Navy Blood Program

1
Navy Blood Program

• SAFMLS
• Reno, NV
• March 2009

2
Navy Blood Program Office

• Director
• Brian Williamson, CDR/MSC/USN
• Quality Assurance Manager
• Kathleen Whitlock, MT(ASCP)SBB, CQA(ASQ)
• Administration Manager
• HM1 Tonia Camp, USN

3
Who/Where is the Navy Blood Program

• Component of the ASBP
• 7 BDCs (2 ASBBC)
• 2 OCONUS
• 5 CONUS
• 2 BPDs (Okinawa and Sigonella)
• 21 MTF Transfusion Services
• 14 Afloat Transfusion Services (LHA/D, TA-H, CV,
  other)
• 2 Freezing Sites (Great Lakes and Camp Lejeune)
• HQ
• NBPO BUMED, Washington DC
• PACOM JBPO, Hawaii
• CENTCOM, JBPO AOR FW

4
CONUS BDC
NH Great Lakes
NCR ASBBC Bethesda
NMC Portsmouth
NH Cp Lejeune
NMC San Diego (with NH Cp Pendleton)
5
OCONUS BDC
6
ASBPRBC Platelets Collections
112,697
89,011

• USA 2007 81,352 2008
  59,626
• USN 2007 40,773 2008
  30,064
• USAF 2007 30,676 2008
  23,007

7
Navy Collected 43,130 WB Units
2007
8
Navy Collected 37,541 WB Units
2008
9
Received from Other Sources
2008

• Other Government sources 12,931
• USA 418
• USAF 1,149
• USN 4,649
• ASWBPL 3,335
• ASBBC 2,138
• VA 605
• Other 97
• Civilian sources 3,015
• NBE 30
• ARC 396
• ABC 1,116
• Host Nation 7
• Other 1,466

10
Where did it all go? 2008

• Transfused 7,493
• Shipped to Government (25,855)
• USA 2,143
• USAF 1,761
• USN 5,965
• ASWBPL 10,484
• ASBBC 399
• VA 3,950
• Other 1,175
• Shipped to Civilian (2,301)
• NBE 3
• ARC 108
• ABC 1,015
• Other 1,175
• FRBC
• Frozen 3,734
• Deglyced 319
• Expired 2,570

Data does not include CENTCOM
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Where did it all go?
2008
12
Other Products Collected and
Manufactured 2008

• APT 1,809
• Random PLT 1,479
• FFP 14,650
• 24 Hr FFP 339
• CRYO 3,955
• FRBC 3,734
• Plasma Pheresis 199

13
NBP Site Visits/External
Inspections

• FY08 NBP Technical Assist visits
• All BDCs and associated Transfusion Sites.
• Europe Transfusion Services.
• FY09 NBP Technical Assist Visits
• Scheduled to visit remaining Navy Transfusion
  Services FY09.
• Pensacola Jacksonville Feb 2009
• External Inspections (FY08-Present)
• FDA 9 facilities
• One facility received 483
• Eight facilities No 483s
• AABB 5 facilities Minimal Non-Conformances

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Current Issues/Challenges

• CENTCOM Non-FDA Transfusions (FWB/APT)
• - Notification, counseling and testing
• of recipients per DoD policy.
• BUMED Policy, Jun 2002
• - NBP currently addressing and revising
• policy.

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Current Issues/Challenges (Continued)

• Occasional problems meeting Quotas
• RBC/Weekly Quotas
• Deferrals
• Recruiting
• Facility support/ASWBPL Quotas/Freezing
• FFP/Weekly Quotas
• TRALI Policy (BPL 07-06)
• CENTCOM Usage
• Transfusing 11 RBCFFP ratio
• 27 transfused is AB (9 recipients AB)
• Cryoprecipitate
• Navy only Service manufacturing CRYO.
• Navy supplies entire CENTCOM quota.

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Current Issues/Challenges (Continued)

• Fresher Blood in Theater Initiative (Dec 08)
• RBC lt 14 days old for Massive Transfusions.
• RBCs to arrive in Theater lt 7 days old.
• BDC RBC quotas to arrive ASWBPL lt 4 days old.
• Process, test, label and ship within 3-4 days of
  collection.
• Required Changes
• Test results within 24 hours of collection.
• CONUS BDCs to outsource ID testing to local
  civilian Lab.
• Mini-pool NAT vice Single Donor
• Lot Release by Day 2
• Label by Day 3

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Fresher Blood In Theater Initiative Navy Stats
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Current Issues/Challenges (Continued)

• Okinawa/Guam BDC
• Transfer of 15000 Marines and dependents from
  Okinawa to Guam 2009
• What does this mean?
• Stand up BDC in Guam
• Stand down/reduce ASBBC Okinawa.
• ASBBC will continue performing ID and NAT
  Testing.
• Director PACOM developing Plan of Action Options.
  

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Current Issues/Challenges (Continued)

• Navy SBBs
• Total 17 Navy SBBs/12 Billets/2 Deployments
• 3 Deployed (PCS moves)
• JBPO Qatar (3 week training 6 months)
• Afghanistan (4 month training 12 months)
• Afghanistan (HCA Billet 12 month Deployment)
• 2 Non-BB Billets
• 1 in Blood Bank Fellowship
• Retirements
• Dec 09 1 SBB
• Aug 11 1 SBB
• Future SBB Fellowships
• July 2009-December 2010 LTJG Pecenka/LTJG
  Stephan
• July 2010-December 2011 3 Slots Available

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Frozen Red Blood Cells (ACP-215)

• Freezing Sites
• NHGL (Freezing avg. 80/week)
• NHCL (Freezing avg. 20/week)
• BPDs
• PACOM ASBBC
• USUH Sigonella
• CONUS
• NNMC
• NMC Portsmouth
• NMC San Diego
• OCONUS
• USNH Guam
• USNH Yokosuka
• USNH Rota
• USNH Naples
• USNH Guantanamo Bay

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Frozen Red Blood Cells

• Recent and Future FRBC Deployments
• US CENTCOM Deployed Aug 2008.
• EBTC Qatar and BSDs in Balad and Bagram.
• ENS Pecenka trained and assisted in
  implementation.
• Currently minimal inventory for supplemental use.
• EUCOM Navy MTFs
• Replace Liquid Inventory.
• Thaw/Deglyc for Inventory Requirements.

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Upcoming Changes

• Navy Policy-BPL 09-01
• Revision of Donor Screening, Donor Deferral,
  Notification and Look-back
• Authorizes BDCs to utilize NAT mini-pool for
  HIV-1, HCV, HBV and WNV.
• ASBP Released 19 Feb 09.
• Implementation required by 06 Apr 09.
• Phase out DBSS and transition to COTS
• Tentative transition date is FY2010

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Challenges for FY 2009 Beyond

• Collection of Non-DoD Donors ASD(HA) Policy
• Double Red Blood Cell Collections
• Will help facilities manage O Negative
  inventories better
• Will help meet the needs of the Frozen Blood
  Program
• Leuko-reduced products
• Leuko-reduced RBCs at all BDCs
• Leuko-reduced FRBCs (ADSOL)
• Leuko-reduced RBCs/FRBCs (extended life solution
  56 day)
• Hemostatic Agent (platelet derived)
• Frozen Platelets (DMSO)

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CENTCOM THEATER
UNCLASSIFIED

UZB/K2
UZB/K2
TKM
TKM
AFG
AFG
IRAQ
IRAN
IRAQ
IRAN
Kuwait
Kuwait
PAK
PAK
EGYPT
EGYPT
SAUDI ARABIA
OMAN
SAUDI ARABIA
OMAN
Qatar
Qatar
SUDAN
SUDAN
YEMEN
YEMEN
Djibouti
Djibouti
SOMALIA
SOMALIA
ETHIOPIA
ETHIOPIA
UNCLASSIFIED
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CENTCOM BLOOD SHIPMENTS
UNCLASSIFIED
UNCLASSIFIED
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EBTC, QATAR
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EBTC, QATAR
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EBTC, QATAR
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EBTC, QATAR
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TRAVEL IN THEATER (BALAD)
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TRAVEL IN THEATER
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BSD BALAD, IRAQ
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BSD BALAD
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332nd BALAD
35
332nd BALAD
36
332nd BALAD
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BALAD
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BALAD
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BASE HOUSING
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TRAVEL TO BAGHDAD
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TRAVEL TO BAGHDAD
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TRAVEL TO BAGHDAD
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TRAVEL TO BAGHDAD
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BAGHDAD
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MOVING BLOOD
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ARMY CSH, BAGHDAD
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BAGRAM AFGHANISTAN
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BAGRAM BSD
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BAGRAM BSD
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BASE HOUSING
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AFGHAN COMMUNITY
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AFGHAN COMMUNITY
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DUST STORM
UNCLASSIFIED
QUESTIONS?

UNCLASSIFIED