1. BLOOD TRANSFUSION IN TURKEY

2. SHORT HISTORY 1921: Prof. Dr. Burhanettin TOKER gave a start to Transfusion works in TURKEY 1938 : First transfusion in Cerrahpasa Medical Faculty 1940 – 1945 : Some university and hospitals constitude small blood donation units. 1952 : Cerrahpasa Medical Faculty separated blood plasma 1953 : “Turkish Red Crescent Blood Assist Organization” consituted 1954 : TRC send medical doctors to England and USA for Blood Transfusion Education 1957 : In ankara and Istanbul TRC Blood Banks constructed and opened 1959 : Bursa and Samsun TRC Blood Banks constructed 1967 : TRC Ankara Plasma Fractination Laboratory constructed 2

3. SHORT HISTORY 1974 : Turkish Red Crescent Blood Donation Organization” constituted 1981 : Plastic blood Bags started to use 1983: Accepted “Law on Blood and Blood Products, No: 2857”, A and B type Blood Stations 1996 : “ Blood Banks and Transfusion Society” constituted 1996 : Anti – HCV accepted as a mandatory screening test in Blood Banking in Turkey 1997 : “Blood donor questioning form” is accepted as a mandotory form in all blood banks in Turkey 2005 : “Safe Blood Project”, MoH – TRC Project on Blood Safety and Safe Blood 2006 : Demonstrade NAT study 2007 : New Law accepted on Blood and Blood Products, No: 5624, OJ No: 26510, 02.05.2007, Regional Blood Centers 3

4. MAIN ORGANİZATIONS The Ministry of Health (MoH) in Turkey is the main authority regulating and auditing the blood and blood products services throughout the country. TRC (Turkish Red Crescent Society) is the primary nongovermental organizsation in the country that has purposes of collecting blood from voluntary, nonremunerated blood donors, process and separate them to components, achieve the mendatory laboratory tests, store and distribute to hospitals. TRC manages Regional Blood Banks in Turkey in close cooperation with the MoH.. BBTST ( Blood Banks and Transfusion Society ) is the primary nongovernmental organisation in the country that has the purposes of producing training materials and related documents, organising courses and publishing books in close cooperation with the MoH. 4

5. “SAFE BLOOD PROJECT” In 2005 MoH and TRC prepared a project named “ Safe blood Project” and put into practice. Some main parts of this project was as follow: 5

6. ORGANIZATION Blood supply system in Turkey has long been a hospital based and decentralized one. Hospital blood banks provide approximately 65 % of the annual blood supply and Turkish Red Crescent blood banks provide only 35%. The blood law before the new one was published in 1983 and the system was composed of blood centers of A and B type In 2007, there were more than 400 hospital based blood banks and 27 TRC Blood Centers in Turkey and a new law needed to estsablish the standards. And while this law prepered EU directives was taken into consideration. The new blood law (Law on Blood and Blood Products, No: 5624, OJ No: 26510, 02.05.2007) published in May 2007 describes a centralized blood supply system with regional blood centers, transfusion centers and donation centers. ORGANİZATION 6

7. ORGANIZATION 2005 : more than 400 Hospitalize based blood banks ( A and B type), 23 TRC Blood Banks (All B Type) 2008: 12 Regional Blood Banks and 42 Blood Donation Center – TRC provide 50% of the annual blood suply – Hospitalize based blood banks are transforming as transfusion centers and stop the donation work. – Goal is to stop donation in hospitals by the reach enough voluntary blood donation number. ORGANİZATION 7

8. DONOR RECRUITMENT Donor Recruitment Department Behaviour Change Project Club 25 Activities: Targeting 18 – 25 years old population Donor Education and Recruitment Programs Refusal Donor Database Voluntary Blood Donor Cards SMS reminds NATIONAL VOLUNTARY DONOR RECRUITMENT PROGRAM 8

9. 9 TRC 2003-2004-2005-2006-2007 BLOOD DONATION NUMBERS 447.836 145.129 592.965 225.349 177.977 176.770 376.060 135.938 127.347 116.797 126.042 342.146 312.708 305.324 502.102 20032004200520062007 MOBILECENTERTOTAL

10. DONOR NUMBER in TRC DONOR DATABASE: 1.208.339 TOTAL DONATION THAT TRC COLLECTED: – 2005 : 342. 146 – 2006: 502.102 – 2007: 592.965 – 2008: 308.000 (First six mounths) Donor numbers that donated more than 1 blood in the years 2006 – 2007 : 134.464 Donor number that donated just 1 time between 2005 – 2007: 554.481 10

11. 2004 20062007 2005 %42 %85 %99 %58 %15 %1 11 2005 Whole Blood usage is 529.607 2007 Whole Blood usage is 256.092

12. 2004 – 2007 BLOOD DONATION, PRODUCTION AND DISTRIBUTE NUMBERS BLOOD DONATION NUMBERS PRODUCTION NUMBERS DISTRIBUTION NUMBERS _ 12

13. YEARDONATİON NUMBER DESTROY NUMBER (Because of approved test pozitive) RATE 2004305.3248.8822,97 % 2005342.1468.6132,54 % 2006502.10211.5282,29 % 2007592.96513.4942,28 % 13 In spite of rasing donation number, the decreasing number of destroy number of bloods because of screening test pozitive is showing the success on measure on safe blood and donor education. Because first time donor rates are stil high in Turkey.

14. NATIONWIDE IT SYSTEM Donor Registry and Monitoring FlebotomyDonor Tests Product Processing Inventory Management Quality Control Patient Registry and Monitoring Transfusion American Association of Blood Banks Standards AABB Guide to the Preparation, Use and Quality Assurance of Blood Components Standards Council of Europe The International Council for Commonality in Blood Banking Automation; International Standards of Blood Transfusion ICCBBA / ISBT 128 Health Level 7 HL7 BLOOD BANK INFORMATION MANAGEMENT SYSTEM 14

15. OTOMASYON VE HEMOVİJİLANS

16. NATIONAL HAEMOVIGILANCE SYSTEM Processes: Feedback from donor recruitment until the end of Tx Purpose: Prevention of adverse events stemming from therapeutic use of blood and blood components Method Standard surveillance system Practice A web-based system which allows for feedback from all units dealing with blood banking processes NATIONAL HAEMOVIGILANCE SYSTEM 16

17. QUALITY MANAGEMENT The new law states that all procedures in the blood transfusion system must follow national and international quality standards that needs to be clarified in detail with a national guideline Quality certificate (TÜV) 40 donation center : ISO 9001:2000 (Jun 2006)  Mittle Anatolia Regional Blood Center acreditation certificate : International acreditation : JCI (July 2007) First acrediated Blood Bank in the world Acreditation for medical laborotory: ISO 15189 (November 2007) QUALITY MAMAGEMENT 17

20. BİYOMEDİKAL BİRİMİ

21. BÖLGESEL KAN MERKEZİ PROJESİ MARMARA REGIONAL BLOOD CENTER İSTANBUL - KARTAL EGE REGIONAL BLOOD CENTER İZMİR - BORNOVA

22. THANK YOU…