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HUMAN BLOOD AND TRANSPLANTS ACT
To regulate the collection and testing of human blood and blood components and to establish standards of quality and safety for human tissues and cells intended for human transplants.
15th September, 2006
ACT IV of 2006, as amended by Legal Notice 427 of 2007.
Transplants Act.
Short title.
PART I
PRELIMINARY
"allogenic use" means cells or tissues removed from one person and applied to another;
"autologous transfusion" means transfusion in which the donor and the recipient are the same person and in which pre-deposited
blood and blood components are used;
"aut ol og ou s u s e" mea n s cell s o r ti ssue s rem o v e d from and applied in the same person;
"blo od" mean s who l e b l oo d co llected from a donor and processed either for transfusion or for further manufacturing;
"blood component" means a therapeutic constituent of blood (red cells, white cells, platelets, plasma) that can be prepared
by various methods;
"blood component release" m eans a process which e nables a blood component to be released from a quarantine status by the
use of systems and procedures to ensure that the finished product meets its release specification;
"blood establishment" mean s any structure or body that is responsible for any aspect of the collection and testing of human
blood or blood components, whatever their intended purpose, and thei r processing, storage and distribution when intended for transfusion,
but does not include a hospital blood bank;
"bl ood prod uct " m eans any th erapeuti c p roduct derived from human blood or plasma;
"cells" means individual human cells or a collection of human cells when not bound by any form of connective tissue;
"the Commission" means the European Commission;
"deferral" means suspension of the eligibility of an individual to donate blood or blood components, such suspension being
either permanent or temporary;
"Directive 2004/23/EC" means the Commission Directive 2004/
Interpretation.
Cap. 458.
23/EC of the European Parliament and of the Council of 31 March,
2004 on setting standards of quality and safety for the donation, pr o c ur emen t, t e st in g , pr o cessi ng, preservation,
storage and
distribution of human tissues and cells;
"Directive 2004/33/EC" means the Commission Directive 2004/
33/EC of 22 March, 2004 implementing Directive 2002/98/EC of the European Parliam ent and of the Council as regards certain technical requirements for blood and blood components;
"distribution" means in the case of blood and blood components, the act of delivery of blood and blood components to other
blood establishments, hospital blood banks and manufacturers of blood and plasma derived products. It does not include the issuing
of blood or blood components for transfusions. In the case of human tissues and cells "distribution" means transportation
and delivery of tissues or cells intended for human application;
"donor" means every human source, whether living or deceased, of human cells or tissues;
"donation" means donating human tissues or cells intended for human applications;
"establishment" includes a blood establishment and a tissues and cells establishment;
"haemovigilance" means a set of or gan i sed surv eil l ance p r oc ed ure s rel at i ng to seri ou s ad ve rse or une xpec
ted events or reactions in donors or recipients, and the epidemiological follow- up of donors;
"hospital blood bank" means a hospital unit which stores and distributes and may perform compatibility tests on blood and
blood components exclusively for use within hospital facilities, including hospital based transfusion activities;
"human application" means the use of tissues or cells on or in a human recipient and extracorporal applications;
"i nspect ion " means f o rmal and obj ecti ve cont rol to identi fy problems i n accord ance w ith stan dards adopted
to assess compliance with these regulations;
"the Licensing Authority" means the Superintendent of Public
Health as established in article 3(1);
"t he Med i ci nes A u t h or i t y " me ans the Licensing Authority established under the Medicines Act;
"organ" means a differentiated and vital part of the human body, formed by dif f erent tissues , that main tai n s it
s structu r e, vascularisation and capacity to develop physiological functions with an important level of autonomy;
"processing" means all operations involved in the preparation, man i pul ati on, p r eservation an d packag ing of t i ssu
e s or cells intended for human applications;
"procurement" means a process by which tissues or ce lls are made available;
"preservation" means the use of chemical agents, alterations in envi ron m ent a l co ndi tio ns or ot her mean s durin
g processing to prevent or retard biological or physical deterioration of cells or tissues;
"quarantine" means the status of retrieved tissues or cells, or t i ssu e i s o l ated phy si cally or by o t her effectiv
e m eans, whi l st awaiting a decision on their acceptance or rejection;
"serious adverse event" means in the case of blood and blood com ponents, any untoward occurrence associat ed with the
collection, testing, processing, storage, and distribution, of blood and blood components that might lead to death or life-threatening,
disabling or incapacitating conditions for patients or which results in, or prolongs, hospitalisation or morbidity; and in the case
of tissues and cells means any untoward occurrence associated with the procurement, testing, processing, storage and distribution
of t i ssues and cells that might le ad to t h e t r ansmissio n of a communicable disease, to death or life-threatening, disabling
or incapacitating conditions for patients or which might result in, or prolong, hospitalisation or morbidity;
"serious adverse reaction" in the case of blood and blo o d components means an unintended response in donor or in patient
associated with the collection or transfusion of blood and blood components that is fatal, life-threatening, disabling, incapacitating,
or which results in, or prolongs, hospitalisation or morbidity; in the case of tissues and cells it means an unintended response,
including a communicable disease, in the donor or in the recipient associated with the procurement or human application of tissues
and cells that is fatal, life-threatening, disabling, incapacitating or which results in, or prolongs, hospitalisation or morbidity;
"st o rage" means mai n t a in i n g t h e pr od u c t un der ap pr op ri ate controlled conditions until distribution;
"tissue" means all constituent parts of the human body formed by cells;
"tissues and cells establishment" means a tissue bank or a unit of a hosp ital or anot her bod y w h ere activi ties o
f pro cessin g , preservation, storage or distribution of human tissues and cells are undertaken. It may also be responsible for
procurement or testing of tissues and cells;
"qualified health professional" includes a doctor, nurse and any health professional regulated by the Health Care Professions Act.
PART II
THE LICENSING AUTHORITY
Licensing Authority for the purposes of this Act.
(2) The Licensing Authority, hereinafter referred to as the
Licensing Authority, shall have the following functions:
(a) to verify that the establishments are in compliance with the requirements set out under this Act and any regulations made
thereunder;
Cap. 464.
Functions of the Licensing Authority.
(b) to indicate to the establishment which activities it may undertake;
(c) to establish conditions applicable to establishments;
(d) to issue, renew, amend, vary, suspend or revoke any licence that may be required by or under this Act;
(e) to carry out inspections of establishments and organize control measures in such establishments regularly and in any case not
less than once every two years;
(f) to conduct such additional inspections of establishments as it considers necessary for the purpose
of ensuring compliance with the requirements of this Act and any regulations made thereunder;
(g) to inspect hospital blood banks to ensure that such banks and persons responsible for the management of such banks comply
with the requirements of this Act and any regulations made thereunder;
(h) to organize, in the event of any serious adverse event or reaction or suspicion thereof, inspections and other control measures;
(i) to establish guidelines concerning the conditions of the inspections and control measures, and on the training and qualification
of the officials involved in order to reach a consistent level of competence and performance;
(j) to establish and maintain a publicly accessible register of tissue establishments specifying the activities for which they
have been licensed;
(k) to do all such things as may be necessary for the purpose of ensuring compliance with any of the provisions
of this Act or regulations made thereunder.
(3) The Licensing Authority may by rules delegate any of the functions referred to in subarticle (2) to the Medicines Authority,
or any other authority or institution it deems competent.
(4) The Licensing Authority shall levy such fees as may be prescribed for the purpose of this Act.
Inspections and control measures.
PART III
BLOOD ESTABLISHMENTS AND HOSPITAL BLOOD BANKS
(a) inspect at any reasonable hour:
(i) any premises owned or managed by a blood establishment or person responsible for management of a
hospital blood bank, or at which the blood establishment or person responsible for management of a hospital blood
in this Part of this Act;
(ii) any premises of any person who carries out any of the activities referred to in this Part of this Act on behalf of, and pursuant
to a contractual arrangement with, a blood establishment or a person responsible for management of a hospital blood bank;
and
(iii) where any facilities for donor evaluation and testing are in the premises of any person other than a blood establishment
or hospital blood bank, those facilities in that person’s premises;
(b) to require the production of, and inspect any article or substance at the premises;
(c) to require the production of, inspect and take copies of, or extracts from, any book, document, data or record, in whatever
form held at the premises, or any computer data or records which are accessible thereat;
(d) to take possession of any samples for examination and analysis and any other article, substance, book, document, data,
record in whatever form held at the premises, or any computer data or records which are accessible thereat;
(e) to question any person whom he finds at the premises and whom he has reasonable cause to believe is able to give him relevant
information;
(f) to require any person to afford him such assistance as he considers necessary with respect to any matter within that
person’s control, or in relation to which that person has responsibilities;
(g) to require, as he considers necessary, any person to afford him such facilities as he may reasonably require that person
to afford him;
(h) carry out any activity he may deem appropriate for the proper execution of his duties and responsibilities as provided by
this Act and any regulations made thereunder.
(2) he activities referred to in sub-article (1) are:
(a) the collection of human blood components, whatever their intended purpose; and
(b) the testing of human blood components, whatever their intended purpose; and
(c) their preparation, storage and distribution when intended for transfusion, unless any such activity is undertaken
in a blood establishment licensed for that purpose by the Licensing Authority.
Licensing of blood establishments.
(3) A licence shall not be required for -
(a) the storage and distribution of, and the performance of compatibility tests on, blood and blood components exclusively for
use within hospital facilities, including transfusion activities where such activities are performed by a hospital
blood bank; or
(b) any person carrying out any of the activities referred to in subarticle (2) where that person carries out that activity
on behalf of, and pursuant to, a contractual arrangement with -
(i) a blood establishment which is licensed under this Part to carry out the activity in question; or
(ii) a person responsible for the management of a hospital blood bank.
(4) The application for the grant of a licence shall be made to the Licensing Authority and shall be accompanied by the prescribed
fee.
(5) The application shall contain the information as may be prescribed and shall be submitted in the form and in the manner
as may by rules be laid down by the Licensing Authority.
(6) Where an application is received by the Licensing
Authority, it may -
(a) grant or refuse any application;
(b) grant such licence in respect of particular sites or activities only;
(c) grant such licence subject to conditions;
(d) refuse to process the application if such application has not been submitted in accordance with this Act and regulations made
thereunder;
(e) request the applicant to furnish it with additional information as it may deem necessary.
(7) When the Licensing Authority grants a licence following an a p p l i cat io n, it shal l g i v e no ti ce in wr it i
n g t o th e bl o o d establishment specifying -
(a) the activities which the blood establishment may undertake under this Act and regulations made thereunder
at each site in respect of which licence is granted; and
(b) the conditions which apply to the undertaking of those activities.
(8) The Licensing Authority may at any time remove or vary any of the licence conditions, or may impose additional conditions.
(9) When the Licensing Authority removes or varies any co ndit i on or i m poses any addit i on al co ndit i on the Licen
s i n g Aut hor ity shall in form in wri tin g t h e bl ood establi s h m ent in question giving reasons for its decision.
(10) A blood establishment may not make any substantial
written approval of the Licensing Authority.
(11) Any application for approval to make a substantial change in its activities shall be made in writing to the Licensing Authority,
and shall be accompanied by the prescribed fee.
(12) For the purpose of this article, a substantial change in a blood establishment’s activities is any change -
(a) to the sites from which the blood establishment operates or to the activities to be carried out at each site;
(b) which would result in breach of this Act or regulations made thereunder or of any condition specified by the Licensing Authority;
or
(c) to the quality system which is likely to have a substantial impact on the conduct of, or might compromise
the safety of, any of those activities which the blood establishment has been licensed to undertake.
(a) that the blood establishment has failed, in any material respect, to comply with the requirements of this Act or regulations made
thereunder;
(b) that the collection, testing, processing, storage or distribution of blood or blood components by the blood establishment
cannot be carried out safely;
(c) that any blood or blood components cannot be supplied to hospital blood banks in such a state that they could be
safely administered for transfusion; or
(d) that the information given by the blood establishment was false or incomplete in any material respect.
(2) Prior to suspending or revoking the licence of a blood establishment, the Licensing Authority shall serve a notice
on the blood establishment stating that it intends to suspend or revoke its licence with effect from the date specified in the notice,
giving reasons for such decision:
Provided that a suspension or revocation shall take effect imm edi at e ly when the Licen si ng A u th ori t y co nsider s that
it is necessary in the interests of safety.
(3) In those cases where -
(a) the blood establishment has failed, in any material respect, to comply with the requirements of this Act or regulations
made thereunder; or
(b) the information given by the blood establishment was false or incomplete in any material respect,
and the Licensing Authority considers that the failure in question is
Revocation or suspension of licence.
not sufficiently serious to warrant suspension or revocation of the l i cen c e of t h e blo od establi s h m ent in t h e fir s t
instance, the Licensing Authority may serve a notice on the responsible person of the blood establishment:
(i) identifying the requirements of which the blood establishment is in breach or, in the case of false and incomplete
information, the further information which is required;
(ii) identifying the action which the blood establishment is required to take; and
(iii) giving the timescale within which the blood establishment shall take the action identified in the preceding subparagraph.
(4) If the blood establishment fails to comply with the requirements set out in the notice within the specified
timescale, the Licensing Authority m a y, by a notice served on the blood est a bl ish m en t, su spen d or revo ke the licence of
the blood establishment.
(5) Any suspension shall be for such period as the Licensing Authority shall consider necessary having regard to the reasons for
the suspension.
(6) The suspension or revocation of an licence may be total, or limited to a particular activity or to one or more activities carried
out at a particular site or sites, or to a particular blood component.
Notice served on hospital blood banks.
(a) the person responsible for management of a hospital blood bank has failed, in any material respect, to comply with the
requirements of these articles; or
(b) the testing, storage or distribution of blood or blood components by the hospital blood bank is such that any blood or blood
components cannot be safely administered for transfusion; or
(c) the information given by the person responsible for management of a hospital blood bank was false or incomplete in
any material respect,
the Li censin g A u th ori t y may ser v e a no tice on th e person responsible for management of the hospital bank requiring that
the hospital ceases to conduct any of this Activities specified in the notice, or refrains from administering to patients any blood
or blood components specified in the notice, until the conditions set out in the notice are complied with.
(2) Any notice served by the Licensing Authority pursuant to subarticle (1) shall specify the date from which the prohibition
specified in the notice shall take effect, which shall be not less than seven days from the date on which the notice is served:
Provided that where the Licensing Authority considers that it is necessary in the interests of safety, it may specify in the notice
that the prohibition takes immediate effect.
(3) The notice shall be withdrawn if:
(a) the person responsible for management of the hospital blood bank is no longer in breach of the requirements of these articles;
(b) the hospital blood bank is able to show that the activity or product referred to in the notice given pursuant to subarticle (1)(b) may be safely carried out or, as the case may be, administered; or
(c) all necessary information has been supplied to the
Licensing Authority.
(2) Every licence shall, unless previously revoked, be re new a b l e u p o n ap pl i cat io n by th e holder ma de at least thre e months before the expiry of the period of validity.
Validity of licence.
33/EC and any amendments thereto.
(a) the blood establishments that those criteria must be adopted; and
(b) the Commission of the epidemiological situation and the additional deferral criteria which blood establishments
are required to adopt in relation to it pursuant to paragraph (a).
(2) A blood establishment shall adopt and comply with any criteria for additional tests not if ied to th em b y t h e Li
cen s in g Authority pursuant to subarticle (1).
PART IV
TISSUES AND CELLS ESTABLISHMENTS
(a) inspect at any reasonable hour:
(i) any premises owned or managed by a tissues and cells establishment, or at which the tissues and
Importation.
Specific epidemiological situations.
Inspection and control measures.
activities in relation to the procurement of human tissues and cells;
(ii) any premises of any person who carries out any of the activities referred to above on behalf of, and pursuant to a contractual
arrangement with, a tissues and cells establishment; and
(iii) where any facilities for donor evaluation and testing are in the premises of any person other than a tissues and
cells establishment, those facilities in that person’s premises;
(b) to require the production of and inspect any article or substance at the premises;
(c) to require the production of, inspect and take copies of, or extracts from, any book, document, data or record, in whatever
form it is held at the premises, or any computer data or records accessible thereat;
(d) to take possession of any samples for examination and analysis and any other article, substance, book, document, data,
record, in whatever form they are held at the premises, or any computer data or records accessible thereat;
(e) to question any person whom he finds at the premises and whom he has reasonable cause to believe is able to give him relevant information;
(f) to require any person to afford him such assistance as he considers necessary with respect to any matter within that
person’s control, or in relation to which that person has responsibilities;
(g) to require, as he considers necessary, any person to afford him such facilities as he may reasonably require that person to
afford him;
(h) to evaluate and verify the procedures and the activities carried out in tissues and cells establishments and the facilities
of third parties that are relevant to the requirements of this Act and regulations made thereunder;
(i) carry out any activity he may deem appropriate for the proper execution of his duties and responsibilities as provided by this
Act and regulations made thereunder.
Supervision and licensing.
(2) A licence shall not be required for -
(a) the storage and distribution of, and the performance of compatibility tests on, tissues and cells exclusively for use within hospital
facilities; or
(b) any person carrying out any of these activities referred to in subarticle (1), where that person carries out that activity on
behalf of, and pursuant to a contractual arrangement with a tissues and cells establishment which is licensed under
this Part to carry out the activity in question;
(c) the direct distribution of specified tissues and cells for immediate transplantation to the recipient as long as the supplier
is licensed for such activity.
(3) The application for the grant of a licence shall be made to the Licensing Authority and s h all be accompanied by the prescribed
fee.
(4) The application shall contain the information as may be prescribed and shall be submitted in the form and in the manner
as may by rules be laid down by the Licensing Authority.
(5) Where an application is received by the Licensing
Authority, it may -
(a) grant or refuse any application;
(b) grant such licence in respect of particular sites or activities only;
(c) grant such licence subject to conditions;
(d) refuse to process the application if such application has not been filed in accordance with this Act and regulations
made thereunder;
(e) request the applicant to furnish it with additional information as it may deem necessary.
(6) When the Licensing Authority grants an application for licence, it shal l give notice in w r iting t o the tissu es
and cells establishment specifying -
(a) the activities which the establishment may undertake under this Act and regulations made thereunder at each site in respect of
which a licence is granted;
(b) the conditions which apply to the undertaking of those activities; and
(c) the tissues and cells preparation processes which the establishment may carry out.
(7) The Licensing Authority may at any time remove or vary any of the licence conditions, or may impose additional conditions.
(8) When the Licensing Authority removes or varies any condition or imposes any additional condition, it shall inform in
writing the establ ishm ent in question giving reasons for its decision.
(9) A tissues and cells establishment may not make any substantial change in the activities which it undertakes without
the prior written approval of the Licensing Authority.
(10) Any application for approval to make a substantial change in the activities of the tissues and cells establishment shall be
made
the prescribed fee.
(11) For the purposes of this article, a substantial change in a tissues and cells establishment’s activities is any change -
(a) to the sites from which the establishment operates or to the activities to be carried out at each site;
(b) which would result in breach of this Act or regulations made thereunder or of any condition specified by the Licensing Authority;
or
(c) to the quality system which is likely to have a substantial impact on the conduct of, or might compromise
the safety of, any of the activities which the establishment has been licensed to undertake.
(12) The Licensing Authority shall suspend or revoke the licence of a tissues and cells establishment or of a tissue or cell
preparation process if inspections or control measures demonstrate that such an establishment or process does not comply with the
requirements of this Act and regulations made thereunder.
Revocation or suspension of licence.
13.(1) (a) The Licensing Authority may suspend or revoke the licence of a tissues and cells establishment on one or more of the following grounds:
(i) that the establishment has failed, in any material respect, to comply with the requirements of this Act or regulations made
thereunder;
(ii) that the information given by the blood establishment was false or incomplete in any material respect.
(b) In addition the Licensing Authority shall suspend or revoke the licence of a tissues and cells establishment or of a tissues
or cells preparation process if inspections or control measures demonstrate that such an establishment or process does
not comply with the requirements of this Act and regulations made thereunder.
(2) Prior to suspending or revoking the licence of a blood establishment, the Licensing Authority shall serve a notice
on the blood establishment stating that it intends to suspend or revoke its licence with effect from the date specified in the notice,
giving reasons for such decision:
Provided that such suspension or revocation shall take effect immediately when the Licensing Authority considers that it is
necessary in the interests of safety.
(3) In those cases where -
(a) the establishment has failed, in any material respect, to comply with the requirements of this Act or regulations
made thereunder; or
(b) the information given by the establishment was false or incomplete in any material respect, and the
Licensing Authority considers that the failure in question is not sufficiently serious to warrant suspension
or revocation of the licence of the establishment in the first instance,
the Licensing Authority may serve a notice on the responsible person of the establishment:
(i) identifying the requirements of which the establishment is in breach or, in the case of false and incomplete
information, the further information which is required;
(ii) identifying the action which the establishment is required to take; and
(iii) giving the timescale within which the blood establishment shall take the action identified in subparagraph (ii).
(4) If the establishment fails to comply with the requirements set out in the notice within the specified timescale, the Licensing
Authority may, by a notice served on the establishment, suspend or revoke the licence of the establishment.
(5) Any suspension shall be for such period as the Licensing Authority shall consider necessary having regard to the reasons for
the suspension.
(6) The suspension or revocation of an licence may be total, or limited to a particular activity or to one or more activities carried
out at a particular site or sites, or to a particular tissue and cell.
(2) Every licence may, unless previously revoked, be renewed upon application by the holder made at least three months before the expiry of the period of validity.
Validity of licence.
(a) such an activity is undertaken by a licensed tissues and cells establishment;
(b) the imported tissues and cells can be traced from the donor to the recipient and vice versa in accordance with the procedures
established by regulations under this Act;
(c) the tissues and cells establishments that receive such imports from third countries ensures that they meet standards of quality
and safety equivalent to the ones laid down in Directive 2004/23/EC.
(2) No person shall export tissues and cells to third countries unless:
Import or export of human tissues and cells.
(a) such activity is undertaken by a licensed tissues and cells establishment;
requirements of Directive 2004/23/EC.
(3) The Licensing Authority may, after ensuring that the that imports and exports of tissues and cells referred to in subarticle
(2) meet quality and safety standards equivalent to those laid down in Directive 2004/23/EC, directly authorise:
(a) the import or export of tissues and cells referred to in article 12(2)(c);
(b) the import or export of certain tissues and cells in case of emergency.
Power of the Minister to make regulations.
Offences and penalties. Amended by:
L.N. 427 of 2007.
Special procedure.
Amended by:
L.N. 427 of 2007.
PART V
MISCELLANEOUS
Authority, by regulations provide for -
(a) the requirements to be satisfied by blood and tissues and cells establishments;
(b) standards of good practice in manufacture;
(c) the requirements to be satisfied by hospital blood banks;
(d) the requirements to establish an effective system of haemovigilance;
(e) prescription of the fee to be paid for the issue of a licence;
(f) any other matter to better put into effect the provisions of this Act.
(2) The Minister shall prescribe the penalties that may be demanded by the Licensing Authority in relation to any specified
offence:
Provided that such penalty shall not exceed the amount of eleven thousand and six hundred and forty-six euro and eighty- seven cents
(11,646.87).
(3) Where a notice under this article has been given, the person named in the notice may, within twenty-one days of the service
of the notice, accept responsibility for the offence specified in the notice and within the same period pay the penalty indicated
in the
notice, and comply with the relative provision of this Act, or of the regulations or rules made thereunder and no further proceedings
may be taken under this Act in respect of such offence.
(4) Where the person to whom notice is given under subarticle (1) h a s not paid the penalty with in the twenty -o ne day perio
d referred to in subarticle (3) and has not, within the time specified, complied with the requirements of this Act, criminal proceedings
may be taken against him in accordance with the provisions of the Criminal Code, of this Act and of any other law applicable to the offence.
Cap. 9.
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