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| BOOK REVIEW |
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| Year : 2011 | Volume
: 133
| Issue : 4 | Page : 448-449 |
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Screening donated blood for transfusion-transmissible infections, recommendations
Neelam Marwaha
Department of Transfusion Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh 160 012, India
| Date of Web Publication | 29-Apr-2011 |
Correspondence Address:
Neelam Marwaha
Department of Transfusion Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh 160 012
India
 Source of Support: None, Conflict of Interest: None  | Check |
How to cite this article:
Marwaha N. Screening donated blood for transfusion-transmissible infections, recommendations. Indian J Med Res 2011;133:448-9 |
(World Health Organization, Geneva, Switzerland) 2010.
67 pages. Price: CHF/US $ 30.00; in developing countries: CHF/US $ 21.00
ISBN 978-92-4-154788-8
Adequate supply of safe blood and blood products is an essential component of healthcare. Quality assured screening of donated blood for transfusion-transmissible infections (TTI) is the key element to achieve this goal. However, global data on testing for TTIs reveal wide variations in screening strategies as well as quality measures adopted, thus exposing recipients to high risk of acquiring these infections. In countries where effective blood screening strategies have been implemented, the risk of TTIs has declined significantly over the last two decades. This publication is specifically designed to guide the development of reliable blood screening programmes in countries where such systems are not yet fully established.
The WHO Recommendations on Screening Donated Blood for Transfusion-transmissible Infections have been developed as a result of the initiative by the Blood Transfusion Safety Team in the WHO Department of Essential Health Technologies. The document is based on the contribution of international experts in the field of transfusion medicine and microbiology from various geographic regions of the world.
The contents of the document have been divided into seven sections: Introduction; National blood screening programme for transfusion-transmissible infections; Screening assays; Screening for transfusion-transmissible infections; Blood screening, quarantine and release; Confirmatory testing and blood donor management; and Quality systems in blood screening. Each section is further sub-divided into subsections. The Glossary of various terms is useful for providing clarity to the readers. References have also been cited for further reading.
The Introduction section aptly describes the constraints and challenges faced by developing and transitional countries, both at the policy level and operational level, in implementing national blood screening programmes. It also outlines the aims and objectives and the methodology of preparation of this document. The methodology is commendable and should be referred to while developing national guidelines on blood safety in any country. The second section describes a framework for establishing a screening strategy for TTIs as a component of the national blood policy. The efficient co-ordination of blood transfusion services at the national level is essential for an effective, sustainable and quality assured blood screening programme. This fact has been adequately emphasized, and useful guidelines and key issues are outlined for the design and development of a national blood screening programme for TTIs.
The third and fourth sections respectively discuss the screening assays and screening for TTIs. The section on screening assays provides information on available immunoassays and nucleic acid amplification technology testing and the suitability, selection and evaluation of the assays. The subsection on Selection of assays, Critical assay characteristics and Monitoring assay performance is a 'must-read' for all those concerned with blood transfusion services. An important note of caution has been inserted before introducing new technologies for blood screening. Section four gives specific recommendations for universal screening of all blood donations for four diseases which pose serious consequences for the recipient. These include screening for human immunodeficiency virus 1 and 2, hepatitis B, hepatitis C and syphilis. The summary of screening markers, assays, recommendations and comments is tabulated in a clear and concise manner for ready reference. Recommendations for screening for other infections are based on endemicity and risk to special recipient groups. The contents of these two sections provide operational guidelines for TTI screening.
Management of blood donors who are reactive with screening tests for TTIs is a highly sensitive and essential issue, both from point of view of recipient safety and donor care. This WHO document incorporates guidelines on confirmatory testing for TTIs in screen reactive blood donors and subsequent blood donor counselling, referral and deferral. The seventh and final section outlines the key elements of the quality system for blood screening, including organizational management, quality standards, documentation, traceability, training assessment and maintenance and calibration.
This is a timely publication and provides evidence based ready and concise information for healthcare policy makers, transfusion medicine specialists, quality managers and technical staff. The recommendations would definitely help countries with limited resources to develop national blood screening programme and where such programmes are already established it will assist in further strengthening the quality systems.
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