title: An Analysis of and Recommendations for the Peruvian Blood Collection and Transfusion System.
abstract: BACKGROUND
  Peru experienced a crisis in its blood collection and supply system in the mid-2000s, as contaminated blood led to several transfusion-transmitted infections (TTI), occurring in the backdrop of extremely low voluntary donation rates and a national blood supply shortage. Thus, the Peruvian Ministry of Health (MINSA) implemented a national investigation on the safety and quality of the Peruvian blood collection/transfusion network.
  
  
  METHODS
  Every Peruvian blood bank was evaluated by MINSA from 2007-2008. These evaluations consisted of an update of the national registry of blood banks and visits to each blood bank from MINSA oversight teams. Information was collected on the condition of the blood bank personnel, equipment, supplies, and practices. Further, previously-collected blood at each blood bank was randomly selected and screened for TTI-causing pathogens.
  
  
  RESULTS
  Uncovered in this investigation was a fragmented, under-equipped, and poorly-staffed blood collection and transfusion network, consisting of 241 independent blood banks and resulting in suboptimal allocation of resources. Further, blood with evidence of TTI-causing pathogens (including Hepatitis B, Hepatitis C, and syphilis) and set for transfusion was discovered at three separate blood banks as part of the random screening process.
  
  
  CONCLUSIONS
  Using the successful reorganizations of national blood supply systems in other Latin American countries as examples, Peru would be well-served to form large, high-volume, regional blood collection and transfusion centers, responsible for blood collection and screening for the entire country. The small, separate blood banks would then be transformed into a network of blood transfusion centers, not responsible for blood collection. This reorganization would allow Peru to better utilize its resources, standardize the blood collection and transfusion process, and increase voluntary donation, resulting in a safer, more abundant national blood product.
authors.affiliation: Division of Infectious Diseases, UCLA David Geffen School of Medicine, Los Angeles, California, USA.
authors.forename: Paul E
authors.initials: PE
authors.lastname: George
authors.affiliation: National Hospital Cayetano Heredia, Lima, Peru.
authors.forename: Julio
authors.initials: J
authors.lastname: Vidal
authors.affiliation: Unit of Epidemiology, STDs and HIV, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Garcia
keywords: Blood transfusion; Chagas; HIV; Hepatitis B virus; Hepatitis C virus