(P-PH-3) Blood Safety Index: A Glidepath to Improve Blood Safety in Low and Middle-Income Countries

Background/Case Studies: The AABB Global Transfusion Forum Policies, Practices and Implementation (GTF PPI) committee is tasked with finding practical solutions for blood centers in resource limited settings. The GTF PPI determined that data on current blood shortages, practices, and operational procedures could help establish a baseline from which to improve the level of safety, which we named the Blood Safety Index (BSI). One of the lessons learned from US military experiences in the last 20 years is the lack of standardized safety data on allied military and host nation blood systems. When US personnel were transfused with non-FDA approved blood products, patients were followed-up for two years to test for transfusion-transmission of infectious agents which resulted in significant administrative, logistical, and financial burden. The GTF PPI committee determined that this blood safety index could be useful understanding interoperability among countries and to identify opportunities where limited resources would have the greatest impact to improve the safety of a nation/region’s blood supply.

Study

Design/Methods: The GTF PPI established a database from open-source information on global, national and regional blood suppliers to determine a baseline from High, Medium, and Low Income countries. Data was obtained from already published sources including the WHO, national blood reports, published papers and first-hand knowledge from international and regional experts in the field. Twenty-one indices were identified to aid in the evaluation of the level of safety of the blood supply. Ethiopia was used as an LMIC test case to evaluate the effectiveness of this planning tool.

Results/Findings: The US Armed Services Blood Program evaluated several high-income blood systems including the United States, France, Canada, South Korea, and Poland. These blood systems were found to be substantially equivalent. The US military uses a BSI to help establish interoperability between nations areas of military operations and disaster response. Efforts to coordinate assistance in LMIC among different organizations are ongoing with the African Society of Blood Transfusion and the International Society of Blood Transfusion to complement and to mutually support those most in need.

Conclusions: As a transfusion community, it is our responsibility to provide a safe and adequate blood supply. Given the limited financial resources available, the GTF PPI can make a significant impact on improving the blood supply with the implementation of a BSI. The GTF PPI believe the BSI could be a valuable tool in determining where and how to improve the availability and safety of blood within a resourced constrained community. Continued development, refinement and reevaluation of the BSI will assist in the execution of the working group to ensure a safer available blood supply.