Transfusion Blood Supply Latin America and Caribbean (2020)

Highlights

• In Latin America and the Caribbean, more than 8.2 million units of blood have been collected, showing a decrease of about 20% compared to 2017, when 36 countries reported.
• Out of the 8.2 million donations, 48% come from voluntary donors, which represents an increase of 2% compared to 2017.
• Four countries collect almost 74% of the total blood collected in the region, and 30 countries the remaining units.
• 14 countries exceeded the regional average (48%) of voluntary donations, and nine countries didn't reach 10% of voluntary donations
• Ten countries reported a total of 1,558,637 transfused patients.

Governance mechanisms

• The provision and access to safe blood for transfusions are closely related to the organization and degree of development of blood services, governance, and the participation of society through voluntary unpaid donation.
• The aspects of governance with better progress in the countries are the regulations of donation (84.85%) and operation (84.85%), licensing and authorization service (81.25%), and the availability of a national reference center (78.13%).
• PAHO/WHO recommends that all activities related to blood collection, testing, processing, storage, and distribution; should be coordinated at the national level through a well-organized and effectively integrated blood supply network. . The national blood system should be governed by the national blood policy and legislative framework to promote the uniform implementation of standards and consistency in the quality and safety of blood and blood products.

Blood Services Organization of blood services

• The organization and improvement of the efficiency of the services and the increase in voluntary donation are considered related variables since the models of spread blood banks, with a small collection and processing capacity, tend to provide their supply with replacement donors.
• More than 1,700 blood centers in 34 countries report processing 8.2 million units of blood.

• In 6 countries the average number of units processed per bank year was higher than 10,000 units, in 8 countries this average was between 5,000 and less than 10,000 units, and in 20 countries the average processing units per bank was below 5,000 units.

Blood donors

Types of blood donors

Voluntary blood donors reached 48% of Regional blood donations. The countries that exceeded the regional average were Argentina, Bermuda, Brazil, Colombia, Costa Rica, Cuba, Ecuador, Nicaragua, Guyana, Cayman Islands, Turks and Caicos Islands, Suriname, Uruguay, and Venezuela.

Age and sex of blood donors

50.35% of donations come from women. 49.68% of blood donors are between 24 to 44 years old, followed by donors under 24 years with 25.02%. The 45-64 age group accounted for 20.23% of donors. The least represented age group was those over 65 years of age, with 1.86% of donors.

Blood screening for infectious diseases

• 99.8% of the blood obtained was analyzed for HIV, hepatitis B virus surface antigen, antibodies against hepatitis C and syphilis, and for the T. cruzi test 95.08% of all countries considered endemic screened their blood units.

Blood components separation

Blood collected in an anticoagulant can be stored and transfused to a patient in an unmodified state. That is known as a "whole blood" transfusion. However, the units of blood could be more effectively used if separated into components, such as red blood cell concentrates, platelet concentrates, plasma, and cryoprecipitate. In this way, you can meet the needs of more than one patient. Out of the 8.2 million units collected, more than 90% were separated or fractionated to obtain red blood cells.

Components obtained, according to type

Clinical use of blood

• Unnecessary transfusions and unsafe transfusion practices expose patients to the risk of severe adverse transfusion reactions and transfusion-transmissible infections. Unnecessary transfusions also reduce the availability of blood products to patients who need them.
• In Latin America, six countries reported 1,555,672 patients transfused. For the non-Hispanic Caribbean, four countries reported 3,000 blood recipients.
• The most frequently transfused blood component was red blood cells, with 55.37%, followed by platelets with 12.96%, and fresh frozen plasma with 10.81%.
• 27 countries reported transfusing more than 2.8 million units of red blood cells.

Pandemic potential impact on blood collection

• When we compare the collection of the years 2019 versus 2020, seven of the 17 Latin American countries reduced the number of units, with the greatest reduction observed in El Salvador, Honduras, Peru, Guatemala, Mexico, Ecuador, and Bolivia.
• In the Caribbean countries, the impact was less significant.

PAHO/WHO recommends:

• • Continue to implement defined strategies to improve universal access to safe blood.
  • Strengthen the reorganization of blood service networks to improve their efficiency.
  • Integrate blood systems into health systems to improve strategies such as surveillance, hemovigilance, and networking coordination.
  • Strengthen the analysis of data that allows analyzing aspects such as blood availability, use, safety, and the existence of monitoring and control mechanisms.

*Source: Pan American Health Organization. Latin America and the Caribbean country report. Preliminary information 2020.