Evolution of the role of Finnish Red Cross Blood Service in the national plasma product program IPFA/PEI 20th International Workshop on surveillance and screening of blood borne pathogens Helsinki 23 24 April 2013 Martti Syrjälä www.veripalvelu.fi www.veripalvelu.fi 1
Prof. Harri Nevanlinna Prof. Juhani Leikola Prof. Gunnar Myllylä Prof. Jukka Koistinen 2 www.veripalvelu.fi 2 2
2012 key figures Blood Service in Brief 540 employees 18 permanent locations and mobile services A non-profit organisation 66 million euros in turnover 143,000 250,000 50,000 donors > blood donations > patients We create potential for saving lives Blood components to hospitals Clinical laboratory services Antenatal blood group determination Tissue compatibility tests Stem cell transplants Tissue services Pharmaceutical distribution Research and development 3 www.veripalvelu.fi 3 3
FRCBS locations 18 donor centres blood collection Blood Service Centre Helsinki collection, production, distribution testing other FRSBS operations Mobile blood service Helsinki, Oulu, Kuopio, Tampere, Turku, Seinäjoki over 1000 sessions yearly around the country Vaasa Pori Turku Kokkola Seinäjoki Tampere Hämeenlinna Espoo Oulu Kuopio Jyväskylä Rovaniemi Mikkeli Lappeenranta Lahti 4 Helsinki Joensuu www.veripalvelu.fi 4 4 www.veripalvelu.fi
Milestones in the national plasma product program 1920 1930 The Boy Scout Blood Union is founded 1940 The Defence Forces organises blood collections during the war 1950 FRC BS is founded Freeze-dried plasma (in cooperation with Orion Ltd) Fresh frozen plasma for haemophilia patients Albumin and gammaglobulin fractionation (State Serum Institute) 5 www.veripalvelu.fi 5 5
Number of blood donations in Finland in 1948-2012 400.000 350.000 300.000 250.000 200.000 150.000 100.000 50.000 0 6 1950 1960 1970 1980 1990 2000 2002 2004 2006 2008 2010 2012 www.veripalvelu.fi 6 6
Milestones 1960 Contract manufacturing (albumin and gammaglobulin): Kabi AB, Swiss Red Cross, Dutch Red Cross) Cryo-AHG frozen plasma 1970 Lyophilized Cryo-AHG (pools of 2 or 8 units) First Cohn fractionation unit in FRC BS (with the help of Swiss and Dutch Red Cross) 1980 Second Cohn fractionation unit in FRC BTS Intermediate purity, heat inactivated FVIII concentrate. HIV safe, heat treated Cryo-AHG was introduced in 1987 1990 High purity SD-treated FVIII product (under a licence from Baxter. Virus safe IvIg 7 www.veripalvelu.fi 7 7
Planning of the plant (Presented by Dr. Myllylä in the Seminar on National Self-reliance in Blood and Blood Fractions for Developing Countries, Stockholm 27.9-1.10 1982) 8 www.veripalvelu.fi 8 8
1980 1971 1990 1990 9 www.veripalvelu.fi 9 9
Costs of the 2nd fractionation unit 4.830.000 10 www.veripalvelu.fi 10 10
Milestones 2000 FRC BS market share albumin 100 % FIX 100 % FVIII 80 % iv-immunoglobulins 70 % im-immunoglobulins 100 % Closing of the FRC BS fractionation plant in Helsinki Contract manufacturing from Finnish plasma: 2004-2009 Sanguin 2010-2011 Octapharma 2010 Sales of plasma collected in Finland Baxter Octapharma 11 www.veripalvelu.fi 11 11
500000 Products and donations 1984-2012 450000 400000 350000 300000 250000 200000 150000 100000 50000 0 Whole blood RBC Platelets FFP Donations 12 www.veripalvelu.fi 12 12
HIV infections transmitted by blood or plasma components in Finland 2/220 haemophilia patients transmitted 6 other patients transmitted by blood components all transmissions -1986. No transmissions 1986-. transmission rate (< 1 % of haemofiliacs) was one of the lowest in the developed countries. Two main reasons: low incidence of HIV in the donor population small pool FVIII product 13 www.veripalvelu.fi 13 13
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Estimated residual risk of infectious donation in Finland in 2009-2011 HBV HCV HIV Residual risk - per million donations 1.6 0.04 0.04 - donations per infectious 625,000 25,000,000 25,000,000 donation Data are given for all donors as weighted average of first time and repeat blood donors 15 www.veripalvelu.fi 15 15
Annual number of HIV-, HBV-, HCV- ja syphilis infections in blood donors in Finland in 2001-2012 HIV/yr HBV/yr HCV/yr Syphilis/yr Donations/yr 0-3 1-10 6-17 0-8 280 000 16 www.veripalvelu.fi 16 16 Tom Krusius 25 February 2011 16
Finnish Red Cross Blood Service 1948- Aim during the first six decades: National self-sufficiency of whole blood, blood products, plasma and plasma derived drugs. Now: National self-sufficiency of plasma and plasma derived drugs is not an issue any more. It has turned to European selfsufficiency. 17 www.veripalvelu.fi 17 17