a riskBlood supply safety

Whether the blood a patient may be given during an operation was screened, and screened under a quality system. WHO recommends that screening for HIV, hepatitis B, hepatitis C and syphilis be mandatory for all donations. Of the countries reporting to WHO for 2023, 10 were not able to screen all donated blood for one or more of those four.

The WHO Global Database on Blood Safety collected data from 153 countries for 2023, with responses from 168 covering 97% of the world's population. Of 120.4 million donations collected globally, 36% came from high-income countries holding 15% of the world's people. Donation rates ran from 28.9 per 1,000 people in high-income countries to 4.5 per 1,000 in low-income ones.

Two figures in that release bear directly on an operation abroad. First, external quality assessment: 63% of blood screening laboratories worldwide took part in such schemes, and by income group the figures were 92%, 66%, 48% and 68% for high-, upper-middle-, lower-middle- and low-income countries. A laboratory that screens without external assessment is screening; whether it is screening correctly is unverified. Second, WHO states plainly that the prevalence of transfusion-transmissible infections in donations is considerably lower in high-income countries than in low- and middle-income ones.

The donor base matters for the same reason. In 59 countries more than half the supply still comes from family, replacement and paid donors, and WHO's position is that regular voluntary unpaid donors are the safest group because the prevalence of bloodborne infection is lowest among them.

Inference — the exposure is concentrated in a small set of procedures and almost absent from the rest. A dental implant and a hair transplant do not reach the blood bank. Cardiac surgery, liver transplantation and a revision joint do.

A hospital's own transfusion service is not the same thing as its country's national blood system, and a large private hospital may run to a standard well above the national figure. Neither position is published at hospital level anywhere this project has looked. What is published is the country figure, and the exclusion line on the package: the Bumrungrad knee package read for this site excludes blood transfusion from its fixed price, which prices the bag without describing where it came from.

As of 16 September 2026 the only figures available are national and come from one annual WHO collection. No accreditor publishes a facility-level transfusion-safety measure, and no destination publishes one for the hospitals that treat foreign patients.