Bernard Allen
Question:100 Mr. Allen asked the Minister for Health and Children his views on the Irish Blood Transfusion Service proposal to develop testing techniques and the use of safe alternatives to standard blood products. [8471/01]
Written Answers. - Blood Transfusion Service.
Bernard Allen
Question:101 Mr. Allen asked the Minister for Health and Children his views on the Irish Blood Transfusion Service strategy to reduce allogeneic blood transfusion where possible. [8472/01]
Bernard Allen
Question:102 Mr. Allen asked the Minister for Health and Children his views on the Irish Blood Transfusion Service strategy regarding the sourcing of some blood products from BSE-free areas and discontinuing the sue of cryopicipitate. [8473/01]
Bernard Allen
Question:103 Mr. Allen asked the Minister for Health and Children his views on the Irish Blood Transfusion Service proposals regarding the deferral of donors with known or putative risk of harbouring variant CJD. [8474/01]
Bernard Allen
Question:104 Mr. Allen asked the Minister for Health and Children the steps he has taken to improve the infrastructure of hospitals to allow people store their own blood before undergoing medical procedures. [8475/01]
Bernard Allen
Question:105 Mr. Allen asked the Minister for Health and Children the proposals he has to ensure that the management of blood supply be streamlined. [8476/01]
I propose to take Questions Nos. 100 to 105, inclusive, together.
Last month the chairman of the National Blood Users Group, Professor John Bonnar, and I announced a new guideline for transfusion of red blood cells in surgical patients. The guideline provides specific advice to clinicians in relation to best practice in transfusion and the application of strategies which reduce or avoid transfusion as part of the management of patients requiring surgery. The guideline recommends that the use of proven strategies to reduce exposure to allogeneic transfusion should be made widely available, and applied where appropriate. Such strategies include autologous transfusion techniques, and surgical, anaesthetic and pharmacological techniques to reduce blood loss.
Given the importance of this guideline, my Department's chief medical officer, wrote to clinicians and advised that, although it is not known whether vCJD can be passed from person to person by blood transfusion, avoidance of unnecessary transfusion of allogeneic blood constitutes the most important approach available at this time in reducing any possible risk to patients of infection with vCJD through blood transfusion. My Department has circulated the guideline to hospitals throughout the country and to general practitioners.
The National Blood Users Group is preparing additional guidelines on neonatal and paediatric transfusion, use of platelets and plasma, administration of blood products, use of blood products in the management of massive haemorrhage and these are expected to issue later this year.
In reply to a question from the Deputy on 31 January 2001, I advised of a number of strategies under consideration by the Irish Blood Transfusion Service to reduce or minimise the possible risk of the transmission of vCJD by blood transfusion in the absence of a test to detect the presence of vCJD in blood donors. The possible strategies included the deferral of donors who resided in the UK and the sourcing of blood products from BSE free countries. On 14 March 2001, the IBTS announced its decision to defer donors who spent a cumulative period of five years in the UK during the period 1980 to 1996. The implementation of this decision will reduce the existing donor pool by 5%. In advance of this announcement, I met with the IBTS and the CJD Advisory Group. The CJD group advised me that while it supported the IBTS donor deferral proposal, it was of the view that efforts should be in place to replace the potential supply deficit, prior to its introduction. On 8 March the IBTS briefed me in detail in relation to its plans to address the potential shortfall in donations which include the following: (i) recruitment of new donors to replace deferred donors; (ii) encouraging lapsed donors to donate and occasional donors to increase their donations; (iii) improving the management of the donor programme by extending clinic opening hours and opening a fixed clinic in Ardee in March and establish additional fixed donor clinics in Dublin, Limerick and Galway; (iv) improving blood stock management nationally to reduce the level of blood discards; (v) implementing focused and local media advertising campaigns to encourage donors to attend local donor clinics.
At my suggestion, the CJD Advisory Group and the IBTS met on 12 March. At the meeting the IBTS advised the group of its plans, and reassured the group as to its concerns about the balance of risks involved and the need to ensure an adequate blood supply.
Maintaining an adequate blood supply will require effective management throughout the health system involving the IBTS and hospitals. It will require a significant response from donors and the recruitment of new donors. Donors have always responded generously and I am confident that they will continue to do so. I am establishing a national blood strategy implementation group to address the potential impact on hospital blood supplies of the deferral decision. The group will seek to improve blood stock management, progress the use of alternatives to blood transfusion, widen availability of autologous transfusion and support the implementation of the red cell guideline I referred to earlier. The group will comprise representatives of the hospitals, IBTS and my Department. Extensive monitoring of the impact of the current deferral decision will take place in the coming months to assess the success of the measures undertaken to replace the 5% reduction in donors.
As regards the sourcing of blood products from non-BSE countries, the IBTS is currently assessing the availability of plasma and fibrinogen to replace its fresh frozen plasma and cryoprecipitate, respectively. The Irish Medicines Board, the regulatory authority for the importation of medicinal products, including blood products, has statutory responsibility in relation to the authorisation of medicinal products for use here. The IBTS has advised the IMB in relation to its strategy and further discussions will take place concerning any specific proposals of the IBTS to import replacement blood products.
Question No. 106 answered with Question No. 98.