The production of the Blood Transfusion Service in theCzech Republic in 2003

Overview

The production of the Blood Transfusion Service in the Czech Republic in 2003 follows trends ofprevious years. Discussion on reorganisation neither the principal change of the regimen of GMPcontrolling does not lead so far into change of structure. Vast majority of donations is performed by notvery large Blood transfusion establishments, which are at most a part of hospital. Majority of blood isprocessed locally into blood components but the number of donations sent for processing into largercentres is increasing (12 % in 2003 versus 8 % in 2002). Occasionally larger blood establishmentstakeover all activities previously independent blood donations centres of other hospital. Both alogeneicand autologous blood components are produced by 55 establishments, additional 14 collect and processautologous blood only. Donor pool is stabilised and total number of donors registered is only a littlelower then recommended (36,6 registered donors per 1000 of inhabitants), 9 % of donors were first-timedonors. Number of donations is slightly over WHO recommended value (43 /1000 inhabitants). Number of plasmaphereses is increasing, but does not reach the number of mid-nineties. Number of thrombocytapheresesincreases slowly. Great majority of donations is performed without direct financialcompensation (98.7 % of whole blood donations, 82 % of plasmaphereses, 32.4 % of thrombocytaphereses).Number of donors with positive hepatitisBorC markers is decreasing, prevalence of HIV positivityremains very low. Processing shifts to products with lower leukocyte contamination. Proportion ofblood in-process or early leukodepleted is increasing – „Packed red cells buffy-coat removed, in additivesolution“ being the standard product, circa 11 % of packed red cells are leukodepleted by in-procesfiltration. Platelet production shifts slowly to single donor apheresis products (75 % of a total of 22,6thds of therapeutical doses of platelets produced now), circa 42%of platelet concentrates are in-processleukodepleted. Proportion of plasma used for clinical purposes remains extremely high (17 unit of 220ml per 1000 of inhabitants), the amount of plasma sent for fractionation is stable (80.8 thds. of litres in2003). The number of preoperative autologous whole blood donations (PABDs) in the Czech Republichas increased for several years, of 3.7 % in comparison to 2002. PABDs in children have increased (167vs 86), PABDs in pregnancy have decreased (12 vs 19). Most of PABDs were performed in the Moravskoslezskýregion (3.73 per 1000 inhabitants), the least rate was in the Ústecký region (0.84 per 1000inhabitants). Autologous erythrocytapheresis and plasmapheresis were performed in very low rate (34,resp. 71 donations). 5304 acute normovolaemic haemodilution (ANH) and 438 perioperative bloodsalvage (PBS) processes were made. Nevertheless, real numbers of ANH and PBS could be higher incase of optimal cooperation in nonmandatory report of procedures mentioned above by anaesthesiologicaland surgery departments. Collected autologous blood units were processed in whole blood in55.8 % and in red blood cells in 44.2 % (with some lower rate of autologous plasma). The incidence ofanti-HCV, HBsAg and syfilis positivity in autologous donations is higher than in allogeneic ones. Threehospitals used microagreggate filters for autologous whole blood transfusion, red cells leukodepletionwas performed in one department. Autologous cord blood transfusion was not performed. The utilisationof autologous red blood cells and plasma was 83 % resp. 77.2 %.

Key words:
blood transfusion service, production, preoperative autologous blood donation, apheresis,acute normovolaemic haemodilution, perioperative blood salvage, statistics