrigerated Centrifuges • Automated Blood Grouping Machines • ELISA Processors • Blood Bank Refrigerators
Whole blood is collected Only in IBTO blood centers Fixed centers Mobile (Factories, Offices, Universities) The Iranian Blood Supply system
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
The Iranian Blood Supply system • Blood is provided to hospitals free of charge No 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
The Rare Blood Donor Program Screens for Rare Donor Bloods to be frozen for thalassemia patients and other rare blood type patients/ Used for panel cell production.
The Iranian Blood Supply system • Type of Blood collected annually
1.80 % average growth rate of Whole Blood collection (2000-2007) The Iranian Blood Supply system
The Iranian Blood Supply system • Per capita rate Blood Collection 24/1000 (06- 07) • Collection rate age- eligible donors (18+) 36/1000 (05- 06)
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
Regulation, Standardization and Certification • Registrations/ Certifications
Regulation, Standardization and Certification • Technical & QA Deputy acts as National Regulatory Authority • 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.
Recruitment of Blood Donors • Blood Donor Recruitment strategies • 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
Recruitment of Blood Donors • Demographic characteristics of Blood Donors 2006 • Gender
Recruitment of Blood Donors • Demographic characteristics of Blood Donors 2006 • Age
Recruitment of Blood Donors • Demographic characteristics of Blood Donors 2006 • Education
Recruitment of Blood Donors • Demographic characteristics of Blood Donors 2006 • Employment
Recruitment of Blood Donors • Demographic characteristics of Blood Donors 2006 • Marital Status
Medical Assessment of whole Blood Donors • To ensure the safety of the donor and to obtain a high quality blood component that is as safe as possible for the recipient there is a complete pre donation screening in place • The emphases is on volunteer blood donation • A complete medical history is obtained by a trained physician before donation • A brief physical examination before donation is conducted • The donor’s identity is checked against a local Blood Center deferral registry (Nation wide deferral registry is in process of being implemented by a new computer donor registry system)
Medical Assessment of whole Blood Donors • Use of the confidential donor deferral system by which the donor can confidentially in private designate his/her unit as unsuitable for transfusion is in place • Individuals may donate not more than 4 times a year (every 8 weeks interval) • Donor is given information (Poster/Brochures) about • Blood donation • Transmissible disease testing • Factors or behavior that would preclude blood donation • Action that will be taken in the event of a positive test result for a transmissible disease
Medical Assessment of whole Blood Donors • A physician interviews the donor in complete privacy and direct questioning • Medical history • Assesses the donor’s general condition • Asks specific sex-related questions • Informed consent A written informed consent from the prospective donor is required Blood donor medical history questionnaire
Medical Assessment of whole Blood Donors • The volume of blood collected should be between 405 and 495 ml (450 ml±10%) • Nationally 18.9% of donors were deferred after being assessed as unsuitable to donate blood in 2007
Future changes in process • Total Laboratory Automation will be implemented in regional IBTO Blood Center in order to centralize the testing of the donated blood.
On the Road to ISBT 128 Conversion • Internationally recognized Barcode SystemISBT128 will replace the old system. Tracking of specimens, test results and individual components is done by computers using these labels.
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.
Tracking 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.
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
Disaster preparedness Is promoted by establishing IBTO Disaster Task Force to prepare policies and guidelines on blood needs during disasters. Readiness between IBTO and other relevant government organizations at the time of disaster is the aim.
Medical Assessment of whole Blood Donors • Blood containers Blood is collected in to FDA or CE licensed container (450±10% plus 63 ml CPDA)
Laboratory Testing of Donated Blood • Each unit of whole blood undergoes a standard battery of tests • Required tests
Laboratory Testing of Donated Blood • Prevalence of marker of infection in blood donations in 2007
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