The production of the Blood Transfusion Service in the Czech Republic in 2003 follows trends of previous years. Discussion on reorganisation neither the principal change of the regimen of GMP controlling does not lead so far into change of structure. Vast majority of donations is performed by not very large Blood transfusion establishments, which are at most a part of hospital. Majority of blood is processed locally into blood components but the number of donations sent for processing into larger centres is increasing (12 % in 2003 versus 8 % in 2002). Occasionally larger blood establishments takeover all activities previously independent blood donations centres of other hospital. Both alogeneic and autologous blood components are produced by 55 establishments, additional 14 collect and process autologous blood only. Donor pool is stabilised and total number of donors registered is only a little lower then recommended (36,6 registered donors per 1000 of inhabitants), 9 % of donors were first-time donors. Number of donations is slightly over WHO recommended value (43 /1000 inhabitants). Number of plasmaphereses is increasing, but does not reach the number of mid-nineties. Number of thrombocytaphereses increases slowly. Great majority of donations is performed without direct financial compensation (98.7 % of whole blood donations, 82 % of plasmaphereses, 32.4 % of thrombocytaphereses). Number of donors with positive hepatitisBorC markers is decreasing, prevalence of HIV positivity remains very low. Processing shifts to products with lower leukocyte contamination. Proportion of blood in-process or early leukodepleted is increasing – „Packed red cells buffy-coat removed, in additive solution“ being the standard product, circa 11 % of packed red cells are leukodepleted by in-proces filtration. Platelet production shifts slowly to single donor apheresis products (75 % of a total of 22,6 thds of therapeutical doses of platelets produced now), circa 42%of platelet concentrates are in-process leukodepleted. Proportion of plasma used for clinical purposes remains extremely high (17 unit of 220 ml per 1000 of inhabitants), the amount of plasma sent for fractionation is stable (80.8 thds. of litres in 2003). The number of preoperative autologous whole blood donations (PABDs) in the Czech Republic has increased for several years, of 3.7 % in comparison to 2002. PABDs in children have increased (167 vs 86), PABDs in pregnancy have decreased (12 vs 19). Most of PABDs were performed in the Moravskoslezský region (3.73 per 1000 inhabitants), the least rate was in the Ústecký region (0.84 per 1000 inhabitants). Autologous erythrocytapheresis and plasmapheresis were performed in very low rate (34, resp. 71 donations). 5304 acute normovolaemic haemodilution (ANH) and 438 perioperative blood salvage (PBS) processes were made. Nevertheless, real numbers of ANH and PBS could be higher in case of optimal cooperation in nonmandatory report of procedures mentioned above by anaesthesiological and surgery departments. Collected autologous blood units were processed in whole blood in 55.8 % and in red blood cells in 44.2 % (with some lower rate of autologous plasma). The incidence of anti-HCV, HBsAg and syfilis positivity in autologous donations is higher than in allogeneic ones. Three hospitals used microagreggate filters for autologous whole blood transfusion, red cells leukodepletion was performed in one department. Autologous cord blood transfusion was not performed. The utilisation of autologous red blood cells and plasma was 83 % resp. 77.2 %.

        Key words: blood transfusion service, production, preoperative autologous blood donation, apheresis, acute normovolaemic haemodilution, perioperative blood salvage, statistics