MMSC409 Blood donation Pt.3

Viral Markers Blood collection facilities test for

• Hepatitis B surface antigen/AntiHBc and DNA using NAT (antigen/antibody test)

• Anti-HCV using NAT (antigen/antibody test)

• Anti-HTLV: testing for antibodies to Human T-cell lymphotropic Virus-1 &2 antigen

• anti-HIV 1&2 AND HIV-1-Ag: testing for HIV antibodies/antigens using NAT

  • anti-HIV 1 testing using Western Blot gel electrophoresis (Antibody testing) as well

• Cytomegalovirus (Anti-CMV)

Nucleic Acid Testing (NAT)

Helps to decrease the window period of presence of the virus but not yet detectable

Babesia Testing

Used in endemic area only, 14 states plus the district of Columbia

International Society of Blood Transfusion (ISBT)

Information required on Blood label bt FDA

• Classification of donor (volunteer or paid)

• Component Name

• Name/quantity of anticoagulant

• the volume of blood collected

• Unique donor identification number

• Storage temp/expiration date

• ABO & RH₀ (D)

• Name/address of the collection facility

Donor records

• Maintain file with pertinent donor information

• Permanent “deferral file” must be kept

  • lookback documents

• Must have a system in place to be able to track final disposition of all donated blood products

  • Ex. transfused, discarded, and used for further manufacturing

Autologous (Self)

• Donation of unit of blood for one’s self (preoperative collection

  • Common reasons

    • Elective surgery

    • very rare blood type (have antibody to high frequency RBC antigen or multiple “common RBC antibodies)

Benefits of Autologous (Self)

• peace of mind

• no transmission of disease

• no alloimmunization to RBC, WBC, Platelets

• phlebotomy process stimulates erythropoiesis

• reduce possibility of a transfusion reaction

Autologous (Self) Requirments

• need prescription

• need review by blood bank medical director

• patient must sign consent

• if patient weighs less than 110 lbs, maybe labeled as “low volume collection”

Autologous (Self) donor criteria

• no age limit

• no weight limit

• can donate frequently (every 3 days)

• medical history- usually no reason to defer (physician authorization needed first)

• if pregnant, 2nd trimester

Autologous (Self) Testing

• ABO & Rh(D) testing

  • If it will be transfused outside collection facility

  • 1st unit must be tested for HBsAg, Anti HBc , HCV RNA, Anit-HIV-1&2, HIV-RNA-1, and STS

    • If any tests reactive-biohazard label needed

Autologous (Self) labeling

• same as homologous “for autologous use only”

• Name/ID of patient

• No “crossover”

Other types of Autologous (Self)

• intraoperative collection

• postoperative blood salvage

Irradiation (Calculation Question on Exam)

• Reduces expiration to 28 days from date of irradiation-not to exceed the original expiration (shorten expiration)

  • prevents transfusion-associated graft vs. host disease (kills lymphocytes)

• Gamma irradiation

  • required for 1st and 2nd degree relatives

Apheresis

• Procedure

  • removal of whole blood (Wb) from donor or patient- separate it into components

  • Keep desired component

  • return remaining elements back to the donor or patient dependent on different densities of blood constituents

Cytapheresis

• Collection of specific cells

  • Plateletpheresis- single donor platelet (SDP) or apheresis (donor)

  • leukapheresis- granulocytes (donor)

  • double red cell collection by apheresis

  • plasmapheresis- collection of plasma (patient or donor)

Apheresis indications

• desiring specific blood products that specific type of patient

• treat specific type of patient (plasmapheresis

Apheresis benefits

• higher concentration of specific blood component, no need to expose recipient to as many donors

• treatment choice for certain patients

Apheresis donor criteria

• Medications

  • Aspirin free for 3 days (plateletpheresis)

  • plavix/ticlid (blood thinner) for 14 day deferral (plateletpheresis)

• Platelet count greater than 150,000uL (leukapheresis & plateletpheresis)

• WBC with differential greater than 4000uL (leukapheresis)

• serum protein greater than 6.0g/dL

Apheresis Deferral periods

• Whole blood donation= 8 weeks

• double red cell donation = 16 weeks

• platelet donation by apheresis = at least greater than 2 days

• plasma donation by apheresis = 4 weeks