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Abstract Blood donation is a highly regulated practice in the world, ensuring the safety and efficacy of collected blood and its components whether used as irreplaceable parts of modern transfusion medicine, as a therapeutic modality or additional support to other clinical therapies. In Norway blood donation is regulated by governmental regulations ("Blodforskriften") and further instructed by national guidelines, "Veileder for transfusjonstjenesten" [1], providing an aid for assessment of donor health. This concise review touches upon: definitions of donor health and disease; some important pitfalls; and the handling of some common and less common pathophysiological conditions; with an example from the Blood center of Oslo University Hospital, Norway's largest blood center. I also comment on some medications used by a number of blood donors, although wounds, ulcers and surgery are not included. Considering the panorama of conditions blood donors can suffer from, blood donation can never be completely safe for everybody, as zero risk does not exist, but it is our task through donor evaluation to identify and reduce risk as much as possible. [ABSTRACT FROM AUTHOR]

Abstract: The voluntary, non-remunerated blood donation organization is the important part of the International Red Cross movement. Historically the Red Cross Blood Program was established in Oslo with the main objectives to recruit new donors, support the blood banks with recruiting materials and to support in recruiting efforts made by local Red Cross branches. Currently the continual education of the recruited skilled personals, at all levels, is considered to be an essential part of such a program. The 2013 coincide with the 12th anniversary of Norwegian educational program in Quality in Transfusion Medicine. This report focuses on the historical background on the Red Cross Quality Course in Transfusion Medicine, as well as the progress made so far and looking into future perspectives. [Copyright &y& Elsevier]

Thromboelastography (TEG) has been part of the assessment of patients receiving massive transfusion (MT) at Haukeland university hospital (HUH) since 2007. However, the test has been used inconsistently, and in general, the value of the test in evaluation of patients with critical bleeding is still debated, although it has been suggested that the TEG-guided treatment decreases blood usage. This single-centre retrospective study examines the use of TEG and discusses its place as part of assessing MT patients. The study focuses on the amount of blood product transfused in TEG-tested and non-TEG tested patients and whether TEG assisted coagulation therapy has affected mortality compared to conventional coagulation tests (CCTs). The study is based on the data from the massive transfusion study (MTS) 2002-15. 241 MT patients were identified, and they were grouped into patients assessed with TEG and patients who did not get this evaluation. In a sub-analysis, the patients with the initially (first TEG-test) 30 best and 30 worst TEG curves were defined based on normal ranges for the parameters R-time, α-angle, Maximal Amplitude (MA) and lysis after 30 min (LY). Survival rate and blood product usage were compared between these groups and between TEG and non-TEG patients. 111 patients were tested with TEG and 130 were not. The patients with highly pathological TEG curves (worst) have significantly higher mortality than the 30 normal-TEG patients (best) after 24 h (p < 0.001), 5 days (p < 0.05) and 30 days (p < 0.05). The best group had significantly lower mortality than the non TEG-group (p < 0.001). The difference in mortality between TEG and non-TEG patients overall was not statistically significant (p = 0.679). The TEG patients received more blood transfusions than non-TEG patients, (p < 0.001) and the patients with the worst TEG curves received the highest number of blood components. The use of TEG is debated in patients with critical bleeding. This study shows that TEG-testing is variably used in the assessment of massively bleeding patients at Haukeland University Hospital. 43.2% of 241 patients receiving massive transfusion packs were tested by TEG. When we compared the patients with the 30 best TEG curves with the 30 worst curves, there was a significantly better survival in the "best" group - without any significant difference in blood component usage. This study was not designed to provide causal information, but despite the limitations, the study indicates that the role of TEG in this patient group should be further evaluated., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Bacterial contamination of blood and its cellular components remains the most common microbiological cause of transfusion associated morbidity and mortality, even in developed countries. This yet unresolved complication is seen more often in platelet transfusions, as platelet concentrates are stored at room temperature, in gas permeable containers with constant agitation, which support bacterial proliferation from relatively low undetectable levels, at the beginning of storage time, to relatively high virulent bacteria titers and endotoxin generation, at the end of shelf life. Accordingly, several combined strategies are introduced and implemented to at least reduce the potential risk of bacterial contaminated products for transfusion. These embody: improved donors arms cleaning; bacterial avoidance by diversion of the first portion of collection; reducing bacterial growth through development of newer storage media for longer platelet shelf life; bacterial load reduction by leucoreduction/viral inactivation, in some countries and eliminating the use potentially contaminated units through screening, through current available testing procedures, though none are not yet fully secure. We have not seen the same reduction in bacterial associated transfusion infections as we have observed for the sharp drop in transfusion associated transmission rates of HIV and hepatitis B and C. This great viral reduction is not only caused by the introduction of newer and more sensitive and specific detection methods for different viruses, but also the identification of donor risk groups through questionnaires and personal interviews. While search for more efficient methods for identifying potential blood donors with asymptomatic bacteremia, as well as a better way for detecting bacteria in stored blood components will be continuing, it is necessary to establish more standardized guidelines for the recognition the adverse reactions in recipients of potentially contaminated units. Efforts also should be also directed to identify blood donors with significant risk of bacteremia, at the time of donation in the first place as a high priority. The goal of this review is to highlights strategies for identifying both the sources of bacterial contamination of blood components in Norway and identifying donors with a higher risk of bacteremia at the time of donation. The key to achieving this goal is initiating continual revising and upgrading the Norwegian transfusion guidelines, based on the transfusion legislation and by introducing a relevant specialized donor bacterial questionnaire., (Copyright © 2014 Elsevier Ltd. All rights reserved.)