Haematologia 14. (1981)
1981 / 1. szám - Hollán, S. R.: Editorial. Training of blood transfusion teams
4 S. R. Hollón: Training of blood transfusion teams The first three tasks are universally accepted but the two latter ones have not been included into the basic tasks of many Centres. In contrast, in my opinion training and teaching as well as an active research programme are essential features of an efficient blood transfusion service. Fundamental research is to contribute information to the fields of science related to blood and is a sine qua non for the development of new techniques in processing blood and blood derivatives and for the scientific evaluation of the results of routine tests. The first basic task of a BTS is aimed at producing adequate amounts of safe and effective blood components and plasma products. A regional centre has to provide whole blood, blood components and plasma fractions of guaranteed biological activity for the whole area to be supplied. The staff has to be aware of the fact that the quality of the final product depends upon the quality and the handling of the source material throughout processing. As a consequence, the productive, diagnostic and safety aspects of a BTS are not separated but integrated elements. What is the optimum basic training for the director of a BTS? I hold the opinion that the director should be preferably a physician, trained in the laboratory and clinical aspects of haematology, immunology and blood transfusion. Advances in these fields of biomedicine have progressed so rapidly that most physicians and surgeons find it difficult to keep up with the changes in basic concepts which underlie the everyday practice of blood transfusion. However, they will only consult the blood bank physician if he is known to have a good scientific reputation and to be well versed in clinical problems. In setting up a National Blood Programme the director of the BTC has to make calculations of the amount of blood and blood derivatives needed. He has to organize the blood collection and distribution. The optimum size of a donor panel comprises seven donors per one emergency bed and the recruitment of around 2 to 5 % of the population as regular donors. In Hungary 5.8% of the population are regular voluntary blood donors. It is also indispensable to have a panel of donors with rare blood group and a panel of donors with high levels of specific antibodies. When planning the size of the blood donor panel the need for different components has to be approximated. In planning the size of the plasmapheresis and platelet-paheresis panels, the need for plasma for specific plasma proteins and for platelet concentrates has to be calculated. Granulocyte donors are recruited most frequently from family members of the recipient. In many countries, especially in developing countries, there is a deficiency in whole blood and blood derivatives. But even in countries with highly developed BTS, the amount of blood and plasma collected, has to be increased year by year. New methods have arisen which consume blood voraciously. Let me list some of these fairly new fields of indication. Coronary bypass surgery alone may raise by 26% the need for whole blood. Emergency direct coronary arterial revascularization, infarctectomy, aneurysmectomy, repair of ruptured ventricular septum, liver surgery, surgery of cerebral ischaemia, as well as major surgery in traumatology