‘Guidelines for blood banks’

National Blood policy recommends rationalisation and centralisation of blood transfusion services with 100 per cent blood collections from voluntary non-remunerated donors. Voluntary blood donation is the backbone of blood safety. While many countries globally have already achieved 100 per cent voluntary donation, our country’s current voluntary donation statistics show that we are yet to close the gap from 83.5 per cent. Although the National Blood Transfusion Council (NBTC) through the state blood transfusion councils (SBTC) promotes blood donor motivation, recruitment and retention programmes, it remains the individual effort of blood banks across the country to ultimately achieve this goal. In our organisation, we successfully converted from replacement to 100 per cent voluntary donations within a period of two years.

Universal leucodepletion (ULD) of blood has been introduced in several countries to improve clinical safety of blood components transfused. Adopting ULD of blood in our country would provide potential benefits to transfusion recipients; however cost-effectiveness remains an influential factor in policy decisions, with blood banks opting for selective leucodepletion instead.

Since the Quality Council of India, through the NABH for blood banks, introduced standards for blood bank services in 2007, many blood banks in the country are pursuing accreditation to ensure uniformity of blood bank processes and continuous quality improvement.

Automation for progress

Automation in blood banking has significantly minimised human errors while improving turnaround time of blood testing and issue.

Advanced technology has further helped to improve the quality and safety of blood and blood components provided to patients. Today our country has Nucleic Acid Testing (NAT) technology to reduce window period of transfusion transmitted infections, leukoreduction to reduce adverse transfusion reactions attributed to leucocytes, bacterial detection using an automated culture system, technology for continuous temperature monitoring of blood during transport and cell separators to separate the desired blood components.

In Dr LH Hiranandani Hospital, we have significantly brought down our transfusion reaction rate with the use of filter bags and pre-storage leukoreduction techniques.

Hurdles to be handled

With major advancement in technology and emphasis on blood safety and assurance of quality, blood banks are faced with the constant dilemma of providing blood and blood components at an affordable cost. Due to this reason, maintaining uniform standards of quality and processes in blood banks remains a major challenge even today. Emerging pathogens in India add to the concern that current testing procedures alone may not be adequate to prevent transmission of potential human pathogens.

– Dr Lincy Jacob, Consultant, Department of Transfusion Medicine, Dr L H Hiranandani Hospital