1. Blood transfusion 1. Bloodtransfusion in the Netherlands and in the LUMC 2. Haemovigilance 3. Quality indicators 4. Blood transfusion research in Leiden

4. Blood in the Netherlands 500.000 donors SanquinProducts/com ponents distribution via 4 blood establishments 750.000 components Hospital bloodbanks Central facilityproductsapotheek 1.000.000 donations

5. Blood components Component*PriceNumber erythrocytes≥ € 200600.000 Platelets≥ € 500 60.000 Plasma € 175100.000 *NB about 100 products

6. Blood transfusion in the LUMC -Dept of IHB : B of Bloodtransfusion - Section Blood Transfusion - patient care : BTD* - resesearch * Blood Transfusion Dienst ( Service)

7. Personel Blood Transfusion Service 2009 FunctieFTEORD Administratief medewerker0.33 Analist14.7314.04 Arts assistent Hemovigilantiemedewerker0.25 Hoofdanalist1.00 ICT1.39 Klinisch chemicus Kwaliteitsmedewerker1.00 Medisch specialist0.65 Hoogleraar sectiehoofd1.00 Secretaresse0.00 Senioranalist1.841.21 Totaal FTE22.1915.25

8. Finances Blood Transfusion Service IHB

9. Haemovigilance in the hospital • to transfuse or not to transfuse? • and if so: the right product to the right patient.

10. Why Haemovigilance? • to improve the quality of - bloodproducts - transfusion medicine • to inform and educate the society

11. Transfusion safety > component safety

12. Dutch blood components are very safe The risk of transfusion-transmitted infection is nearer to that of being struck by lightening than by being struck by a motor vehicle. HBV2 : 1.000.000 HCV2 : 10.000.000 HIV1 : 10.000.000

13. Hepatitis C virus RNA test • introduced in UK in 1999 to detect infection missed by routine hepatitis C virus screening • had detected one additional positive sample per 1.4 million donations tested, at a cost of £ 8.3 million per detection • a suggested cost of £ 7.9 million per quality of life year gained is therefore almost certainly an underestimate (McLelland and Contreras '05)

14. Risks of blood transfusion