WELCOME TO OUR FIRST LIFE BLOOD E-ZINE, DEVELOPED TO ENHANCE INFORMATION SHARING


WPBTS is proud of the excellent clinical relationships that have been formed and maintained with clinicians throughout the Western Cape. Some important results of these open lines of communication are: early, and relevant reporting of transfusion reactions/incidents, advice on selecting the correct products for the correct clinical indications, assistance with unusual transfusion - related clinical scenarios, continuing additions of new products and services to the existing array, and sustained growth of our Autologus/Designated blood donation service.

We believe that the addition of this e-zine will enhance information sharing, and we intend to keep clinicians informed of any current issues and news through this medium.The e-zine will be distributed quarterly, but in order to provide continuity we will shortly be introducing a website. If there are any particular subjects where coverage is required, please do not hesitate to contact Dr Greg Bellairs - Medical Officer on 021 507 6317 or Warwick Currie - Marketing Officer on 021 507 6326, or email marketing@wpbts.org.za .
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NAT TESTING

WP Blood Transfusion Service (WPBTS) is implementing NAT (Nucleic Acid Testing) during October 2005.

These tests, based on DNA/RNA technology, allow us to detect very small quantities of viral and genetic materials. Through the use of appropriate probes, the genetic material is detected, amplified and then picked up by the tests. This technology will effectively minimise the window period of average HIV infection to 8-11 days, enabling the laboratory to pick up earlier cases of HIV infection. Currently the average window period is about 2-4 weeks.

These new tests form part of the risk management procedure being followed by the blood services in trying to ensure a safe and sustainable blood supply. Even though the blood services are implementing the most sensitive tests available, no test can presently effectively "close" the window period of HIV infection. Donors are still urged to be honest in answering questions on their donor questionnaires. Ensuring a safe blood supply is a responsibility that must be shared by the entire community.

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LEUCOCYTE DEPLETION OF BLOOD COMPONENTS


POLICY RECOMMENDATION OF BLOOD TRANSFUSION SERVICES OF SOUTH AFRICA

Leucocytes in blood components are responsible for a number of adverse effects associated with blood transfusion. The pathogenesis has not been precisely elucidated in many instances but it is likely that it is immunologically mediated. Potential mechanisms include clonal deletion or anergy, induction of suppressor cells, production of anti-idiotypic antibody, suppression of NK cell activity and several others.1 As a consequence a number clinicians prefer to use leucocyte depleted components.

The clinical indications advanced for depleting blood components of leucocytes (leucodepletion) are as follows:

• Avoidance of febrile - non haemolytic transfusion reactions (FNHTR's)
• Reduction in incidence of refractoriness to platelet transfusions (as a result of HLA alloimmunisation)
• Prevention of cytomegalovirus (CMV) infection by blood components
• Reduction in incidence of post operative infections
• Reduction in incidence of cancer recurrence (specifically colo-rectal cancer)
• Reduction in post-operative mortality
• Avoidance of reactivation of viral infections such as HIV and CMV
• Avoidance of sensitisation to transplantation antigens
• Avoidance of prion transmission [i.e. avoidance of agent for variant Creutzfeldt-Jakob disease (vCJD)]

Accordingly, filters capable of reducing leucocytes by several orders of magnitude have been developed and can effectively reduce the number of white cells in, for example, a red cell concentrate to < 1x106 . A less efficient but much more economical process for depleting components of leucocytes involves removing the buffy coat from red cell components. The buffy coat refers to the ±0.5cm layer that sits on top of the red cells following centrifugation of the donated blood unit and consists largely of young red cells (reticulocytes), platelets and leucocytes.

The removed buffy coats can be pooled, admixed with plasma and, by means of differential centrifugation, used for the preparation of platelet concentrates. This ultimately results in red cell concentrates with residual leucocytes intermediate in number between leucocyte depleted components and those with the buffy coat retained. Buffy coat derived platelet concentrates have also been shown to have fewer leucocytes than other technologies using platelet rich plasma as starting material. It is important to note that single donor platelet concentrates collected by apheresis are leucocyte depleted as part of the process of collection...
read further click here

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DONOR FACTS

Donors are eligible to donate blood if they are: in good health, weigh at least 50kg, 17 years of age or older. At every donation each donor is required to fill in a questionnaire, to ensure firstly that it is safe for the donor to donate blood without compromising his/her health, and secondly, to ensure that the donor's blood is as safe as possible for the recipient.

Haemoglobin screening is performed using the droplet/copper sulphate method, with the cut-off for safe donation being set at 12.5g/dl. A Haemoglobinometer is used for marginal results, and a confirmatory FBC may also be taken.

For further information of the importance to safe blood donation, click here

The transfusion guidelines issued by the UK Blood Transfusion Service may be freely accessed, click here and contain recommended deferral periods for donors who may either have medical conditions, or risk behaviour that precludes them from donating.
WPBTS and SANBS (SA National Blood Service) deferral criteria are similar.
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CLINICIAN SURVEY

In June of this year a clinical survey was conducted to determine the levels of service delivery to our major users. The key elements to emerge from the research were the following :

1. Issues regarding quality, clinical advice, labelling and safety of blood and blood products are being met to the satisfaction of those surveyed.

2. There was a general lack of knowledge with regard to the cost of blood and blood products.

3. There was adequate access to blood related information in both print and via personal interaction with the service. The one area of concern being that of access to information in electronic format.

The outcome of the above being the creation of the WPBTS e-zine. This new electronic publication will highlight and cover issues of interest to both the local as well as international blood transfusion community. To further enhance the flow of information between the service and our users a new website is under construction specifically focussed on clinical issues related to blood and blood products.

A copy of the latest price lists is available on our existing website :
http://www.wpblood.org.za/prices.html

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Use of Emergency Blood

The WPBTS has 77 emergency banks scattered throughout the Western Cape and parts of the Northern Cape. These Emergency Banks are stocked with group O Rh Positive and Group O Rh Negative blood which is replenished approximately every 3 weeks, or as the need arises. Due to the shortages of Group O Rh Negative blood, clinicians making use of emergency blood are reminded of the following:

When a patient requires an urgent transfusion and there is no time for submitting a blood sample to the nearest blood bank for crossmatched blood, emergency blood should be used as follows;

Where the patients' Rh status is known, use the same Rh type as the patient. Use the patients' previous records (e.g. antenatal results, previous crossmatch results) to obtain the patients' Rh.

Where the patients' Rh is unknown, perform the Rh quick test with the reagents provided in the ebank fridge (all hospital staff dealing regularly with emergency blood have been trained by WPBTS on the Rh quick test). Once the Rh is established, use the same Rh as the patient i.e. if the patient is Rh Positive and there is Rh Positive blood available, Rh Negative blood should not be given.

In dire emergencies where no Group O Rh Negative blood is available, Rh Positive blood can be given to males and females outside of child-bearing age. Contact the nearest Blood Bank with regard to the administration of RhoGam.

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NAT TESTING
WP Blood Transfusion Service (WPBTS) is implementing NAT (Nucleic Acid Testing) during October 2005.
read more >

LEUCOCYTE DEPLETION OF BLOOD COMPONENTS - Policy Recommendation of Blood Transfusion Services of South Africa
read more >

DONOR FACTS
Donors are eligible to donate blood if they are: in good health, weigh at least 50kg, 17 years of age or older...
read more >

CLINICIAN SURVEY
In June of this year a clinical survey was conducted to determine the levels of service delivery to our major users..
read more >

Use of Emergency Blood
The WPBTS has 77 emergency banks scattered throughout the Western Cape and parts of the Northern Cape...
read more >