IBTO Research Center

Iranian Blood Transfusion

Organization

History of blood transfusion

in Iran

The first hospital of National Iranian oil company was

established in Masjed Soleiman in 1924 and the blood
transfusion was first carried out in this hospital.
1948: Establishment of the First Private Blood
Transfusion in Iran as Dr. Motamed blood transfusion
center
1949: Publication of the First Notice to Call for Blood
Donation
1950s: Hospitals started to use replacement blood
1952: Establishment of Armys Blood Transfusion Center
1954: Establishment of the First Iran Red Lion and Sun
society (Red Crescent) blood Transfusion Center

History of blood transfusion

in Iran (cont)

1955: Establishment of the First Center for preparation

of Blood Derivatives
1955: Establishment of the First Provincial Blood
Transfusion Center

1962: Establishment of the First Independent Iran Red

Lion and Sun society (Red Crescent) Blood Transfusion
Center.
1974: Establishment of National Blood Transfusion
Organization
1978: Iran Blood Transfusion Organization & Islamic
Revolution
1979:The Blood Transfusion Organization was assigned
to the Ministry of Health and Welfare.
5

History of blood transfusion

in Iran (cont)

1980: Iran Blood Transfusion Organization & Imposing War

Supply of blood and blood products required by the
thousands of wounded soldiers
1984: Introduction of the Organization as the Sole
responsible of the Supplying Blood and Blood Products in
Iran
1974: HBs Ag Screening test
1987: HIV-Ab Screening Test
1997: HCV screening test
2005: Implementing HIV-Ab, HIV-Ag screening test
2006: Development of Iran Blood Transfusion Network
2006: Commencement of technical and software
automation of Iran blood transfusion stations
2007: Achievement the 100% voluntary nonremmunerated
blood donation
6

Ministry of Health & Medical

Education
IBTO's High Council

Managing Director

Department of
Legal Affairs

Department of Public
Relation &
International Affairs

Security Office

Deputy of Management
Expansion &
Improvement

Office of Activity
Evaluation &
Complaints

Deputy of Technical &

Quality Assurance

Managing Director
Office

Deputy of
Research &
Development

Director of Renovation &

Administrative Improvement

Technical Department

Department of Administrative Affairs

Quality Assurance Department

Department of
Education

Department of Financial Affairs

Blood Donors Education &

Recruitment Department

Research
Center

Department of Supply, Maintenance &

Services for Medical Equipments

Department of
Research

Occupational Safety & Health

Department

Provincial Blood Centers

The Iranian Blood Transfusion

Organization
Total number of Blood Centers/ Blood Donation
Centers

Blood Donation Centers

288
206

Blood Collection & Preparation Centers

17

Blood Centers

65

Provincial Centers
30
Regional & Educational Centers 9
Blood donation center: Responsible for the collection of blood and
associated activities for donor recruitment and recall, assessment of donor
suitability and donor care.
Blood Collection & Preparation Centers: Responsible for recruitment,
blood collection, processing, storage & distribution.
Blood center: Carries out donor recruitment, blood collection (whole blood
and in some cases, apheresis), testing for transfusion- transmissible
infections and blood groups, processing in to blood components, storage,
distribution to other blood centers and hospital blood banks within a defined
region, the clinical use of blood and surveillance of adverse transfusion
8
events.

The Iranian Blood Supply

system

Blood centers are nonprofit and governed by

a director appointed
by the IBTOs
Managing Director
Major function is to provide the communitys
blood supply and hospitals within the blood
collection area and hospitals in other areas
as well
Area covered is determined by

Historical factors
An overall plan by Central Technical & QA
Department
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IBTO Research Center

10

10

The Iranian Blood Supply

system

Whole blood is collected

Only in IBTO blood centers

Fixed centers
Mobile (Factories, Offices, Universities)

11

promoting the network of.3

providing blood supply and
transporting system

12

Blood Centers

Arak

Isfahan
13

Blood Centers

Qom

Rasht

14

Blood Donation Center

Karaj

Zabol

15

The Iranian Blood Transfusion

Organization

Major equipments and consumables are

approved and procurement nationally
Examples:

Blood Bags
Test Kits
Refrigerated Centrifuges
ELISA Processors
Blood Bank Refrigerators
Hemoglobin Color Scale strips
16

The Iranian Blood Supply

system

Blood is provided to hospitals free of charge

No charges or fees are requested for the cost of collecting, testing,
processing, storing and shipping the blood
Central Immunohematology Reference Laboratory provides
advance techniques for serological investigations on donors /
patients
Produces home made panel cells to be used by the Blood Centers

17

Regulation, Standardization and

Certification

IBTO constitution adopted in 1974 revised in 1984 is

approved by the I.R of Irans Parliament
The 2nd version of IBTO standards titled Iranian
National Standards for Blood Transfusion was
published in 2005 and went in to effect in Sep. 2005

18

Regulation, Standardization and

Certification

Technical & QA Deputy acts as National

Regulatory Authority
Same Standard Operating Procedures (SOPs)
are in use in all Blood Centers
Establishment of all Blood Centers/ Blood
Donation Centers is required to be approved
by IBTOs Higher Council. Licenses are issued
by Central Technical & QA Department
before any facilities are operative renewed
annually.
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Units

Trend of Blood Donation

in Iran (1974-2007)

20

Percent

Trend of Transition to 100%

Voluntary Blood Donation in Iran
(1996-2007)

21

The Iranian Blood Supply

system

Per capita rate Blood Collection 24/1000 (06- 07)

Collection rate age- eligible donors (18+) 36/1000
(05- 06)

22

Medical Assessment of
whole Blood Donors
Blood containers

Blood is collected in to FDA or CE licensed

container (45010% plus 63 ml CPDA)

Number of Whole Blood collected in 2007

Total donation 1735000
Donations from
New
donors

Lapsed
donors

39%

21%

Family
Replace Paid
Autologo
Regular
ment
donor us donors
donors donors
s
40%

0.0%

0.0%

Per
request

23

Laboratory Testing of
Donated Blood

Prevalence of marker of infection in blood

donations in 2007
Type of Infection

Percentage

HIV

0.004%

HBV

0.41%

HCV

0.12%

Syphilis

0.04%

Malaria

0.0%

HTLV

0.02%
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Education & Research

Deputy of Research and Development is

responsible
for
National
&
International
Educational programs
32 Faculty members of the Research Center
provide teaching and training including basic
scientific research in the field of transfusion
medicine in cooperation with other IBTO scientific
investigators in the country
Blood Centers conduct seminars, and educational/
technical training classes & in-services to provide
updates
and
continuing
education
for
technologists, nurses and physicians involved in
collection, preparation and transfusion of blood
and components
25

Education & Research

An educational program leading to a master

degree is offered by educational department for
7 students holding B.S. degree and 4 phD
annually
Publication and translation of technical &
scientific books & literatures are provided by
Educational department
IBTOs technical & scientific materials in
transfusion services have been provided for
neighboring Persian speaking countries through
collaboration with WHO office in Cairo EMRO
26

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28

Laboratory Testing of
Donated Blood

Each unit of whole blood undergoes a standard

battery of tests

Required tests
Blood Grouping tests

Total Units
Tested

ABO Grouping

100%

RhD Typing

100%

29

Recruitment of Blood Donors

A national recruitment department

Director of recruitment department
leads the related activities
Lectures, media printed/ visual,
community social activities etc.
A system of pre-donation counseling
of blood donors exist

30

IBTO Red crescent

cooperation in blood donor
recruitment

31

The Iranian Blood Supply

system

32

Recruitment of Blood
Donors

Demographic characteristics of Blood Donors

2006

Gender

33

Recruitment of Blood
Donors

Demographic
Donors 2006

characteristics

of

Blood

Age

34

Recruitment of Blood
Donors

Demographic characteristics of Blood Donors

2006
Education

35

Recruitment of Blood
Donors

Demographic characteristics of Blood Donors

2006

Employment

36

Recruitment of Blood
Donors

Demographic characteristics of Blood Donors

2006
Marital Status

37

Laboratory Testing of
Donated Blood
Transmissible Disease Testing

Total Units
Tested

Hepatitis B surface antigen (HBsAg)

100%

Hepatitis C antibody (anti-HCV)

100%

HIV 1 & 2 antibody-antigen (HIV Ab/Ag)

100%

HTLV I, II antibody (anti- HTLV I, II)

8%

Syphilis (RPR)

100%

Malaria

0.5%
38

Quality Control of
Laboratory Testing

External controls

WHO
BBI
Lab Quality Finland
Acro-Metrix The Netherlands, NRL Australia
EQAS collaboration
Run Control Samples (go- no-go samples)
IBTO Central QC laboratory sends samples
to provincial Blood Centers
39

Quality Control of
Laboratory Testing

National Internal Controls

Central Quality Control Laboratory

Blood group serology
Positive and Negative controls

Supplemental Tests
HIV (Western Blot) or Line Immuno Blot / HIV P24 Ag / HIV-1 Ag
confirm

HTLV (Western Blot)

HCV (Riba)
HBsAg (Neutralization)/ (HBcAb)
RPR (FTA- ABS)

There are specific and clear Strategies (Algorithms) set

by Technical and QA department to be used by
laboratories for all screening test results
40

changes in process

Total
Laboratory
Automation
has
been
implemented in regional IBTO Blood Center in order
to centralize the testing of the donated blood.

41

changes in process

42

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44

45

46

47

Extraction-Automation

IBTO Research Center

48

48

Production-Blast Freezer

IBTO Research Center

49

49

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On the Road to ISBT 128

Conversion

Internationally
recognized Barcode
System
ISBT128
was replaced the old
system. Tracking of
specimens,
test
results
and
individual
components is done
by computers using
these labels.
53

On the Road to ISBT 128

Conversion

54

Implementing new software

system

IBTO is in the process of implementing the use of a single

Organizational Wide Software System MAK
System in all its blood centers through out the country.

55

Tracing Blood
Electronically
Recipient Tracing
There is a process of recipient tracing (LookBack) in IBTO by making sure that records
(Manual & semi- manual) are carefully reviewed,
in order to identify the patients who have
received seronegative blood from a donor later
found to be infected by blood borne pathogens.
The Use of a single National Computer Network
System is an effort to make sure that, the
current look back process work more efficiently.

56

Cord Blood and other cellular therapies

Establishment of a National Public Cord Blood Bank
based on National & International standards and to be
accredited internationally (Net Cord) is in process

57

Disaster preparedness
Is promoted by establishing IBTO
Disaster Task Force to prepare policies
and guidelines on blood needs during
disasters.
Readiness between IBTO and other
relevant government organizations
at the time of disaster is the aim.

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