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17 - Quality in the screening of donations for transfusion-transmissible infections

from Section 2 - Selection and testing

Published online by Cambridge University Press:  12 January 2010

John A. J. Barbara
Affiliation:
Visiting Professor in Transfusion Microbiology, University of the West of England, Bristol, UK
Alan D. Kitchen
Affiliation:
Head, National Transfusion Microbiology Reference Laboratory, NHS Blood and Transplant, Colindale, London, UK
John A. J. Barbara
Affiliation:
University of the West of England, Bristol
Fiona A. M. Regan
Affiliation:
HNSBT and Hammersmith Hospitals NHS Trust, London
Marcela Contreras
Affiliation:
University of the West of England, Bristol
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Summary

Introduction

The field of transfusion microbiology has developed rapidly over the last 20 years. However, not only has the field developed in terms of the understanding of the biology and science of the infectious agents, the advent of automated mass screening systems, and the increased general focus on the microbial safety of blood and blood products, but importantly the overall quality – the reliability and effectiveness of screening has improved significantly. This quality improvement has come from a number of sources:

  • The identification of those transmissible infectious agents of most concern for transfusion

  • A more detailed and comprehensive understanding of the biology of transmissible agents

  • The development of sensitive assays for transmissible agents

  • The improvements in assay design, including the inclusion of specific features to monitor the step-by-step performance of the assay

  • The introduction of quality management systems into blood transfusion services (BTSs)

  • The development of appropriate automation

  • The introduction of licensing/accreditation of BTSs

  • The introduction of haemovigilance systems.

Overall, it is the amalgamation of the above elements into a single seamless system that has resulted in the current overall high level of safety of the blood supply in most countries with developed health care systems. Nonetheless, it must be understood that these systems are not always as robust as one would wish, and vigilance is necessary to ensure that quality standards are maintained. In addition, the potential threat of new, as yet unidentified, agents must not be forgotten.

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Chapter
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Publisher: Cambridge University Press
Print publication year: 2008

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References

Barbara, J., Ramskill, S., Perry, K., et al. (2006) The National Blood Service (England) approach to evaluation of kits for detecting infectious agents. Transfus Med Rev, 21, 147–58.Google Scholar
Ferguson, M., Pipkin, P. A., Heath, A. B., et al. (1993) Working standards for hepatitis B surface antigen for use in the UK Blood Transfusion Service: results for a collaborative study. Vox Sang., 65 (4), 303–8.CrossRefGoogle ScholarPubMed
Hertzberg, M. S., Mammen, J., McCraw, A., et al. (2006) Achieving and maintaining quality in the laboratory. Haemophilia, 12 (Suppl. 3), 61–7.CrossRefGoogle ScholarPubMed
HPA EQAS (available at: http://www.hpa.org.uk/cfi/quality/default.htm).
Newham, J. and Kitchen, A. D. (2006) Lot release of microbiology blood screening kits and HCV NAT in the English National Blood Service. Vox Sang, 91 (S3), 6 (Abs).Google Scholar
NSRL Quality Assurance Programme (available at: http://www.nrl.gov.au/dir185/nrl-pub.nsf/Structure/QualityAssuranceProgramme-JSOL-44Q9HG).

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