IBTO Research Center1. 2 Iranian Blood Transfusion Organization.

IBTO Research Center 1

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Iranian Blood Transfusion Organization

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بهازايجمعيت درصداهدا

0 0.5 1 1.5 2 2.5 3

آذربايجان

پاكستان

تركيه

ازبكستان

قرقيزستان

ايران

مصر

اردن

كويت

مراكش

عمان

قطر

عربستان

سودان

سوريه

امارات

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

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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.

History of blood transfusion in Iran (con’t)

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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

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Ministry of Health & Medical Education

IBTO's High Council

Managing Director

Department of Legal Affairs

Department of Public Relation &

International Affairs

Security Office Office of Activity Evaluation & Complaints

Managing Director Office

Deputy of Management Expansion & Improvement

Deputy of Technical & Quality Assurance

Deputy of Research &

Development

Technical Department

Quality Assurance Department

Blood Donors Education & Recruitment Department

Occupational Safety & Health Department

Department of Research

Department of Education

Research Center

Director of Renovation & Administrative Improvement

Department of Administrative Affairs

Department of Financial Affairs

Department of Supply, Maintenance & Services for Medical Equipments

Provincial Blood Centers

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The Iranian Blood Transfusion Organization

Total number of Blood Centers/ Blood Donation Centers

288

Blood Donation Centers206

Blood Collection & Preparation Centers17

Blood Centers65

Provincial Centers 30 Regional & Educational Centers 9

Blood donation center: Responsible for the collection of blood and associated activities for donor recruitment and recall, assessment of donor suitability and donor care.Blood Collection & Preparation Centers: Responsible for recruitment, blood collection, processing, storage & distribution.

Blood center: Carries out donor recruitment, blood collection (whole blood and in some cases, apheresis), testing for transfusion- transmissible infections and blood groups, processing in to blood components, storage, distribution to other blood centers and hospital blood banks within a defined region, the clinical use of blood and surveillance of adverse transfusion events.

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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

10IBTO Research Center 10

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Whole blood is collected Only in IBTO blood centers

Fixed centers Mobile (Factories, Offices, Universities)

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

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Blood Centers

Arak Isfahan

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Blood Centers

Qom Rasht

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Blood Donation Center

Karaj Zabol

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The Iranian Blood Transfusion Organization

Major equipments and consumables are approved and procurement nationallyExamples: Blood Bags Test Kits Refrigerated Centrifuges ELISA Processors Blood Bank Refrigerators Hemoglobin Color Scale strips

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Blood is provided to hospitals free of chargeNo 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

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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

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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.

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Trend of Blood Donation in Iran (1974-2007)

1735000

12,354

1,183,630

1,448,149

746,868

0

200000

400000

600000

800000

1000000

1200000

1400000

1600000

1800000

2000000

Un

its

21

64

10092

95 95 96 9799

79807777

0

20

40

60

80

100

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

Per

cen

tTrend of Transition to 100%

Voluntary Blood Donation in Iran (1996-2007)

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Per capita rate Blood Collection 24/1000 (06- 07) Collection rate age- eligible donors (18+) 36/1000

(05- 06)

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Medical Assessment of whole Blood Donors

Blood containers Blood is collected in to FDA or CE licensed

container (450±10% plus 63 ml CPDA)

Number of Whole Blood collected in 2007Total donation 1735000

Donations fromFamily Replace

ment donors

Paid donor

s

Autologous donors

New donors

Lapsed donors

Regular donors

39%21%40%0.0%0.0%Per request

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Laboratory Testing of Donated Blood

Prevalence of marker of infection in blood donations in 2007

Type of InfectionPercentage

HIV0.004%

HBV0.41%

HCV0.12%

Syphilis0.04%

Malaria0.0%

HTLV0.02%

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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

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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

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0% 20% 40% 60% 80% 100%

افغانستان

قزاقستان

جيبوتي

مصر

اردن

كويت

ازبكستان

قرقيزستان

مراكش

ايران

پاكستان

قطر

عربستان

سودان

سوريه

تونس

اماراتمتحدهعربي

يمن

درصدانواعاهدا

داوطلبانه

جايگزين

پولي

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Each unit of whole blood undergoes a standard battery of tests

Required tests

Blood Grouping testsTotal Units Tested

ABO Grouping100%

RhD Typing100%

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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

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IBTO – Red crescent cooperation in blood donor

recruitment

0

10000

20000

30000

40000

50000

60000

70000

1385 1386

RCS donors

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1200000

1300000

1400000

1500000

1600000

1700000

1800000

2000 2001 2002 2003 2004 2005 2006 2007

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Demographic characteristics of Blood Donors 2006 Gender

Total Whole Blood Donors

Women; 8.1

Men; 91.9

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Demographic characteristics of Blood Donors 2006

Age

41- 50 yrs 18.8

51-60 yrs 7.2

> 60 yrs 0.8

< 20 yrs 7.2

21- 30 yrs36.9

31-40 yrs 29.1

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Demographic characteristics of Blood Donors 2006 Education

High school not completed; 34.7

High School Diploma; 38.7

Higher Education; 2.2

Illiterate; 2.6

Associate Degree; 8.5

B.S Degree; 13.3

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Employment

Unemployed 3

Farmer 1.8

Factory employee 4.8

Civil employee 4.5

Service Personnel 3

Government employee

26.6

High school Student

2.7

Home maker 5.7

Self employed 41.6

College student 6.5

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Marital Status

Marital Status

Unmarried; 28.2

Married; 71.8

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Transmissible Disease TestingTotal Units

Tested

Hepatitis B surface antigen (HBsAg)100%

Hepatitis C antibody (anti-HCV)100%

HIV 1 & 2 antibody-antigen (HIV Ab/Ag)100%

HTLV I, II antibody (anti- HTLV I, II)8%

Syphilis (RPR)100%

Malaria0.5%

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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

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Quality Control of Laboratory Testing

National Internal Controls Central Quality Control Laboratory Blood group serology Positive and Negative controls

Supplemental TestsHIV (Western Blot) or Line Immuno Blot / HIV P24 Ag / HIV-1 Ag

confirmHTLV (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

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changes in process

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

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changes in process

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Extraction-Automation


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Production-Blast Freezer


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On the Road to ISBT 128 Conversion

Internationally recognized Barcode System ISBT128 was replaced the old system. Tracking of specimens, test results and individual components is done by computers using these labels.

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On the Road to ISBT 128 Conversion

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Implementing new software system

IBTO is in the process of implementing the use of a single Organizational Wide Software System “MAK System” in all its blood centers through out the country.

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Tracing Blood Electronically

Recipient Tracing

There is a process of recipient tracing (Look-

Back) in IBTO by making sure that records

(Manual & semi- manual) are carefully

reviewed, in order to identify the patients who

have received seronegative blood from a donor

later found to be infected by blood borne

pathogens.

The Use of a single National Computer Network

System is an effort to make sure that, the

current look back process work more efficiently.

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Cord Blood and other cellular therapies

Establishment of a National Public Cord Blood Bank based on National & International standards and to be

accredited internationally (Net Cord) is in process

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Disaster preparedness

Is promoted by establishing IBTO Disaster Task Force to prepare policies and guidelines on blood needs during disasters.Readiness between IBTO and otherrelevant government organizations at the time of disaster is the aim.

IBTO Research Center1. 2 Iranian Blood Transfusion Organization.

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