Abstract

Regular blood transfusions have been a crucial aspect of the treatment of thalassemia since the 1960s. thalassemic patients are the largest community of lifelong users of donated bloods and between 6000,000-12000,000 transfusions are needed each year for around 500,000 patients with beta thalassemia1. Ensuring the safety and availability of blood and blood components is an essential public health responsibility. Measures to ensure blood safety play a major role in preventing the transmission of HIV, hepatitis B and C viruses and other emerging blood borne pathogens in health care system. The World Health Organization (WHO) supports that providing safe and adequate blood should be an integral part of every country's national health care policy and infrastructure. According to WHO report specific legislation covering the safety and quality of blood transfusion are only implemented in 62% of countries worldwide (of which 81% are high-income countries, 60% are middle-income countries and 44% are low-income countries). Of the 112.5 million blood donations collected globally, approximately half of these are collected in the high-income countries, with 19% of the world's population. There is a marked difference in the level of access to blood between low-and high-income countries. The whole blood donation rate is an indicator for the general availability of blood in a country. The median blood donation rate in high-income countries is 33.1 donations per 1000 people. This compares with 11.7 donations per 1000 people in middle-income countries, and 4.6 donations per 1000 people in low-income countries. 70 countries report collecting fewer than 10 donations per 1000 people. Of these, 38 countries are in WHO's African Region, 6 in the Americas, 6 in the Eastern Mediterranean, 5 in Europe, 6 in South-Eastern Asia and 9 in the Western Pacific. All are low- or middle-income countries. Thus there is a significant difference in the level of access to safe blood between low-and high-income countries, especially considering that up to 65% of blood transfusions are given to children under five years of age in low-income countries. To safeguard the health of the transfusion recipient, including patients with thalassaemia, blood should be obtain from carefully selected regular voluntary, non-remunerated donors and should be collected, tested processed, stored and distributed, in the context of dedicated, quality assured national blood transfusion centers. Blood screening should be performed according to the quality system requirements. According to WHO report16 countries are not able to screen all donated blood for 1 or more of the above infections 2. WHO recommends that all blood donations should be screened for transfusion transmitted infections prior to use. Irregular supply of test kits is one of the most commonly reported barriers to screening. Haemovigilance is required to identify and prevent occurrence or recurrence of transfusion related adverse effect, to increase the safety, efficacy and efficiency of blood transfusion. in this review we discuss some aspects of blood safety from vein to vein with focus on information provided from countries in the region.