[Transfusion medicine in the 2000s, on a reform].
The creation of the Etablissement Français du Sang (EFS) was mentioned in the Law of July 1, 1998, pertaining to sanitary safety. The EFS is the sole operator of blood transfusion. With a unique legal status, supervised by the Ministry in charge of Health, the EFS organizes the activities involved in the transfusion chain over the whole territory, it promotes research activities and take part in international scientific cooperation. Its activities include medical biology as well as cell and gene therapy. As part of the new 2000-2004 territorial transfusion scheme, the EFS network comprises 18 centers (versus 43 in the previous plan), 14 of which are located in the French territory and the other 4 overseas. The network includes 18 technical platforms for the biological qualification of blood products, while 27 are dedicated to their preparation, transformation and storage. The activities of collection and distribution, which comply with the principle of proximity to both donors and patients, are ensured by 220 sites spread over the whole territory. For the future, the EFS wants to focus its efforts on reducing residual infectious risks (using molecular biology tools), preventing immunological risks, drawing up an education program aiming at teaching transfusion medicine differently. Despite the advances achieved in biotechnologies, the development of substitution products to replace blood transfusion will still require a lot of time. The EFS wishes to focus its action following three different axes: transfusion medicine, medical biology and cell engineering. With its 18 centers and its 8,200 persons, the EFS must face the challengers of the 2000s, relying on the advances in biotechnologies.