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An Analysis of and Recommendations for the Peruvian Blood Collection and Transfusion System
Paul E George1, Julio Vidal2, Patricia J Garcia3
1Division of Infectious Diseases, UCLA David Geffen School of Medicine, Los Angeles, California, USA.
Background:
Peru experienced a crisis in its blood collection and supply system in the mid-2000s, as contaminated blood led to several transfusion-transmitted infections (TTI), occurring in the backdrop of extremely low voluntary donation rates and a national blood supply shortage. Thus, the Peruvian Ministry of Health (MINSA) implemented a national investigation on the safety and quality of the Peruvian blood collection/transfusion network.
Methods:
Every Peruvian blood bank was evaluated by MINSA from 2007-2008. These evaluations consisted of an update of the national registry of blood banks and visits to each blood bank from MINSA oversight teams. Information was collected on the condition of the blood bank personnel, equipment, supplies, and practices. Further, previously-collected blood at each blood bank was randomly selected and screened for TTI-causing pathogens.
Results:
Uncovered in this investigation was a fragmented, under-equipped, and poorly-staffed blood collection and transfusion network, consisting of 241 independent blood banks and resulting in suboptimal allocation of resources. Further, blood with evidence of TTI-causing pathogens (including Hepatitis B, Hepatitis C, and syphilis) and set for transfusion was discovered at three separate blood banks as part of the random screening process.
Conclusion:
Using the successful reorganizations of national blood supply systems in other Latin American countries as examples, Peru would be well-served to form large, high-volume, regional blood collection and transfusion centers, responsible for blood collection and screening for the entire country. The small, separate blood banks would then be transformed into a network of blood transfusion centers, not responsible for blood collection. This reorganization would allow Peru to better utilize its resources, standardize the blood collection and transfusion process, and increase voluntary donation, resulting in a safer, more abundant national blood product.
Insights
Peru
Area of Science:
- Public Health
- Transfusion Medicine
- Health Systems Management
Background:
- A 2000s crisis in Peru's blood supply involved transfusion-transmitted infections (TTI) due to contaminated blood.
- Extremely low voluntary donation rates and national blood shortages exacerbated the crisis.
Purpose of the Study:
- To investigate the safety and quality of Peru's national blood collection and transfusion network.
- To identify systemic issues contributing to the blood supply crisis.
Main Methods:
- National evaluation of 241 Peruvian blood banks by the Ministry of Health (MINSA) from 2007-2008.
- Assessment of blood bank personnel, equipment, supplies, and practices.
- Random screening of collected blood for TTI-causing pathogens.
Main Results:
- The investigation revealed a fragmented, under-equipped, and poorly-staffed national blood collection system.
- Suboptimal resource allocation was evident across the 241 independent blood banks.
- Screening detected Hepatitis B, Hepatitis C, and syphilis in blood intended for transfusion at multiple sites.
Conclusions:
- Reorganization into large, high-volume regional centers for blood collection and screening is recommended.
- Transforming smaller banks into transfusion-only centers would improve resource utilization and standardization.
- This model, adapted from other Latin American countries, aims to enhance blood product safety and availability.
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