Clinical and practical aspects of indications and administration of blood products in inherited and acquired bleeding disorders

Transfusions of blood products -both blood components and plasma derivativescan be life-saving procedures if used rationally Blood components/labile blood products/cells, plasma and cryo/ are provided by blood services and produced from single individual donations or pooled from several (up to 10-20) donations. Stable blood products/albumin, clotting factors, immunoglobulins , coagulation inhibitors, etc., are procured from human plasma from large numbers of individual donations. Even though provision of these products by transfusion services and pharmaceutical industry has become safe, standard and accessible in most countries, good clinical practice -i.e. proper use of these quality productsis often still inadequate. This has been proved by a number of studies documenting large variations in the use blood components for identical sets of patients in different countries or even institutions having comparable access to blood products. It has been recognised by the Council of Europe and a publication dealing with optimal use of blood (“Summaries of Product Characteristics”) has been published in 2005. Another source of information is the Manual of Optimal Use of Blood published as an EU project in 2010 by the Scottish National BTS (www.optimalblooduse.eu) or available guidelines of the BCSH (British Comm. on Standards in Haematology).