In the 1980s, Blood Service operations focused on safety
Professor Jukka Koistinen has held several management positions in the Blood Service throughout his career. We achieved many things in the 1980s, but the decade was also marked by concerns about the safety of blood products.
"The early 1980s was an optimistic time. The industrial production of plasma took place at Kivihaka, and we used it to make various preparations for the treatment of haemophilia, for example. We also produced albumin and gamma globulin preparations. Subsequently, we had to abandon plasma production, as competing products were being developed.
We also produced antiviral interferon for research purposes. Virtually the entire production was sold to the USA and the Blood Service was known as the manufacturer of almost all interferon in the world. Economically, this was significant for the Blood Service, and the dollar revenues also ensured that the price of blood bags remained reasonable.
Storage methods for blood products developed rapidly. As late as the early 1980s, thrombocytes had to be transferred to a patient within three of hours of blood donation and our officers were calling donors at all hours of the day to ask them to come in. The development of a new type of plastic extended the shelf life to three days, which made a huge difference.
At the end of the 1970s, the Blood Service's recently established IT department developed the first automatic data processing system for processing donor and product data.
Component therapy was here to stay, and the use of whole blood had practically ceased. The therapy that revolutionised blood supply means that patients are only administered the required blood component. In this way, all the blood can be utilised. We visited hospitals across the country to talk about this, and the hospitals also learnt a lot from each other".
Swift action minimised risks
"Then the bombshell dropped. We began hearing news of a fatal disease that was not even initially identified as a virus disease. We monitored the situation closely in international arenas. When HIV test kits finally came on the market, they were not available due to the huge demand. In the autumn of 1984, we finally received 200 kits in Finland and made a swift decision to start testing the risk groups.
The following autumn, the Blood Service began HIV testing of blood donors and free tests were introduced to health centres. Initially, the Blood Service also carried out these tests at cost. Fortunately, the HIV virus did not spread in Finland the way it did in certain other countries. We found six HIV-positive blood donors. This number was also too high, of course, as four of the blood donors had infected others with the fatal disease. However, our swift action helped to keep infections down by international standards.
In the 1980s, doping in sport was making the headlines; endurance athletes, in particular, were using blood transfusions to improve their performance. Of course, at the Blood Service, we didn't know what the hospitals were using the blood for. We issued a statement saying that the blood supplied by the Blood Service was only intended for the exclusive treatment of diseases for medical reasons. What was most unfortunate was that some people connected doping with the Blood Service, although we had nothing to do with it.
At the Blood Service, blood safety has always been at the core of our operations. As far back as the 1970s, we studied, free of charge, all blood transfusion reactions that occurred in hospitals. We actively informed the hospitals of the results and lessons were learnt. We were always happy to give a lecture if invited – and sometimes we went uninvited".
Spreading expertise throughout the world
"The Blood Service has always been the home of research, and the positive attitude towards research was one of the factors that attracted me to the Blood Service. Research was very practical, and in most cases it related to routine activities in haematology. The results were actively shared in weekly meetings. They helped to put together donor panels of people with rare blood group characteristics, for example. I wrote my doctoral thesis in 1975 on immunoglobulin A deficiency.
In fact, I discovered haematology by chance. When I was a student, I took summer jobs in Sweden because the pay was better. Harri Nevanlinna, the (then) director of the Blood Service, heard about one of my jobs at the blood centre at St. Erik's Hospital and asked me to work in Oulu as a consulting physician. Things were done a little differently in Sweden, and it was good to exchange experiences.
Nordic cooperation had already been established in the late 1960s when I worked in Stockholm during the summer. All of a sudden, the whole country ran out of O negative blood units
(emergency blood suitable for everyone). I rang the Blood Service, and they immediately sent 40 bags of O negative blood on the afternoon flight. Even then, the Blood Service was recognised for its agility and pragmatism.
In the 1980s, the Blood Service participated in many international development projects in locations such as Somalia and Ethiopia. Our doctors and chemists stayed for a few weeks, but nurses sometimes stayed for three months. We brought our expertise to these countries and taught them how to run blood services. Some of their workers also visited Kivihaka to learn more.
People in Somalia were particularly committed to developing blood services, and I made some life-long friends there. Since then, the Blood Service has also participated in numerous other projects in the Far East and South America.
This was a busy decade, but everything has always been based on the blood donors' genuine desire to help others. In Finland, there is a great spirit in blood donation, and people value giving blood. It is obvious as soon as you talk to donors".
Text: Minna Kalajoki / Mediafocus
Photos: Matti Rajala