ISBTABS 369 Preview 6
ISBTABS 369 Preview 6
ISBTABS 369 Preview 6
Backgroud: Based on data reports from the Ministry of Health of the Republic of Indonesia, there are 470 blood
transfusion units in Indonesia (235 units managed by the Indonesian Red Cross, 220 units managed by the government,
four units of health services provinces, nine units of vertical hospital BTUs, two unit’s Indonesian police and army
hospital) distributed in 38 provinces. With so many BTUs spread throughout Indonesia, each BTU must have the same
quality standards to maintain and improve blood services. Therefore, it is necessary to carry out Quality Control of the
blood component products produced. Quality control is critical in safely and effectively processing blood and other
components. A quality concept comprises quality control, assurance, and management. The laboratory service should
have a quality control system. Quality testing and monitoring of blood components for transfusion is carried out during the
manufacturing or production development process. Factor VIII levels are internal quality control parameters required for
quality analysis of Fresh Frozen plasma (FFP). According to international standard guidelines and national government
regulations (PMK 91/2015), coagulation factors are tested to ensure the quality of FFP products, including Factor VIII
levels as much as 1% of all units produced, or four units of blood per month.
Aims: This study aims to evaluate factor VIII levels in each FFP unit to ensure the availability of a standard quality
product with maximum therapeutic effects and minimum risks for recipients.
Methods: The retrospective data were collected from Research and Development CBTS Indonesian Red Cross archives
from 1 January 2019 to 30 April 2023. Out of total 272 units FFP collected from Blood Transfusion Unit Indonesian Red
Cross from Sumatera Island (Lampung Province, Palembang City, Pekanbaru City), DKI Jakarta Province (CBTS IRC),
Jawa Barat Province (Depok City, District of Bekasi City, District of Bogor City), Banten Province (Tangerang City, District
South of Tangerang City), Government Hospital (Fatmawati Hospital BTU), Army Hospital (RSPAD Gatot Soebroto BTU)
were tested Quality Control with semi-automated Sysmex CA50 and automated Sysmex CA620 to determine of factor
VIII levels in each unit FFP.
Results: From a total of 13 BTUs tested for quality, 272 FFP units tested for factor VIII had an average factor VIII content
of 1.2 IU/mL with a range of 0.5 IU/mL to 5.3 IU/mL, which is normal, should be >0.7IU/mL. Only 0.73% (2/272) of FFP
units that do not meet the standards of the BTU have yet to implement GMP. Meanwhile, 99.27% (270/272) of FFP units
were according to standards, originating from BTUs receiving GMP certification.
Summary / Conclusions: We conclude that there are still those below-standard Quality FFP products from blood
transfusion units; it is necessary to increase the processing of blood components to maintain the coagulation factors by
implementing GMP by taking blood, collecting, transporting, and shipping. It is required to carry out quality control to
produce products that meet national and international standards.