Transfusion Medicine in Switzerland

Swiss transfusion medicine currently encompasses 13 Regional Blood Transfusion Services (RBTS) under the Blood Transfusion Service of the Swiss Red Cross Ltd (BTS SRC) which is responsible for quality standards, logistics, and reference activities in immunohaematology and testing for infectious diseases, as well as haematological divisions of several university hospitals. Switzerland covers currently its own needs of labile blood components. According to the law, blood components are drugs and must comply with the actual legal requirements. Furthermore, the BTS SRC has published mandatory guidelines for all RBTS to ensure the standardisation of used methods. Haemovigilance is in charge of Swissmedic and covers all aspects of transfusion medicine, from donor selection to blood transfusion. Measures for preventing immunological and non-immunological risks as well as transfusion-transmitted diseases are also implemented at all stages of the process. The last preventive measures are universal pre-storage leucocyte depletion (in 1999), exclusion from blood donation of individuals who stayed longer than 6 months in the UK (in 2002) or have previously been transfused (in 2004). Mandatory screening of blood donations includes anti-HIV 1/2, HIV NAT, anti-HCV, HCV NAT, HBsAg, anti-Treponema pallidum and alaninaminotransferase. In the last years the calculated residual risk for transfusion-transmitted HIV or HCV was approximately 1:2-3 million and for HBV approximately 1: 200,000-300,000. Future challenges are the maintenance of self-sufficiency, the sustained recruitment of dedicated staff and the rising costs.