As director of the National Blood Centre at the National Institute of Haematology and Blood Transfusion (NIHBT) in Vietnam, Dr Tran Ngoc Que has deep experience in blood supply management and transfusion medicine in the country. In the first of this two-part Q&A series, Dr Que provides an overview of what NIHBT does and how it helped improve Vietnam’s blood supply dramatically over the past few decades.

What is NIHBT and how is it structured?

For many years, NIHBT has been at the forefront of haematology and blood transfusion in Vietnam. In addition to the treatment of blood diseases, it is the largest blood centre in Vietnam, as well as a provider of the highest level of blood testing.

NIHBT also acts as an advisor to the Ministry of Health in issuance of all policies on blood donation advocacy, operational matters, professional procedures, and other issues related to blood donation, testing and blood transfusion safety.

Our institute was originally established as a unit of Bach Mai Hospital [a leading multispecialty hospital in Hanoi] in 1984. In 2004, it was separated to operate as an independent unit under the Ministry of Health. It includes both a Haematology and a Blood Transfusion division.

As part of the institute, the National Blood Centre’s main activities include receiving blood, testing and screening it, and supplying hospitals. Other blood centres and transfusion facilities will also send samples here for further tests, especially NAT tests, including screening for HIV, HBV/HCV, and any samples with abnormalities detected.

What was the status of Vietnam’s blood supply when you started your career in the 1990s?

I have been involved in blood transfusion since my student days, when I was studying medicine at Hanoi Medical University from 1990 to 1996. At the end of the third year, I was fortunate to meet Prof Do Trung Phan, director of NIHBT, who needed medical students to be the first volunteers in blood donation campaigns.

At that time, Prof Phan said that we suffered from a severe shortage of blood reserves in Vietnam. In 1993, the donated blood reserve was one-tenth of its current size—a little more than 100,000 blood units per year nationwide, compared to 1.4 million blood units now. Moreover, 90% of blood was from paid donors while only 10% was from voluntary blood donors. There was a shortage of blood everywhere and most donors sold their blood to make ends meet, so it was considered something that only people at the bottom of society would do.

To change this, Professor Phan and his medical students decided to mobilise blood donations at universities. They recruited students to donate their blood and participate in blood donation campaigns to spread awareness. This activity was essentially a blood donation campaign, but due to social stigma against blood donation, we did not dare to call it that at first.

How have blood donation quantities grown over time?

Back in 2004, the National Blood Centre initially received about 20,000 to 30,000 blood units per year. By 2008, we had already reached 90,000 blood units, and today, we receive an average of 350,000 to 370,000 units of whole blood and about 35,000 units of apheresis platelets per year. In addition to receiving blood in Hanoi, we also receive blood in 12 nearby provinces and cities.

We are currently focusing a lot on encouraging blood donation from staff in state agencies and people living in big cities. In 2018 and earlier, 80% of the blood was from students and young people, but now these groups account for only about 20-30%. Today, we manage more than 2.2 million blood donors. We have also grown the donation volume over time—in 2021, the rate of 350ml blood donation accounted for 77.2%, whereas 250mL blood donations were higher in previous years.

How are you working to further build the blood supply today?

As recommended by the World Health Organisation and the International Blood Transfusion Association, regular voluntary blood donors play an important role in maintaining the safest and best quality blood reserve for a country. To this end, the National Blood Centre initiates and organises advocacy programmes and events to create a stable, high-quality and effective source of blood donors.

For starters, we seek to raise awareness that blood donation is not harmful and should be voluntary to help others. Once someone decides to donate blood, it is important to encourage them to donate their blood repeatedly. By organising programmes that are suitable and convenient, donors feel comfortable, healthy and honoured so they may return to donate blood the next time.

We currently have a Public Relations Department of nearly 20 staff to help ensure that all blood donors receive attentive care, including letters of thanks and messages of congratulation on their birthdays, holidays, and special days to keep in touch with them, so when we are in need of blood, we may contact them via phone, email, and social networks. Our aim is to encourage people to donate blood twice a year.

We also provide services that help donors to monitor their health, including diagnostic tests and information to ensure that results are explained to them and their questions are answered. For example, we now offer test packages to check the health of blood donors every six months. This is also one of the activities to retain blood donors and make them become regular blood donors.

This is the first of a two-part Q&A series with Dr Tran Ngoc Que, director of the National Blood Centre at the National Institute of Haematology and Blood Transfusion (NIHBT) in Hanoi, Vietnam. The second part, which explores how NIHBT responded to the COVID pandemic, can be viewed here.