Four decades of National Blood Service in Iran: outreach, prospect and challenges.

OBJECTIVE: This study aims to compare the changes and progress made to Iranian Blood Transfusion Organization (IBTO) during 1974-2014 in order to identify the shortcomings. BACKGROUND: The History of Blood transfusion in Iran can be traced back to the 1940s. IBTO was established in 1974 as a national centralised organisation, supported by Iranian government for its budget and supplies and provides its products free of charge to both public and private hospitals. METHODS: The statistics have been derived from IBTO Statistical Center. Also related literature has been reviewed. RESULTS: From 1974 to 2014, donation per population has been increased about eight times. IBTO reached 100% voluntary blood donation in 2007, but the number of female blood donors in Iran is six times lower than average global rate. On one hand, the prevalence rate of Hepatitis B virus (HBV) and Hepatitis C virus (HCV) in blood donors was dropped in to one fifth and one third, respectively during past 8 years. On the other hand, irrational blood usage and lack of integrated blood stock management systems and non self-sufficiency on plasma-derivedmedicines are considered as main challenges of IBTO. CONCLUSION: Forty years since the establishment, IBTO managed to achieve considerable improvements in different fields but many challenges still remain, which need to be addressed urgently. Great gap between the number of male and female blood donors in Iran has to be filled. The improvement of knowledge and practice on patient blood management and use of alternatives are on the agenda of IBTO in next coming years.

A new index for discrimination between iron deficiency anemia and beta-thalassemia minor: results in 284 patients.

The present study reports the results in 284 patients of applying a recently developed index, MCV-(10 x RBC), for discrimination between beta-thalassemia trait (beta-TT) and Iron Deficiency Anemia (IDA), the two most common causes of microcytic hypochromic anemias. A total of 284 carefully selected patients (130 patients with IDA and 154 with beta-TT) were studied. Sensitivity, specificity and Youden's index were compared between the proposed index and four other indices, namely England-Fraser, Mentzer, Srivastava and RBC count. The new index correctly identified 263 (92.96%) patients, standing inferior only to Mentzer which correctly diagnosed 269 (94.71%) patients. The best discrimination index according to Youden's criteria was Mentzer (Youden's index = 90.1) followed by the new index (Youden's index = 85.5). There are remarkable inconsistencies among the results obtained in different studies. Larger studies are needed to establish the optimal discrimination index as well as to confirm the results obtained in the present study. Nevertheless, the epidemiological indices of the proposed discrimination index and the simplicity of its calculation make it acceptable for use in Iran.