Blood Donation

Regulation Agencies for blood transfusions

FDA(Food & Drug Administration):

• Federal Agency

• Required

• Publishes the code of federal regulations(CFR)

AABB(Association for the Advancement of Blood & Biotherapies):

• Non-governement program

• Not required

• Ensures compliance with: AABB standard, CFR, CLIA’88

What is the purpose of donor screening?

• To protect the donor

• To protetct the recipient

How does donor screening protect the donor and the patient from?

Donor:

• General health questions are asked( cold, headache, nausea)

• Disease history( Previous surgeries, bleeding problems, pregnancy, heart or lung disease)

Recipient:

• Disease exposure

• Medications

• Vaccinations

What information is included on the donor registration?

• Date and time of donation

• Name

• Address

• Telephone number

• Gender of Donor

• Date of Birth

• Record of reasons for previous deferrals

• Consent for collection, use, and testing

What information must be provided to the donor?

• All donors must be given material indicating the signs, symptoms, and high-risk activities associated with HIV and AIDS

• Must be notified of abnormal test results; if any

• Must be educated on post-donation iron deficiency

What factors are taken into consideration when allowing someone to be a donor?

• Medical history

• Donation interval (How often they donate)

• Major illness/pregnancy

• Medications they are on

• Vaccinations they have had

• Human-derived products injected/ingested

• Areas in which they have traveled

• If they have been in prison

• STDs

What qualifies someone for indefinite deferral?

People who have/ have been administered:

• HIV/HTLV 1&2

• Hep B;Hep C

• Babes, Chagas

• vCJD, CJD( Mad cow disease)

• Bovine insulin (1980-1996)

• Recipient of previous donations has had post transfusion complications

3 year deferral

• Asymptomatic after dx/treatment of malaria

• After living in a malaria endemic country for 5 years

2 year Deferral

Someone who is on PrEP or PEP injection therapy

12 month deferral

• Hepatitis B immune globulin( past exposure)

• Incarceration for greater than 72 hours

• Human rabies vaccine flowing an animal bite

3 month deferral

• Tattoos( Except those done in state-regulated facility w/ sterile needles)

• Exposure to blood(transfusion,mucus membrane, or skin penetration)

• IV drug use

• Prostitution

• Multiple sex partners & anal sex

• New sex partner & anal sex

• Sexual or household contact with person w/ hepatitis

• Completion of therapy for syphilis and gonorrhea

• Return from travel to a malaria endemic country

• PrEP/PEP ORAL therapy

8 week deferral

• Smallpox vaccine

• Someone who has donated blood in the last 56 days

• Double-unit donations within 16 weeks

• Platelet donations within 7 days

6 week deferral

Birth of baby

4 weeks deferral

• Rubella vaccine-German measles

• MMR- measles, mumps, rubella

• Varicella-zoster vaccine-chickenpox

• Zostavax- live shingles vaccine

3 weeks deferral

Hepatitis B vaccine

2 week deferral

• Measles(rubeola) vaccine

• Mumps vaccine

• Polio (oral) vaccine

• Typhoid (oral) vaccine

• Yellow fever vaccine

No deferral

• Flu Vaccine

• Tetanus vaccine

• Meningitis vaccine

• Shingrix- “dead” shingles vaccine

• Covid vaccine

What is the acceptable physical exam criteria

• Age-:17 or older(16 with parental consent)

• Weight:110lbs

• Temperature:less than or equal to 99.5F

• Blood pressure: less than 180/100

• Pluse: 50-100 beats/min

• Hemoglobin: >/= to 12.5g/dL for women; >/= to 13g/dL for men; less than 20 g/dL for everyone

• HCT: >/= 38% Female; >/= 39% Male

• Venipuncture site: No skin lesions, no evidence of IV drug use

• General appearance: In good health, no drug or alcohol abuse suspected

How is the Hgb and Hct determined?

• Spectropotometry(Hemocue)-Lysis RBC, oxidizes, measures absorbance

• Spun hematocrit-measures the % of RBC in blood

• Copper sulfate( blood is dropped in solution; if sinks rapidly-Hgb is good enough for donation)

What is the normal value of the copper sulfate test?

• Specific gravity of 1.053= 12.5 g/dL Hgb

• Sinks rapidly= Hgb ok for donation

• Floats or sinks slowly= Hgb too low for donation

When collecting blood from a donor, what is required?

• Donor ID- Unique bar code

• Donor medical records

• Collection bag

• Pilot tube for testing sample against potential recipent

When collecting blood from a donor, what is a part of arm prep?

• Disinfection- aseptic technique

• Tourniquet: BP cuff; Rubber tourniquet

In blood collection, what does phlebotomy include?

• Vein selection- median cubital is 1st choice

• Mix blood and anticoagulant during collection( EDTA)

• Volume is determined by weight : Most bags are 450mL-500mL

• Less than 10% of target volume is labeled “low volume”

• Low volume units have plasma discarded

• Pilot tubes are filled at the end

What some donor reactions when donating blood?

• Fainting

• Vomiting

• Hyperventilation

• Loss of consciousness

• Convulsions

What steps should be taken in post donation care?

• Make sure the donor is feeling well

• Provide post-donation intructions to include:

• Report Illnesses such as headache, fever, and nausea

Make sure donor remembers something(DOB, Year, Current president)

• Eat and drink

• Bandage venipuncture site

• Iron supplementation as needed

What test should be done on donor blood?

• ABO/Rh

• Antibody screen

• HBsAg-Test for active Hep B

• Anti-HBc-Test for Hep B antibodies

• Anti-HCV

• Anti-HIV 1&2

• Anti-HTLV 1&2

• HCV RNA

• HBV DNA

• HIV-1 RNA

• WNV RNA-West Nile Virus

• Zika virus RNA

• Serological test for Syphilis

• Antibody for T. cruzi- Chagas Disease

Can plasma cells from a donor with a positive Antibody screen be used for donation?

No!

What is an autologous donation?

• Donation intended for yourself (typical used in elective surgeries)

• Eliminates disease transmission

What is a Directed Donation?

• Donation specifically for someone else

• Comforting for friends and family

Autologous Donation requirements

• Must have a physician’s order

• No age or weight requirement

• Donor Hgb: 11 g/dL

• Donor Hct: 33%

• Must be labeled “Autologous Use Only”

• Test that should be run: ABO & Rh; Disease testing if collection & transfusion facility are different

Directed Donation requirements

• Must have a physician order

• Must meet all donor requirements

• There is a waiting period of several days between collection and distribution