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published evidence is lacking, recommendations are based on international best practices and the knowledge and expertise of members of the guideline development group and external review group in the fields of human physiology, pathology and clinical medicine. In conditions where emerging evidence suggests that deferral criteria may be relaxed, a precautionary approach is recommended until good evidence of safety becomes available. It is anticipated that the recommendations in this document will remain valid until 2017 when a review of these guidelines will be undertaken to explore any new evidence, particularly in relation to controversial issues or where changes in practice may be appropriate. 3 Acronyms AIDS Acquired immunodeficiency syndrome BTS Blood transfusion service(s) CDC United States Centers for Disease Control and Prevention CJD Creutzfeldt-Jakob disease CUE Confidential unit exclusion DIID Donation-induced iron deficiency HAV Hepatitis A virus HBV Hepatitis B virus HCV Hepatitis C virus HEV Hepatitis E virus HIV Human immunodeficiency virus HTLV I/II Human T-cell lymphotropic viruses I/II IFRC International Federation of Red Cross and Red Crescent Societies MSM Men who have sex with men TTI Transfusion-transmissible infection(s) UNAIDS Joint United Nations Programme on HIV/AIDS vCJD Variant Creutzfeldt-Jakob disease WHO World Health Organization 4 Preface The safety and availability of blood and blood products for transfusion requires the recruitment and selection of voluntary non-remunerated blood donors, the quality-assured screening of all donated blood and the safe and rational clinical use of blood. The World Health Organization (WHO) recommends the following integrated strategy for blood safety and availability (3). 1 Establishment of well-organized blood transfusion services that are coordinated at national level and that can provide sufficient and timely supplies of safe blood to meet the transfusion needs of the patient population. 2 Collection of blood from voluntary non-remunerated blood donors at low-risk of infections that can be transmitted through blood and blood products, the phasing out of family/replacement blood donation and the elimination of paid donation. 3 Quality-assured screening of all donated blood for transfusion-transmissible infections, including HIV, hepatitis B, hepatitis C and syphilis, blood grouping and compatibility testing, and preparation of blood components. 4 Rational use of blood to reduce unnecessary transfusions and minimize the risks associated with transfusion, the use of alternatives to transfusion, where possible, and safe clinical transfusion procedures. 5 Implementation of effective quality systems, including quality management, documentation, training of all staff and assessment. Each country should establish a national system for blood donor selection for the donation of whole blood, red cells, platelets, plasma and other blood components, donated as whole blood or apheresis donations. The assessment of donor suitability should be undertaken in accordance with national criteria for blood donor selection. These criteria should be consistently applied in every blood donation setting on each occasion of donation to all blood donors, including voluntary non-remunerated donors and even where systems are still based on family/replacement donors and paid donors. These guidelines on blood donor selection should be used in conjunction with other WHO resources, in particular Towards 100% voluntary blood donation: A global framework for action (4), The Melbourne Declaration on 100% voluntary non-remunerated donation of blood and blood components (5), Blood donor counselling: Implementation guidelines (6) and Screening donated blood for transfusion-transmissible infections (7). Dr Neelam Dhingra Coordinator Blood Transfusion Safety 5 Policy recommendations 1 Each country should establish a national system for blood donor selection for the donation of blood or blood components. 2 All prospective blood donors, either donating as whole blood donations or through apheresis donations, should be assessed, prior to blood collection, for their suitability to donate on each occasion of donation, in every blood donation setting. 3 National donor selection guidelines and criteria should be based on epidemiological and/or scientific evidence or, where evidence is limited or lacking, on best practices. 4 Donor acceptance and deferral policies for the prevention of TTI should be based on up-to-date information on the local epidemiology of infections, the markers screened for, the availability of suitable blood screening and confirmatory assays, and the technologies in use. 5 Blood transfusion services should have mechanisms for surveillance to monitor emerging infections and diseases

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