dr.p.k.rath md(path) guru brahma guru vishnu guru devo maheswaraha guru shathshath pra brammam...
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DR.P.K.RATH MD(PATH)
GURU BRAHMA GURU VISHNUGURU DEVOMAHESWARAHAGURU SHATHSHATHPRA BRAMMAMDHASMAISREE GURUVE NAMAHA
QUALITY ASSURANCE IN BLOOD BANKING
Aravindakshan. MURALIDHARANDoctors Blood Bank & Research Centre
Trichy
INTRODUCTION
WHO defines the term QUALITY as, “ The consistent and reliable performance of Services or product in conformity with specified standards”
QUALITY ASSURANCE is vital for the successful operations of any blood transfusion services.
The All Important - Blood Donor - OUR DEMIGOD
Donor Motivation
Donor Awareness
Donor Incentive
Donor Selection
The Single most important factor towards Our Final Goal
SAFE BLOOD
Donor Experience
Donor Retention
Adherence to the SOPs
Blood Collection
Blood Bank policy regarding the blood usageChoice of Bags : Quality of bag/ Type of Bag,
Examination of Bags.Good phlebotomy proceduresBlood Donor recovery and refreshment
Blood Component Preparation :-SOPs as per NABH, DGHS Guidelines for
the preparation of Red Cells, FFP, Platelets & Cryo.
Instrument calibration and validation
Storage
Calibration and validation of various
equipments involved in storage such as BBRs, Deep Freezers, Platelet incubator and agitator etc.
Q A in Screening of BloodGrouping : Manual / Automated
TTI Screening : Manual / Automated Quality control in this with positive control,
negative controls, L J chart in this will help.
QC of Blood Component Preparation
Whole blood :Volume : 350mls excluding anticoagulantHCT : 40±5%pH > 6.5K < 27mmol/LSterility : no growth
Red Cell Concentrates
The expected values
Volume : 280ml ± 50ml, frequency of control 1% of all units
HCT : 65- 75 %pH > 6.5K < 78 mmol/LSterility : no growth
Platelet Concentrates :Volume > 30mlpH : 6.8-7.4Plt count : at least 5.5 x 1010 /bag in at least 75% of
the units tested at the end of the storage.By apheresis : minimum 3 x 1011/bag platelets in at
least 75% units testedWBC contamination: < 2 x 103/bag.RBC contamination: minimal Macroscopic appearance : no visible platelets
aggregatesSterility : no growth
Fresh frozen plasmaQuality Control
Volume: 175 - 250ml Should contain necessary units of factor VIII,
factor IX, vWF and other plasma clotting factors
Macroscopic Examination: no abnormal color or visible clots
Cryo precipitateQuality Control :
Volume : 10- 15 mlFactor VIII : 80 – 100 units/ Conc.Fibrinogen : 150 – 250mg/ Conc.von-Willebrand factor :40–70% of the originalFibronectin : 55 mgFactor XIII: 20-30% of the originalSterility: no growth
References : Compendium of Transfusion Medicine – Dr. Makroo
Issue of Blood Products:
SOPs for issue of individual products
Thawing procedures and calibration for thawing bath
Packing and transportation of the products
QC FOR EQUIPMENT
Trouble shooting of untoward incidences
Reporting and recording of untoward incidences
Recall of components and rechecking (separate SOP for this should maintain)
Changes in SOP for prevention of such incidences
TO CONCLUDEDonor Selection and RetentionInstrument calibrationTest ValidationMaintanence of periodic QC of various blood
productsStrict adherence to SOPsGood Laboratory Practices - GLP
Quality Assurance is the right of every patient and it is the Duty of Every Blood Centre.
References:Compendium of Transfusion Medicine
by Dr. R.N, Makroo MBBS, DIBT, MD Second Edition 2009.
Transfusion Medicine Technical Manual by Director General of Health Services, INDIA - Second Edition 2003
Thank you