1. BLOOD BANK CLS

1. What is the first step in donor blood collection?

Registration, medical history, and physical examination.

2. What aseptic site preparation is required before donor blood collection?

Scrub the collection site for at least 30 seconds with povidone-iodine or another approved antiseptic.

3. What is the maximum whole blood collection volume based on donor weight?

No more than 10.5 mL of whole blood per kilogram of donor body weight, including samples.

4. What is the usual minimum interval between whole blood donations?

8 weeks.

5. Why can blood from a donor who recently took aspirin be restricted for platelet use?

Aspirin irreversibly impairs platelet function, so the unit should not be the only platelet source but may be part of a platelet pool.

6. What is the minimum donor age for allogeneic donation?

At least 16 years old or the minimum allowed by state law.

7. Is there a maximum donor age for allogeneic donation?

No fixed maximum; older donors are evaluated by a physician or according to institutional policy.

8. What is the maximum acceptable donor temperature?

37.5°C or 99.5°F.

9. What is the minimum donor hemoglobin for allogeneic donation?

12.5 g/dL.

10. What is the minimum donor hematocrit for allogeneic donation?

38%.

11. What is the minimum donor weight for allogeneic whole blood donation?

110 lb or 50 kg.

12. How is donor blood pressure eligibility determined?

It must be within normal limits according to institutional policy.

13. What general exposure history can cause a 1-year donor deferral?

Possible exposure to hepatitis, HIV, or malaria.

14. How long is a donor deferred after receiving hepatitis B immune globulin?

1 year.

15. How long is a donor deferred after receiving blood or blood products?

1 year.

16. When does a tattoo cause a 1-year donor deferral?

When the tattoo was not performed at a state-regulated facility.

17. How long is a donor deferred after living with or having sexual contact with a person positive for HBsAg or HBV NAT?

1 year.

18. How long is a donor deferred after mucous membrane exposure to blood?

1 year.

19. How long is a donor deferred after skin penetration with blood-contaminated instruments?

1 year.

20. How long is a donor deferred after completing therapy for syphilis or gonorrhea?

1 year.

21. How long is a donor deferred after a reactive serologic test for syphilis?

1 year from completion of therapy or evaluation according to policy.

22. How long is a donor deferred after travel to a malaria-endemic area?

1 year.

23. How long is a donor deferred after spending more than 72 hours in a correctional institution?

1 year.

24. What malaria-related donor history causes a 3-year deferral?

Being a visitor or immigrant from a malaria-endemic area or having a previous diagnosis of malaria.

25. What hepatitis history causes permanent donor deferral?

Viral hepatitis after age 11.

26. What HBV test results can cause permanent donor deferral?

Confirmed positive HBsAg or positive HBV NAT.

27. What repeat-reactive viral antibody results can cause permanent donor deferral?

Repeatedly reactive anti-HBc or anti-HTLV.

28. What transfusion-transmitted infection history can permanently defer a donor?

Donation of a unit linked to post-transfusion hepatitis, HIV, or HTLV in the recipient.

29. What current or past infections can permanently defer a donor?

HCV, HTLV, HIV, or Trypanosoma cruzi infection.

30. What drug-use history can permanently defer a donor?

Evidence of parenteral drug use, meaning drug use by injection or another non-oral route.

31. What prion-related history can permanently defer a donor?

Family history of CJD or risk of variant CJD.

32. What parasitic infection history can permanently defer a donor?

History of babesiosis.

33. What is ACD?

Acid citrate dextrose, an anticoagulant-preservative solution used for blood collection.

34. What is the RBC expiration time with ACD, CPD, or CP2D?

21 days.

35. What is the RBC expiration time with CPDA-1?

35 days.

36. What is the RBC expiration time with additive solutions?

42 days.

37. What do RBC rejuvenating solutions restore?

2,3-DPG and ATP, which help restore RBC oxygen-delivery and energy metabolism.

38. What must be done before transfusing RBCs treated with rejuvenating solution?

Wash the cells to remove the rejuvenating solution.

39. After rejuvenation, how may the RBC unit be stored if it will be used within 24 hours?

At 1 to 6°C if it will be transfused within 24 hours after washing.

40. What is an autologous donation?

A donation collected for transfusion back to the same donor.

41. What age limit applies to autologous donation?

No age limit.

42. What minimum hemoglobin is commonly required for autologous donation?

At least 11 g/dL.

43. What minimum hematocrit is commonly required for autologous donation?

At least 33%.

44. What infection must not be present in an autologous donor?

Bacteremia, meaning bacteria in the bloodstream.

45. How long before surgery or transfusion should an autologous unit be collected?

More than 72 hours before surgery or transfusion.

46. How must autologous units be handled in storage?

They must be segregated from allogeneic units and used only for the original donor.

47. What is a low-volume autologous collection?

A collection below the expected volume based on donor weight, using the 10.5 mL/kg limit.

48. How should an autologous unit with 300 to 404 mL collected be labeled?

Red Blood Cells, Low Volume.

49. Can components be made from a 300 to 404 mL low-volume autologous collection?

No, components may not be made from that low-volume unit.

50. What is apheresis?

A collection method that selectively removes a blood component and returns the remaining components to the donor.

51. How does apheresis reduce donor exposure for the recipient?

It can collect a therapeutic dose of a component from one donor instead of multiple donors.

52. What is cytapheresis?

Apheresis collection of cells.

53. What is plasmapheresis?

Apheresis collection of plasma.

54. What is plateletpheresis?

Apheresis collection of platelets.

55. What is leukapheresis?

Apheresis collection of leukocytes, such as granulocytes or mononuclear cells.

56. How often can platelet, granulocyte, and leukocyte donations be collected by apheresis?

At least 2 days apart and not more than 2 times in any 7-day period.

57. How long must an apheresis donor wait if RBCs cannot be returned?

8 weeks.

58. What deferral interval applies after a 2-unit RBC apheresis donation?

16 weeks.

59. What donor hemoglobin or hematocrit limit applies after a 2-unit RBC apheresis donation?

The donation must not reduce donor hemoglobin below 10 g/dL or hematocrit below 30%.

60. What is therapeutic apheresis?

Apheresis used to remove a harmful blood component or substance from a patient.

61. What components can therapeutic apheresis remove?

Platelets, leukocytes, RBCs, or plasma substances such as proteins, immune complexes, and high-molecular-weight particles.

62. What are hematopoietic progenitor cells?

Stem cells that can form blood cells and reconstitute bone marrow.

63. Why are hematopoietic progenitor cells collected?

To restore bone marrow after chemotherapy or irradiation or to replace abnormal marrow cells with normal marrow cells.

64. What disorders may require hematopoietic progenitor cell therapy?

Congenital immune deficiencies, anemias, malignant bone marrow disorders, and red cell disorders.

65. What are the major sources of hematopoietic progenitor cells?

Bone marrow, umbilical cord blood, and peripheral blood collected by apheresis.

66. Why is an HLA-identical allogeneic marrow match preferred?

It lowers the risk of graft-versus-host disease, also called GVHD.

67. Is ABO compatibility required for allogeneic marrow transplantation?

No, ABO compatibility is not required.

68. What donor blood test is used to identify ABO group?

ABO typing, with discrepancies resolved before use.

69. What donor blood test is used for Rh typing?

Rh typing with weak D determination when required.

70. What is an antibody screen?

A test for clinically significant unexpected antibodies in donor or patient plasma.

71. Why are donor antibody screens important?

FFP cannot be prepared from units with clinically significant antibodies, and platelets or cryoprecipitate from those units can contain only minimal plasma volume.

72. What serologic test may be used to screen donor blood for syphilis?

RPR, a rapid plasma reagin test.

73. What blood donor test screens for Trypanosoma cruzi antibody?

Anti-Trypanosoma cruzi testing.

74. What hepatitis B donor tests are listed in the source?

HBsAg, anti-HBc, and HBV DNA.

75. What hepatitis C donor tests are listed in the source?

Anti-HCV and HCV RNA.

76. What HIV donor tests are listed in the source?

Anti-HIV-1/2, HIV antigen testing, and HIV RNA testing when required.

77. What HTLV donor test is listed in the source?

Anti-HTLV-I/II.

78. What West Nile virus donor test is listed in the source?

WNV RNA.

79. When is whole blood mainly used?

Severe shock with blood loss greater than 25% of blood volume when both oxygen-carrying RBCs and volume replacement are needed.

80. Why is whole blood rarely used for routine transfusion?

Component therapy is more available and allows specific component replacement.

81. What is a packed red blood cell unit?

A red cell component with most plasma removed.

82. What is the main advantage of packed red blood cells compared with whole blood?

They provide oxygen-carrying capacity with less volume.

83. What hematocrit indicates sufficient plasma removal in packed red blood cells?

Less than 80% hematocrit.

84. What hematocrit is typical for RBCs with additive solution?

About 55 to 65% hematocrit.

85. How much does 1 unit of RBCs usually raise hemoglobin?

About 1 g/dL.

86. How much does 1 unit of RBCs usually raise hematocrit?

About 3 percentage points.

87. What happens to potassium during RBC storage?

Potassium increases.

88. What happens to ammonia during RBC storage?

Ammonia increases.

89. What happens to pH during RBC storage?

pH decreases.

90. What happens to sodium during RBC storage?

Sodium decreases.

91. When can a blood unit not be returned and reissued?

If the unit exceeds 10°C or if the seal has been disturbed.

92. What are washed red cells?

RBCs washed with saline to remove plasma proteins and other soluble substances.

93. Why are washed RBCs used for allergic transfusion reactions?

They remove plasma proteins that can trigger allergic responses.

94. Why are washed RBCs used for IgA-deficient patients with anti-IgA?

They reduce plasma IgA and help prevent anaphylactic reactions.

95. Why may maternal blood for neonatal transfusion be washed?

To remove anti-IgA or other plasma substances and reduce risk to the infant.

96. What else can washing RBCs remove besides plasma proteins?

Complement attached to RBCs or plasma remnants.

97. What is the expiration of washed RBCs after the original seal is broken?

24 hours.

98. What hemoglobin standard applies to individual apheresis RBC units?

More than 60 g hemoglobin in individual units.

99. What hemoglobin standard applies to 95% of apheresis RBC units?

More than 50 g hemoglobin in 95% of units tested.

100. What leukocyte limit defines leukoreduced apheresis RBCs?

Less than 5 x 10^6 leukocytes per unit.