The Establishment of a Modern Blood Bank in Tbilisi, Georgia Levan Avalishvili, M.D. Medical Director Jo Ann Medical Center Bld. Bank Tbilisi, Georgia Christopher J. Gresens, M.D. Associate Medical Director SMF Blood Centers Sacramento, Calif., USA
Why Was a New Blood Bank Needed? Year I: Building the Framework for the Jo Ann Medical Center Blood Bank Year II: Going Operational Important Regulatory, Compliance, and Quality Matters Selected Results to Date Important Miscellaneous Issues Topics of Discussion
Sept., 1996: Global Healing, along with a team of Georgian physicians, established a pediatric cardiac diagnosis, surgery, and treatment center in Tbilisi (named “Jo Ann Medical Center” in 1997); April, 2001: > 400 lifesaving procedures have been done on children with a variety of cardiac defects. Why Was a New Blood Bank Needed?
Why Was a New Blood Bank Needed? Young patient in PICU Mother and daughter in PICU
Old operating room Why Was a New Blood Bank Needed?
New operating room Why Was a New Blood Bank Needed?
Why Was a New Blood Bank Needed? State of the art postoperative care State of the art cardiothoracic surgery
Why Was a New Blood Bank Needed?To Support A Variety of Surgical Procedures Tetralogy of Fallot patient Arterial switch patient
Why Was a New Blood Bank Needed? Georgian pediatric heart surgery patients
Due to poor general quality of blood pro-vided to JAMC and other hospitals in Georgia (prior to establishment of our Blood Bank), multiple septic transfusion reactions occurred during past few years, leading, in some cases, to patient deaths. Moreover, a large percentage of blood products were (are) not tested for some/all significant infectious diseases. Why Was A New Blood Bank Needed?
Why Was a New Blood Bank Needed?The Old System Glass Collection Bottles for Red Blood Cells Sub-optimal Albumin Manufacturing
Inadequate Testing Abilities of Existing Blood Stations Why Was a New Blood Bank Needed?The Old System
Why Was a New Blood Bank Needed? These inadequacies formed our impetus for the development of a modern blood bank, to supply blood not only to JAMC, but (eventually) to all of Georgia
Year I: Building the Framework (1) Identifying/hiring a Medical Director to run the Blood Bank Dr. Levan Avalishvili
Year I: Building the Framework (2) Choosing an appropriate location Tbilisi State Medical University Pediatric Hospital
(3) Creating plans and soliciting funds for renovation (4) Hiring a local contractor Year I: Building the Framework
Year I: Building the Framework (5) Beginning the . . . (a) Renovation
Year I: Building the Framework Loading up in the USA Unloading in Georgia (5) Beginning the . . . (b) Collection of equipment and supplies
(5) Beginning the . . . (c) Formation of medical teams/staff in Georgia and USA; (d) Establishing training program. Year I: Building the Framework
Year II: Going OperationalPrimary Foci:(1) Blood Donor Recruitment(2) Blood Donor Selection Hematocrit screening of donor (part of selection process)
Year II: Going OperationalPrimary Foci (continued):(3) Blood Collection(4) Blood Component Preparation Drawing Blood Making Components
Year II: Going OperationalPrimary Foci (cont.):(5) Donor Testing Samples from every unit are carefullytested
Year II: Going OperationalPrimary Foci (cont.):(6) Labeling(7) Storage and Transportation Red cell Refrigerator Platelet Rotator
Primary Foci (cont.): (8) Compatibility Testing; (9) Issuing and Transfusing Blood; (10) Diagnosing and Managing Transfusion Reactions. Year II: Going Operational
Establishing Quality Standards for All JAMC Blood Bank Operations Using Standard Operating Procedures Training (and Re-training) Employees Verifying Competency of Employees (a constructive process; NEVER destructive) Calibrating and Maintaining Equipment, and Using Controls Important Regulatory, Compliance, and Quality Matters
Ensuring Appropriate Documentation Determining Acceptable Record Storage Practices Performing Targeted Inspections Hiring of Full-Time Compliance Officer (Eventual) Alignment of Quality Program with That of Western Europe/USA Important Regulatory, Compliance, and Quality Matters
Total Number of Attempted Donations: 636 Total Number of Successful Donations: 536 Total Number of Donors with Repeatedly reactive Infectious Disease Screening Results: 36 (6.7%) (Continued) Selected Results to Date
Total Number of Donors With Repeatedly Reactive Infectious Disease Screening*Results Anti-HIV-1/2 3 (0.6%) HBsAg 9 (1.7%) Anti-HCV 14 (2.6%) RPR (syphilis) 10 (1.9%) *Reporting of confirmatory results is pending Selected Results to Date (cont.)
(1) Safety (2) Computerization (3) Assisting Other Georgian Healthcare Facilities (e.g., AIDS Center) Important Miscellaneous Issues
Important Miscellaneous Issues JAMC Blood Bank is fully licensed, and is prepared to supply blood to hospitals throughout Tbilisi and (eventually) all of Georgia (4) Eventually Serving the Entire Country
Marina Abashidze, Levan Avalishvili, Tamuna Babunashvili, Cindy Basso Eaton (provided most of the photos), Marilyn Berry (provided selected photos), Anne Courtney-Gray, Inga Dvalidze, Kent Foley, Nino Gachechiladze, Irakli Gogorishvili, Chris Gresens, Mary McIlroy, Irakli Metreveli, Lillian Morton, Ron Newton, Elizabeth Peo, Herb Perkins, Teona Roschupkina, Lee Schuller, Avto Tsintsadze, & John Watson-Williams AcknowledgementsThe Players
American International Health Alliance,American Red Cross-Oakland, Americares, Arlington Scientific Inc., Baxter Fenwal, Becton Dickinson, British Airways, Carelift International, Charter Medical, Helmer, Open Society Institute, (cont.) Additional AcknowledgementsSponsors
Organon Teknika, Pall, Rockefeller Family Foundation, SMF Blood Centers, Separation Technology, Inc., Terumo, United Blood Services Reno, and US AID. Additional AcknowledgementsSponsors (cont.)
Dedicated to Jo Ann McGowan 1939-1996 And . . .
Also dedicated to The children of Georgia, as well as all children throughout the world