Blood Bank - FFB

Blood is a biological drug regulated by?

FDA

Donor Eligibility - Weight

At least 110 pounds

Donor Eligibility - Donation intervals

8 weeks between whole blood donations

16 weeks for double whole blood donations

7 days between plateletpheresis

Deferment Period - Aspirin Use

No issue w/ whole blood

PLTs cannot be collected until at least 2 days after the last aspirin dose

Deferment Period - Antibiotics

Persons sick or w/ acute infection cannot donate blood

Fever at or above 99.5 F is ineligible

Deferment Period - Birth Control

Eligible to donate

Deferment Period - Vaccines

Influenza, RSV, pneumonia, tetanus, meningitis - eligible if asymptomatic

HPV - eligible

VZV - Shingrix → eligible; Zostavax → 4 week deferment from vaccination date

Deferment Period - Full MMR

4 week deferment from vaccination date

Deferment Period - Measles (Rubeola), Mumps, Polio, Yellow Fever

2 week deferment from vaccination date

Deferment Period - COVID 19

mRNA - eligible

Live attenuated → 2 week deferment from vaccination date

Deferment Period - Smallpox or M-pox

8 week deferment from vaccination date

Deferment Period - Insulin

Eligible to donate if diabetes is under control

Deferment Period - Accutane, Proscar, Propecia

1 month from last dose taken

Deferment Period - Avodart

6 months from last dose taken

Deferment Period - Coumadin

Ineligible, if you stop taking Coumadin then 7 days from last dose taken

Deferment Period - Hepatitis B Immune Globulin

3 months after exposure/administration

Deferment Period - Oral HIV prevention (PrEP + PEP)

3 months after last dose/exposure risk

Deferment Period - Injectable HIV prevention (PrEP + PEP)

2 years after last dose

Deferment Period - Plavix

Whole blood - eligible

PLTs - 14 days after last dose

Deferment Period - Soriatane

3 years after last dose

Deferment Period - Tegison

Ineligible to donate blood

Donor Eligibility - actively being treated for malaria

3 year from completing treatment/last treatment date

Donor Eligibility - Traveled to an area w/ endemic malaria

3 months

Donor Eligibility - Lived in a country w/ endemic malaria (>5 years)

3 years

Donor Eligibility - Diagnosed w/ Zika virus

120 days after last day of symptom resolution

Donor Eligibility - Diagnosed w/ Ebola virus

Ineligible to donate

Donor Eligibility - Positive HIV test

Ineligible to donate

Donor Eligibility - At risk for HIV infection due to activities such as IV drug use, new sexual partner, sex in exchange for money, sex w/ historically HIV positive person

3 months from last date of event

Deferment Period - Allergies

Eligible so long as you are healthy

Deferment Period - Bleeding Disorders

Hypo-coagulable disorders - ineligible

Hyper-coagulable disorders - if you stop taking the medication

Deferment Period - Blood Pressure

Eligible if systolic BP is between 90-180 mmHg

Eligible if diastolic BP is >50 mmHg

Deferment Period - Pulse

Eligible if bpm is between 50-100

Deferment Period - Cancer

Leukemia, lymphoma (including Hodgkin) = ineligible

Other cancer - if cancer free for 12 months since last treatment date

Deferment Period - Chronic illness

If you are healthy + chronic disease is well managed at time of donation

Deferment Period - CJD / Brain Graft / Dura Mater Graft

Ineligible to donate blood

Deferment Period - Heart Disease

At least 6 months following heart attack, surgery, etc.

Deferment Period - Heart Disorders, murmurs, etc.

Eligible if medically approved + asymptomatic over the last 6 months

Deferment Period - Receiving a blood product

3 months of deferment from transfusion date

Deferment Period - Hereditary Hemochromatosis

Depends if you meet eligibility criteria + acceptable H&H

Deferment Period - H&H Values

Woman - >12.5 g/dL

Man - >13 g/dL

>13.3 g/dL if required for double RBC donation (apheresis)

Hemoglobin cannot exceed 20 g/dL

Deferment Period - Hepatitis or Jaundice

Ineligible to donate blood

Deferment Period - Hidradenitis Suppurativa

Ineligible to donate blood

Deferment Period - Hepatitis Exposure

3 months from last point of contact

Deferment Period - HIV / AIDS

Negative HIV test but risky behavior - 3 month deferment from high risk activity

Deferment Period - Sickle Cell Disease

PLTs + plasma donations only

Deferment Period - Tuberculosis

Ineligible if unhealthy + actively taking antibiotics

Successful treatment must be completed before donations are eligible

Deferment Period - Measles Exposure

Eligible if healthy + vaccinated >4 weeks ago

Deferment Period - Skin Disease / Rash / Acne

Eligible if venipuncture site is unaffected

Deferment Period - Acupuncture

Eligible

Deferment Period - Blood Transfusions

3 month deferral from transfusion date

Deferment Period - Dental Procedures

Eligible, but if on antibiotic… then must wait until after antibiotics are finished

Deferment Period - Hormone Replacement Therapy

Eligible

Deferment Period - Transplantation

3 months from transplant date

Deferment Period - General Surgery

Eligible so long as no blood products were given

Deferment Period - Pregnancy

Deferred until 6 weeks after conclusion of pregnancy

Deferment Period - Tattoos

Deferred for 3 months after date of tattoo in unregulated states

Deferment Period - Piercings

Deferred for 3 months after date of piercing in unregulated states

Deferment Period - STDs

Deferred for 3 months after successful treatment of syphilis or gonorrhea

Chlamydia, genital warts - eligible to donate

Filtering Whole Blood - All whole blood collected by venipuncture is filtered to leukoreduce RBC products within __ hrs of collection

48 hrs

Filtering Whole Blood - Product weight recovery must be ___ + have less than ____ WBCs in the unit of pRBCs

>85%

5×10^6 WBCs

Filtering Whole Blood - Prefiltration, the unit weighs 500 g, it must weigh how much after leukoreduction

>425 g

Whole blood is separated out into 3 fractions:

pRBCs

PLTs

Plasma

Plasma frozen <8 hrs is referred to as:

FFP - fresh frozen plasma

Plasma frozen <24 hrs is referred to as:

PF24 - plasma frozen in 24 hrs

Cellular products must be irradiated like:

pRBCs + PLTs

Acellular products do NOT need irradiated like:

Plasma + CRYO

Irradiation changes the expiration date to:

28 days or the original expiration date, whichever is sooner to expire

How much irradiation is delivered to blood products?

25 Gray/Grads

Not more than 50 Gray

Irradiations should be performed within:

24 hrs of collection

RBCs stored in BB fridges lose intracellular ___ + ____ due to ____, rejuvenation solutions can be used to extend shelf life by replacing ___ + ___ levels

2,3-DPG

ATP

Storage lesion

2,3-DPG

ATP

Storage + Expiration - pRBC

Storage - 1-6 C

Expiration: CPD - 21 days, CPDA - 35 days, AS - 42 days

Raised H&H by 1 g or 3%

Storage + Expiration - Frozen Plasma

Storage - < -18 C

Expiration - 1 year

Storage + Expiration - Thawed FFP

Storage - 1-6 C

Expiration - 24 hrs

Storage + Expiration - Thawed Plasma

Storage - 1-6 C

Expiration - 5 days

Storage + Expiration - Random Donor PLTs

Storage - 20-24 C

Expiration - 5 days

>5.5 × 10^10 PLTs

pH >6.2

Storage + Expiration - Single Donor PLTs

Storage - 20-24 C

Expiration - 5 days

>3 × 10^11 PLTs

pH >6.2

Storage + Expiration - Thawed CRYO

Storage - 20-24 C

Expiration - 4 hrs = open pooled, 6 hrs = close pre-pooled

>80 IU fVIII

>150 FBG

Reagent - monoclonal antibody

Highly specific

IgM

Clear + blue reagent

Yield 3 to 4+ reactions

1-2 drops per test

Anti A (forward)

Reagents - Monoclonal antibody

Highly specific

IgM

Clear + yellow reagent

Yield 3 to 4+ reactions

1-2 drops per test

Anti B (forward)

Reagents - human sourced made to a 4-5% cell suspension

Yield 2 to 4+ reactions

1 drop added

Reagent A1 + B cells (reverse)

O Blood Group - Sugar Name

L fucose (FUT 1) H antigen

A Blood Group - Sugar Name

N-acetylgalactosamine

B Blood Group - Sugar Name

D-galactose

Lectin Used for O Blood Group

Ulex europaeus

Lectin Used for A Blood Group

Dolichous biflorus

Phenotype O - Prevalence

White - 45%

Black - 50%

Hispanic - 56%

Asian - 40%

Phenotype A - Prevalence

White - 40%

Black - 26%

Hispanic - 31%

Asian - 28%

Phenotype B - Prevalence

White - 11%

Black - 20%

Hispanic - 10%

Asian - 25%

Phenotype AB - Prevalence

White - 4%

Black - 4%

Hispanic - 3%

Asian - 7%

Anti A = 0

Anti B = 0

Anti D = +

Rh CTRL = 0

A1 = 1-4+

B = 1-4+

Interpretation:

O+

Anti A = 0

Anti B = 1-4+

Anti D = +

Rh CTRL = 0

A1 = 1-4+

B = 0

Interpretation:

B+

Anti A = 1-4+

Anti B = 0

Anti D = +

Rh CTRL = 0

A1 = 0

B = 1-4+

Interpretation:

A+

Anti A = 1-4+

Anti B = 1-4+

Anti D = +

Rh CTRL = 0

A1 = 0

B = 0

Interpretation:

AB+

RBC Products Selection

Patient w/ A = donor w/ O or A

Patient w/ B = donor w/ O or B

Patient w/ AB = donor w/ O, A, B, or AB

Patient w/ O = donor w/ O

Plasma Products Selection

Patient w/ A = donor w/ A or AB

Patient w/ B = donor w/ B or AB

Patient w/ AB = donor w/ AB

Patient w/ O = donor w/ O, A, B, AB

ABO Discrepancies + Resolutions:

Anti A = 0

Anti B = 0

Anti D = 4+

Rh CTRL = 0

A1 = 0

B = 0

Fwd interp = O+

Rev interp = AB

ABO Discrepancy type = missing antibodies

Resolution type = cold incubation of plasma for 5 min

ABO Discrepancies + Resolutions:

Anti A = 4+

Anti B = 1+

Anti D = 0

Rh CTRL = 0

A1 = 0

B = 3+

Fwd interp = AB-

Rev interp = A

ABO Discrepancy type = acquired B

Resolution test = auto-crossmatch

ABO Discrepancies + Resolutions:

Anti A = 3+

Anti B = 0

Anti D = 3+

Rh CTRL = 0

A1 = 1+

B = 4+

Fwd interp = A+

Rev interp = O

ABO Discrepancy type = Subgroup of A

Resolution test = Anti A1 lectin + A2 cell testing

ABO Discrepancies + Resolutions:

Anti A = 0

Anti B = 0

Anti D = 3+

Rh CTRL = 1+

A1 = 4+

B = 4+

Fwd interp = O (invalid Rh control)

Rev interp = O

ABO Discrepancy type = Rouleaux or cold agglutinins

Resolution test = add a drop of blood to a slide + look at it under the microscope… Rouleaux = saline replacement; Cold agglutinins = pre-warm technique

Fisher Race to Weiner:

D

d

C

E

c

e

C + E

D = R

d = r

C = 1 or ‘

E = 2 or “

c = 2 or “ (because you have a E)

e = 1 or ‘ (because you have a C)

C + E = Rz or ry