Development of blood transfusion external quality assessment program at national scale
Keywords:
blood group, blood transfusion, quality control, red blood cell.Abstract
Introduction: External quality assessment is a crucial component in ensuring the quality of blood transfusion testing laboratories.Objectives: To develop a procedure for generating external quality assessment items for blood transfusion testing to evaluate participants' performance.
Methods: Experimental research was conducted at Quality Control Center for Medical laboratory- University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam. Three items, including red blood cell, serum, and atypical antibody serum samples, were assessed for homogeneity and stability; 5 assessment areas, including ABO grouping, Rh grouping, compatible cross matches, Coombs test, and screening of atypical antibodies, were utilized to evaluate the performance of 38 participants in the 2020-2021 period.
Results: Red blood cell and serum samples maintained quality for a specific period at controlled temperatures, while serum samples with atypical antibodies showed stability at different temperatures. The participants demonstrated high satisfactory performance in ABO grouping, Rh grouping, Coombs test, and screening for atypical antibodies. However, the most unsatisfactory performance was reported in crossmatching, with 15% of participants unsatisfactory results.
Conclusion: The procedure of production of proficiency testing items has been successfully developed, and its application at the national level is suggested to improve the quality of blood transfusion laboratories.
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References
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16. Xu GP, Wu LF, Li JJ, Gao Q, Zhi-Dong OL, Qiong-Hua K, et al. Performance Assessment of Internal Quality Control (IQC) Products in Blood Transfusion Compatibility Testing in China. PLoS One. 2015;10(10):e0141145. DOI: 10.1371/journal.pone.0141145
2. Yoshida T, Prudent M, D'alessandro A. Red blood cell storage lesion: causes and potential clinical consequences. Blood Transfus. 2019;17(1):27-52. DOI: 10.2450/2019.0217-18
3. Basavarajegowda A, Shastry S. Pretransfusion Testing. Treasure Island (FL): StatPearls Publishing; 2023. [access: 18/02/2023]. Available at: https://www.ncbi.nlm.nih.gov/books/NBK585033/
4. Yu Y, Ma C, Feng Q. Establishment and performance assessment of preparation technology of internal quality control products for blood transfusion compatibility testing. Exp Ther Med. 2013; 5(5):1466-70. DOI: 10.3892/etm.2013.994
5. WHO. Overview of External Quality Assessment (EQA); 2009 [access: 07/06/2022]. Available at: https://cdn.who.int/media/docs/default-source/essential-medicines/norms-and-standards/10-b-eqa-contents.pdf?sfvrsn=181d9a32_4&download=true
6. Johnson P., Cabuang L. Proficiency testing and ring trials. Rev. Sci. Tech. 2021;40:189-203. DOI: 10.20506/rst.40.1.3217
7. WHO. External quality assessment of transfusion laboratory practice. Guidelines on establishing an EQA scheme in blood group serology. Blood Transfusion Safety. Geneva; 2004 [access: 25/12/2022]. Available at: https://www.who.int/publications/i/item/9241591250
8. WHO. WHO manual for organizing a national external quality assessment programme for health laboratories and other testing sites. Geneva: WHO; 2016. [access: 04/12/2021]. Available at: https://apps.who.int/iris/handle/10665/250117
9. International Organization for Standardization. ISO/IEC17043:2023. Conformity -General Requirements for Proficiency Testing. The International Organization for Standardization; Geneva. Switzerland: ISO; 2023. [access: 18/02/2023]. Available at: https://www.iso.org/standard/80864.html
10. International Organization for Standardization. ISO Guide 13528. Statistical methods for use in proficiency testing by interlaboratory comparisons. Geneva: ISO; 2022. [access: 20/12/2022]. Available in: https://www.iso.org/obp/ui/#iso:std:iso:13528:ed-3:v1:en
11. WHO. Reference materials - General and statistical principles for certification. ISO Guide 35. Geneva; WHO; 2017. [access: 04/12/2021]. Available at: https://www.iso.org/standard/60281.html
12. Khawar H, Kelley W, Stevens JB. Fresh Frozen Plasma (FFP). Treasure Island (FL): StatPearls Publishing; 2023. [access: 04/03/2023]. Available at: https://www.ncbi.nlm.nih.gov/books/NBK513347/
13. Basu D, Kulkarni R. Overview of blood components and their preparation. Indian J Anaesth. 2014; 58(5):529-537. DOI:10.4103/0019-5049.144647
14. Brar RK, Shaiji PS, Sehgal S. Testing for weak D Antigen: Spectrum and its applied role in rhesus-negative transfusions in Andaman and Nicobar Islands. 2019;32(2):167-170. DOI: 10.4103/tcmj.tcmj_222_18
15. Bhattacharya P, Samanta E, Afroza N, Archana N, Biswas R. An approach to incompatible cross-matched red cells: Our experience in a major regional blood transfusion center at Kolkata, Eastern India. Asian journal of transfusion science. 2018; 12(1):51-6. DOI: 10.4103/ajts.AJTS_157_16
16. Xu GP, Wu LF, Li JJ, Gao Q, Zhi-Dong OL, Qiong-Hua K, et al. Performance Assessment of Internal Quality Control (IQC) Products in Blood Transfusion Compatibility Testing in China. PLoS One. 2015;10(10):e0141145. DOI: 10.1371/journal.pone.0141145
Published
2023-12-15
How to Cite
1.
Le CV, Tran NN, Nguyen VTK, Bui NLT, Do TTT, Huynh PTD. Development of blood transfusion external quality assessment program at national scale. Rev Cubana Med Milit [Internet]. 2023 Dec. 15 [cited 2025 Apr. 19];52(4):e02303101. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/3101
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