RESUMO
A comprehensive guide to the principles and procedures involved in establishing or reorganizing a national blood transfusion service in developing countries. Focusedon organizational principles rather than technical details, the book responds to both the growing clinical need for safe and effective blood products and the many problems inherent in the organization of a transfusion service. Guidelines and advice draw upon several clear examples of successes and failures taken from international experiences in the difficult process of establishing a new transfusion service. The objective is to provide information to decision-makers and planners on how to develop a correctly organized scheme of management, select equipment, establish standard procedures, and train staff so as to provide an adequate supply of blood and blood products which are as safe as possible and accessible at reasonable cost. To this end, cost-saving options are presented together with clear indications of areas where expense is inevitable and no short-cuts are possible. The book has nine chapters. The first introduces the main functions, responsibilities, and organizational options of a national transfusion service. Information includes a discussion of the importance of following a policy of voluntary blood donation, an outline of the strengths and weaknesses of different systems for organizing a transfusion service, and advice on how to calculate the staff needs and operating costs of a service. Readers are reminded that a blood transfusion service is an expensive and complex organization, that careful design and management are essential, and that a scheme for meeting recurrent costs needs to be in place. Subsequent chapters outline the guiding principles for planning a donor recruitment programme and discuss the procedures to be followed during blood collection. Details range from the simple observation that a U-shaped arrangement of donation beds increases staff efficiency to a series of 15 questions that can help ensure the safety of both donors and recipients. Of particular value is a chapter devoted to the screening of blood for hepatitis, AIDS, syphilis and yaws, malaria, Chagas disease, cytomegalovirus, and other transmissible diseases. Other chapters outline the organizational procedures that should guide the production of laboratory reagents at the national or regional level, the selection of methods for blood-grouping and compatibility testing, and the acquisition of basic equipment and consumables, moving from refrigerators and centrifuges to pipettes and marking pens. The book concludes with guidelines for quality assurance and biosafety, followed by an outline of clinical indications for the use of whole blood, red cells, plasma, platelets, cryoprecipitate, factor VIII concentrate, factor IX complex, albumin, and immunoglobulins
