BLOOD DONATION

• Autologous Donation

• Directed Donation

• Apheresis Donation

What are the 3 types of blood donation inside blood bank section?

Autologous donor

It is the one who donates blood for his or her own use.

Donor-patient

An autologous donor is referred to as the?

Autologous donation

It is a type of donation wherein a patient donates blood for his/her own use.

Autologous donations

It can be used for the future,

Most autologous blood is used to treat surgical blood loss in very specific situations where there is a reasonable opportunity to avoid homologous transfusions or when compatible allogeneic blood is not available.

Most autologous blood is used to treat ___ in very specific situations where there is a reasonable opportunity to avoid ___ transfusions or when ___ is not available.

• Decreased risk of disease transmission

• Decreased transfusion reactions

• Decreased risk of alloimmunization

• Can be used for patients with very rare blood types (AB-)

• Patients with multiple antibodies for which compatible units in the general blood supply may be

  difficult or impossible to find.

What are the advantages of using autologous blood?

1. Preoperative collection

2. Acute normovolemic hemodilution

3. Intraoperative collection

4. Postoperative blood salvage collection

What are the 4 different types of autologous donation?

Preoperative collection

It occurs during the 5 to 6 weeks immediately preceding a scheduled, elective surgical procedure unless the red blood cells and plasma are scheduled to be frozen.

Preoperative Collection

A type of collection that can be used for orthopedic procedures, vascular surgery, cardiac or thoracic surgery, and radical prostatectomy.

72 hours (3 days)

The last blood collection for Preoperative Collection must occur no later than ___ before scheduled surgery to allow for volume replacement.

None

The minimum age requirement for Preoperative Collection

• 11 g/dL

• 33%

• 450 or 500 +- 10%

Pre-operative collection

• Minimum Hgb

• Minimum HCT

• Volume

Reduced proportionately

If patient is less than 50kg, the volume of blood must be?

• 300-405 mL in 450 mL bag

• 333-449 mL in 500 mL bag

When will you label a unit as low volume?

Acute Normovolemic Hemodilution

It results in the collection of whole blood with the concurrent infusion of crystalloid or colloid solutions, thus maintaining a normal blood volume but decreasing the patient’s hematocrit.

• Crystalloid - 3:1

• Colloid - 1:1

Acute Normovolemic Hemodilution

Ratio of replacement

• Crystalloid

• Colloid

• 12 g/dL

• Room temperature

• Storage bag with anticoagulant or preservative

• Within 8 hours of collection

• 24 hours, only if refrigerated within first 8 hours

Acute Normovolemic Hemodilution

• Minimum Hgb

• Storage Temperature

• Storage requirement

• Reinfusion duration

• Storage duration

Intraoperative Collection

It involves collecting shed blood from the surgical site; processing the blood through an instrument that washes it with saline to remove tissue debris, free hemoglobin, and plasma that may contain activated coagulation factors.

Intraoperative Collection

It concentrates the residual RBCs to a hematocrit of 50% to 60%; and then reinfusing those cells immediately.

• Preoperative donation is not possible due to urgency

• Patient cannot be scheduled for multiple preoperative donation

Intraoperative collection is done when?

• Acute Normovolemic Hemodilution

• Intraoperative Collection

What types of collected blood usually does not leave the OR?

• 6 hours at room temp.

• 24 hours at 1-6 C

  • Only if refrigerated within 4 hours of collection

Intraoperative Collection

• Storage

• Duration

Postoperative Blood Salvage

It is collected from a drainage tube placed at the surgical site. It is reinfused, with or without processing, via a microaggregate filter to screen out any debris.

Postoperative Blood Salvage

It is dilute, partially hemolyzed, and defibrinated.

• No more than 1400 mL

• Within 6 hours of collection (otherwise, discard)

Postoperative Blood Salvage

• Volume reinfused

• Reinfusion duration

Direct Donation

It is collected under the same requirements as those for allogeneic donors and the unit is directed toward a specific patient.

Directed Donation

Often, when a friend or family member needs blood, the donor center will accommodate these donations so that the required testing may be done as soon as possible.

Irradiated to prevent transfusion-associated GVHD

If the directed blood donor is a blood relative of the patient, the unit must be?

Irradiation

It is a process wherein T cells are removed from the blood unit to prevent it from entering the patient’s circulation. Otherwise, it will cause TA-GVHD.

Apheresis

It is an effective mechanism for collecting a specific blood components while returning the remaining whole back to the patient.

• Plateletpheresis

• Leukapheresis

• Plasmapheresis

• Double RBC Apheresis

Types of Apheresis

Plateletpheresis

A term used to describe the removal of platelets using apheresis.

6-8 random platelet units

1 unit of plateletpheresis is equivalent to?

8 weeks / 56 days

How frequently can plateletpheresis donors donate?

• 2 days (no more than 2x a week, or 24x a year)

• More than 150,000u/L

• 500 mL (600 mL if 80 kg)

Plateletpheresis Donation

• Interval between donations

• Platelet count

• Amount of plasma to be removed with platelets

Plasma was the first product to be collected by apheresis methods and was primarily used as a method for collecting “source plasma”, which is further manufactured into plasma derivatives.

___ was the first product to be collected by apheresis methods and was primarily used as a method for collecting “___ ___”, which is further manufactured into ___ derivatives.

• Infrequent/ Occasional

• Serial

Plasmapheresis donors are classified as either?

Infrequent donors

They donate no more than one procedure in a 4-week period.

Serial donors

They donate more frequently than 4 weeks but no more than every 48 hours and no more than 2 donations in a 7-day period.

• 25 mL per week

• 200 mL in 8 weeks

The RBC loss in plasmapheresis must not exceed?

Leukapheresis

It is the only effective method for collecting leukocytes and stem cells.

Leukoreduced PRBC / Leukoreduction

What are other collection methods for WBC components?

• Give donor certain drugs or sedimenting agents

• >1 × 1011 granulocytes

• How can you collect large volumes of leukocytes?

• Measurement

• Hyroxyethyl Starch

• Corticosteroids (Prednisone and Dexamethasone)

• Recombinant Hematopoietic Growth Factors

State the drugs or sedimenting agents given during leukapheresis.

Hydroxyethyl Starch

It enhances the separation of the white blood cells from the red blood cells during centrifugation, which increases the amount of leukocytes collected and decreases the amount of RBC contamination in the final product.

Corticosteroids (Prednisone and Dexamethasone)

They work by pulling the granulocytes from the marginal pool into the general circulation, thus increasing the supply of cells available for collection.

Double RBC Apheresis

A process wherein double units of RBCs are collected using an apheresis machine.

• 10 g/dL

• 30%

• 16 weeks (4 months)

Double RBC Apheresis

• Hemoglobin

• Hematocrit

• Donation interval

• 8 weeks

• 16 weeks

Double RBC Apheresis - Deferral for RBC loss

• > 200 mL but <300 mL

• > 300 mL

• Temporary Deferral

• Indefinite Deferral

• Permanent Deferral

What are the 3 types of donor deferral?

Temporary Deferral

It pertains to a donor that is unable to donate for a limited period of time.

12 months from date of transfusion

Deferral

Donor received blood transfusion

2 weeks from date of vaccination

Deferral

Donor received vaccine for yellow fever

Indefinite Deferral

It pertains that the donor is prohibited from donating blood to another person for an unspecified period of time due to current regulatory requirements. However, they can donate if the current requirement changes.

False.

Indefinite deferral donors can donate autologous blood.

True or False.

Indefinite deferral donors cannot donate autologous blood because the higher concentration of unwanted antigens in the donated units can increase the risks for reactions.

Permanent deferral

It refers that the donor may never donate blood to another person.

False.

Permanent deferral donors can donate autologous blood.

True or False.

Permanent deferral donors cannot donate autologous blood because the higher concentration of unwanted antigens in the donated units can increase the risks for reactions.

• Parenteral drug use

• Hemophilia A and B, vWD, severe thrombocytopenia

• CJD or vCJD

• Treatment of pituitary GH

• Viral hepatitis at 11 y.o.

• Confirmed HBsAg

• Repeatedly reactive anti-HBC and HTLV

• Present or past infection with HIV, HCV, HTLV

• History of babesiosis or Chagas’ Disease

What conditions can lead to permanent deferral?

• Anticonvulsant

• Digitalis

• Glutathione (liver)

• Growth Hormone

• HIV ART

• Insulin

• Tegison (psoriasis)

• Psychosis drugs

What medications result to permanent deferral?

3 years

Deferral for malaria

1 year

Deferral for Syphilis

1 year

Deferral for gonorrhea

1 year

Deferral for exposure to blood components

1 year

Deferral for sexual contact with persons with STDs

8 weeks (56 days)

Deferral for whole blood donation

6 weeks

Deferral for pregnancy

1 year

Deferral for pregnancy that received blood transfusion

4 weeks

Deferral for live attenuated vaccines such as:

• German measles (rubella)

• Chickenpox (VZV)

2 weeks

Deferral for live attenuated vaccines such as:

• Measles (Rubeola)]

• Mumps

• Oral Polio (Sabin)

• Typhoid or Yellow Fever

2-3 weeks

Deferral for smallpox vaccination

None

Deferral for toxoids or killed viral, bacterial, rickettsial vaccines

3 days

Deferral for plateletpheresis donor that received aspirin

3 years after treatment

DOH Deferral for malaria infection

6 months from date of departure from area

DOH Deferral for a vacation to malaria-endemic area for less than 6 months.

12 months from date of departure

DOH Deferral for former resident of malaria-endemic area or stayed more than 6 months.

8 weeks after vaccination

DOH Deferral for Measles, Mumps, Rubella vaccine

• Medical history of donor

• Partial physical examination

• Serologic testing of donor blood

Donor selection encompasses the?

1. Is a donation of 450 mL whole blood harmful to the donor?

2. Could blood drawn from the donor transmit disease to a recipient?

The medical history information and physical examination are designed to answer two questions:

True

True or False.

The blood collection facilities must confirm donor identity and link the donor to existing donor records.

Photographic identification (ID)

Most facilities require a ___ for identification.

Every donor must be checked against a permanent record of previously deferred donors

How to prevent an ineligible donor from donating?

• General appearance

• Weight

• Temperature

• Hemoglobin

• Skin lesions

The donor center representative evaluates the prospective donor with regard to?

The physical examination is usually performed by medical officer but if they are not around, nurse, medical technologist or another physician can take place.

The physical examination is usually performed by ___ but if they are not around, ___, ___, or ___ can take place.

• Excessive anxiety

• Drug or alcohol influence

• Nervousness

What is observed in general appearance?

10.5 mL / kg

What is the maximum blood to weight ratio for whole blood collection, inclusive of pilot testing?

(Donor’s weight in kg/50) x 450 mL

Formula for volume of blood to be collected based on weight

(Volume to collect/ 450 mL) x 63 mL

Formula for reduced volume of anticoagulant

63 mL - reduced volume of anticoagulant

Formula for amount of solution to be removed

<37.5 C or <99.5 F

Temperature requirements for donor

>12.5 g/dL

Hemoglobin requirements for allogenic donors

>38%

Hematocrit requirements for allogenic donors

50-110 bpm

Pulse requirements for donors

An athlete

A bpm of <50 is not deferred if donor is?

<180 / <100

Blood pressure requirements for donors

Indefinitely

Evidence of skin lesions such as multiple puncture marks are deferred?

Not

Skin disorders such as poison ivy and rashes are ___ deferred, only if they are not present in site of venipuncture.

• Aseptic method

• Iodine compound (PVP-iodine), Dry sterile gauze

• 4 cm

• 30 seconds

How is skin preparation done?

• Method

• Materials

• Area

• Duration

• Clorhexidine gluconate

• Isopropyl alcohol

Alternative to iodine in terms of allergy

429 - 583 g

Unit containing 405-550mL should weigh between ___ + the weight of the container and anticoagulant.