Iranian Blood Transfusion Organization

2. Iranian Blood Transfusion Organization

4. History of blood transfusion in Iran • The first hospital of National Iranian oil company was established in Masjed Soleiman in 1924 and the blood transfusion was first carried out in this hospital. • 1948: Establishment of the First Private Blood Transfusion in Iran as Dr. Motamed blood transfusion center • 1949: Publication of the First Notice to Call for Blood Donation • 1950s: Hospitals started to use replacement blood • 1952: Establishment of Army’s Blood Transfusion Center • 1954: Establishment of the First Iran Red Lion and Sun society (Red Crescent) blood Transfusion Center

5. History of blood transfusion in Iran (con’t) • 1955: Establishment of the First Center for preparation of Blood Derivatives • 1955: Establishment of the First Provincial Blood Transfusion Center • 1962: Establishment of the First Independent Iran Red Lion and Sun society (Red Crescent) Blood Transfusion Center. • 1974: Establishment of National Blood Transfusion Organization • 1978: Iran Blood Transfusion Organization & Islamic Revolution • 1979:The Blood Transfusion Organization was assigned to the Ministry of Health and Welfare.

6. History of blood transfusion in Iran (con’t) • 1980: Iran Blood Transfusion Organization & Imposing War Supply of blood and blood products required by the thousands of wounded soldiers • 1984: Introduction of the Organization as the Sole responsible of the Supplying Blood and Blood Products in Iran • 1974: HBs Ag Screening test • 1987: HIV-Ab Screening Test • 1997: HCV screening test • 2005: Implementing HIV-Ab, HIV-Ag screening test • 2006: Development of Iran Blood Transfusion Network • 2006: Commencement of technical and software automation of Iran blood transfusion stations • 2007: Achievement the 100% voluntary nonremmunerated blood donation

7. Technical Department Department of Research Director of Renovation & Administrative Improvement Quality Assurance Department Department of Education Department of Administrative Affairs Blood Donors Education & Recruitment Department Research Center Department of Financial Affairs Occupational Safety & Health Department Department of Supply, Maintenance & Services for Medical Equipments Ministry of Health & Medical Education IBTO's High Council Managing Director Department of Public Relation & International Affairs Security Office Office of Activity Evaluation & Complaints Managing Director Office Department of Legal Affairs Deputy of Management Expansion & Improvement Deputy of Research & Development Deputy of Technical & Quality Assurance Provincial Blood Centers

8. The Iranian Blood Transfusion Organization

9. 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

10. IBTO Research Center 10

11. Whole blood is collected Only in IBTO blood centers Fixed centers Mobile (Factories, Offices, Universities) The Iranian Blood Supply system

12. 3.promoting the network of providing blood supply and transporting system

13. Blood Centers Arak Isfahan

14. Blood Centers Qom Rasht

15. Blood Donation Center Karaj Zabol

16. The Iranian Blood Transfusion Organization • Major equipments and consumables are approved and procurement nationally Examples: • Blood Bags • Test Kits • Refrigerated Centrifuges • ELISA Processors • Blood Bank Refrigerators • Hemoglobin Color Scale strips

17. 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

18. 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

19. Regulation, Standardization and Certification • Technical & QA Deputy acts as National Regulatory Authority • Same 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.

20. Trend of Blood Donation in Iran (1974-2007) Units

21. Trend of Transition to 100% Voluntary Blood Donation in Iran (1996-2007) Percent

22. The Iranian Blood Supply system • Per capita rate Blood Collection 24/1000 (06- 07) • Collection rate age- eligible donors (18+) 36/1000 (05- 06)

23. Medical Assessment of whole Blood Donors • Blood containers Blood is collected in to FDA or CE licensed container (450±10% plus 63 ml CPDA)

24. Laboratory Testing of Donated Blood • Prevalence of marker of infection in blood donations in 2007

25. Education & Research • Deputy of Research and Development is responsible for National & International Educational programs • 32 Faculty members of the Research Center provide teaching and training including basic scientific research in the field of transfusion medicine in cooperation with other IBTO scientific investigators in the country • Blood Centers conduct seminars, and educational/ technical training classes & in-services to provide updates and continuing education for technologists, nurses and physicians involved in collection, preparation and transfusion of blood and components

26. Education & Research • An educational program leading to a master degree is offered by educational department for 7 students holding B.S. degree and 4 phD annually • Publication and translation of technical & scientific books & literatures are provided by Educational department • IBTO’s technical & scientific materials in transfusion services have been provided for neighboring Persian speaking countries through collaboration with WHO office in Cairo EMRO

29. Laboratory Testing of Donated Blood • Each unit of whole blood undergoes a standard battery of tests • Required tests

30. Recruitment of Blood Donors • 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

31. IBTO – Red crescent cooperation in blood donor recruitment

32. The Iranian Blood Supply system

33. Recruitment of Blood Donors • Demographic characteristics of Blood Donors 2006 • Gender

34. Recruitment of Blood Donors • Demographic characteristics of Blood Donors 2006 • Age

35. Recruitment of Blood Donors • Demographic characteristics of Blood Donors 2006 • Education

36. Recruitment of Blood Donors • Demographic characteristics of Blood Donors 2006 • Employment

37. Recruitment of Blood Donors • Demographic characteristics of Blood Donors 2006 • Marital Status

38. Laboratory Testing of Donated Blood

39. 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

40. Quality Control of Laboratory Testing • National Internal Controls • Central Quality Control Laboratory • Blood group serology • Positive and Negative controls • Supplemental Tests HIV (Western Blot) or Line Immuno Blot / HIV P24 Ag / HIV-1 Ag confirm HTLV (Western Blot) HCV (Riba) HBsAg (Neutralization)/ (HBcAb) RPR (FTA- ABS) • There are specific and clear Strategies (Algorithms) set by Technical and QA department to be used by laboratories for all screening test results

41. changes in process • Total Laboratory Automation has been implemented in regional IBTO Blood Center in order to centralize the testing of the donated blood.

42. changes in process

48. Extraction-Automation IBTO Research Center 48

49. Production-Blast Freezer IBTO Research Center 49