Planning for reducing residual risk in blood transfusion

During recent years, blood safety has been increased drastically but the risk of transfusion transmission infection is not zero. Root causes of residual risk (RR) are as follow: Window period (WP) of infections account for 90% or more; Virus epidemiology of the donor population; Frequency of incidence in donors; Failure to test; Human error; Non-conformity of software; equipment and reagents; Variants of known agents; New agents for which no test available; Unknown agents; and Immunosilent donors.Safety measures employed at Iranian Blood Transfusion Organization in recent years for improvement the blood safety included: Exclusion of high risk groups, from establishment; Self-deferral and CUE, 1997 and 2002; Establishment error management, 1999; Establishment quality assurance and GMP, recent two decades; More sensitive Ab/Ag screening test kits, 2005; Establishment proficiency testing, 2005; Voluntary non-remunerated donors, 2007; Regular donors, nearly 60%; Test only for specified donors, 2007; Look-back and call-back, 2008 and 2010; Pilot study for establishment of NAT, 2012; First time blood donor screening, 2016.