Welcome to June-July Med e-News for 2009.

We invite you to participate in a survey about how you access information from Transfusion Medicine Services at ARCBS.  It's just a quick pointer, to help us with planning our communication and educational activities for health professionals.

The survey should only take about five minutes and can be accessed via this link.

If this e-newsletter has been passed on to you and you would like to sign up to receive Med e-News, please email lreid@arcbs.redcross.org.au.  If you have any further feedback or ideas as a result of the survey, feel free to send them to the same address.

ARCBS is continuing to closely monitor the national and international developments with respect to the 2009 influenza A (H1N1) pandemic and responding accordingly.

During the very early stages of the influenza outbreak, ARCBS took the precaution of deferring potential blood donors who had returned from Mexico from donating blood for a period of two weeks from the day they left Mexico in order to cover the incubation period of the disease. The precaution stemmed from the outbreak of  2009 influenza A (H1N1) in Mexico, the high mortality rate in that country and the World Health Organisation’s declaration that it is a public health event of international significance.

This deferral was subsequently lifted on 11 June following further information becoming available about the outbreak in Mexico, which indicates that it is not as severe as previously thought and therefore travel to Mexico posed no greater risk than travel to any other country with cases of 2009 influenza A (H1N1). Additionally, the increasing number of cases of the influenza in Australia meant that a deferral for overseas travel to countries recording 2009 influenza A (H1N1) cases would no longer provide a measurable increase in the safety of the blood supply.

Whilst there are a growing number of confirmed cases of 2009 influenza A (H1N1) in the majority of states around Australia, ARCBS procedures are designed to minimise the potential risk of transfusion-transmission influenza, including the following:-

• Donors with influenza-like symptoms are always deferred.
• The donor questionnaire and interview process are designed to exclude those donors who are not feeling well at the time of donation.
• All donors are advised to contact ARCBS should they feel unwell after donation so that their blood components can be withdrawn before use.

This year, for the first time ever, Australia played host to World Blood Donor Day. Donors, recipients, international colleagues, local health professionals and ARCBS staff turned out in force to the official launch at Federation Square in Melbourne on Sunday 14 June.

Australian Red Cross Blood Service Chairman, The Honourable Dr David Hamill AM, and Chief Executive Officer, Jennifer Williams, were joined on stage by the Health Minister, Nicola Roxon. Delegates from around the globe were in attendance, including the host country for World Blood Donor Day 2010, Spain.

One of the strong messages on the day was that 1-in-3 people will need blood, yet only 1-in-30 give blood. Red mannequins were positioned on every third seat in the auditorium, representing the proportion of the population who will need blood at some point in their life.

New TV and radio advertisements featuring blood donors and recipients were unveiled before the Health Minister and guests. The formal proceedings were followed by a public screening of a documentary ‘Australian Stories in the Year of the Blood Donor’ and a donor-inspired art installation.

World Blood Donor Day was founded in 2004 to mark the birth date of Dr Karl Landsteiner – the Nobel Prize winning founder of ABO blood typing.

World Blood Donor Day is a partnership between the World Health Organisation, the International Federation of Blood Donor Organisations, the International Society of Blood Transfusion and the International Federation of Red Cross and Red Crescent Societies.

Eighty countries around the world are involved in World Blood Donor Day.
 

A recent paper by Dorsey et al (1) entitled Lack of evidence of transfusion transmission of Creutzfeldt-Jakob disease in a US surveillance study published in Transfusion reported on the progress of a large, ongoing lookback study being undertaken in the UK.

Follow-up was conducted of 436 recipients of blood components from 36 blood donors who subsequently developed the classical or non-variant form of Creutzfeldt-Jakob disease (CJD). The current results show no evidence of transfusion transmission of classical CJD.

The authors noted that the results of the study to date reinforce the conclusion that the risk, if any, of transfusion transmission of prion disease by classical CJD donors is significantly lower than the comparable risk of such transmission by variant Creutzfeldt-Jakob disease (vCJD) donors.

ARCBS will continue to permanently defer donors with classical CJD and their relatives as it can be genetically transmitted and is a universally fatal disease. Classical CJD can be transmitted by pituitary hormone injections, neurosurgical instruments and corneal and dura mater transplants even though there have been no reported transmissions by transfusion to date.
 

Reference
1. Dorsey et al. Lack of evidence of transfusion transmission of Creutzfeldt-Jakob disease in a US surveillance study. Transfusion 2009; 49: 977-984.
 

ARCBS is committed to improving the service we deliver. Our annual Customer Satisfaction Survey is a valuable tool in assisting us to better understand our customers’ priorities with respect to the service that we provide, allowing us to focus the direction and priority of our service improvement activities.

The Customer Satisfaction Survey conducted in 2008 showed that:

The areas of greatest importance are:

• Safety of blood components and plasma-derived products
• Overall quality of blood components and plasma-derived products
• Ability to meet order requirements
• Service delivery
• Accuracy of orders

The areas of greatest satisfaction are:

• Overall quality of blood components and plasma-derived products
• Safety of blood components and plasma-derived products
• Quality of ARCBS clinical advice

The areas of least satisfaction are:

• Customer involvement in ARCBS decision making
• Time taken from placing emergency orders to delivery
• Time taken from placing routine order to delivery

The feedback received from the survey has confirmed that we are focusing our improvement efforts on areas that are of greatest importance to our customers. Through our program to ‘Reengineer our Supply and Service’ (RoSS) we are working on a suite of initiatives that will enable the Blood Service to deliver service excellence through customer engagement, empowered staff and innovative business processes. You will receive more information about RoSS initiatives as they progress.

The results of the 2008 Customer Satisfaction Survey have also been analysed at a state level and the detailed data is available from the local ARCBS Transfusion Medicine Services Teams.

The 2009 ARCBS Customer Satisfaction Survey will be released in the next couple of months. Please continue to tell us how we can improve.
 

Callum et al. Cryoprecipitate: The current state of knowledge. Transfusion Medicine Reviews 2009; 23(3): 177-188.

Vamvakis and Blajchman. Transfusion-related mortality: the ongoing risks of allogeneic blood transfusion and the available strategies for their prevention. Blood 2009; 113: 3406-3417.

Shanwell et al. Post-transfusion mortality among recipients of ABO-compatible but non-identical plasma. Vox Sanguinis 2009; 96, 316–323.

G Andreu. Transfusion-associated circulatory overload and transfusion-related acute lung injury: diagnosis, pathophysiology, management and prevention. ISBT Science Series 2009; 4: 63-71.
 

Updated Residual Risk Estimates for Viral Transfusion-Transmitted Infection

ARCBS updates its residual risk estimates for viral transfusion-transmitted infections on an annual basis and has recently released updated figures for 2009. The updated figures are now available on the ARCBS clinical website.

A series of frequently asked questions and answers about the residual risk estimates are also available on the site. These have been developed to provide health professionals with a better understanding of how the ARCBS residual risk estimates are calculated and the rationale for using these calculations.
 

22nd Congress of the International Society on Thrombosis & Haemostasis
11 - 16 July, Boston, USA

HSANZ ANZSBT ASTH Scientific Meeting
18 - 21 October, Adelaide, Australia

AABB Annual Meeting
24 - 27 October, New Orleans, USA

20th Regional Congress of ISBT (Asia)
14 - 18 November, Nagoya, Japan

American Society of Hematology
5 - 8 December, New Orleans, USA