Immunohematology Donor Selection and Blood Collection

Immunohematology: Principles of Donor Selection and Blood Collection

• These standards for donor selection and blood collection are established in the field of immunohematology, as documented by Daniel Held and Elizabeth Will.

Core Procedures for Donor Blood Collection

• Initial Steps: The collection process begins with three essential phases: registration, a thorough medical history, and a physical examination.

• Aseptic Technique: To ensure safety and prevent contamination, an aseptic technique is mandatory. The collection site must be scrubbed for a minimum of $30\,seconds$ using a providine-iodine scrub.

General Collection Standards and Guidelines

• Maximum Collection Volume: The total amount of blood collected must not exceed $10.5\,mL$ of whole blood ($WB$) per kilogram ($kg$) of the donor's body weight. This maximum volume requirement includes both the primary unit and any additional blood samples taken for testing.

• Donation Interval: For individuals donating whole blood, there must be a minimum interval of $8\,weeks$ between donations.

• Medication Review: All medications currently being taken by a potential donor must be evaluated by a Medical Director ($MD$).

• Platelet Function Restrictions: Certain medications taken within $48\,h$ of donation that irreversibly affect platelet function (with aspirin being the primary example) limit the use of the donation. While these units can be utilized as part of a platelet pool, they may not be used as the sole source for platelets.

Criteria for Allogeneic Donor Selection

• Age Requirements: Potential donors must be $\ge 16\,yrs$ or conform to the specific laws of their state. There is no defined maximum age limit, though older donors are subject to evaluation by an $MD$.

• Oral Temperature: The donor's oral temperature must be measured and must not exceed $37.5^{\circ}C$ ($99.5^{\circ}F$).

• Blood Pressure ($BP$) Thresholds:

  • Systolic Pressure: The acceptable range is $90-180\,mmHg$.

  • Diastolic Pressure: The acceptable range is $50-100\,mmHg$.

  • Exception Clause: The Medical Director has the authority to grant exceptions for blood pressure values falling outside these specific ranges.

• Hemoglobin ($Hgb$) and Hematocrit ($Hct$) Requirements:

  • Females: Minimum levels are set at $\ge 12.5\,g/dl$ for hemoglobin and $\ge 38\%$ for hematocrit.

  • Males: Minimum levels are set at $\ge 13.0\,g/dl$ for hemoglobin and $\ge 39\%$ for hematocrit.

• Weight Limit: The minimum body weight required for donation is $110\,lbs$ ($50\,kg$).

Mnemonic Tools and Evaluation Frameworks

• Danny Donor: A quick-reference visual conceptualization of donor requirements, summarizing the key thresholds: $\le 37.5^{\circ}C$ ($99.5^{\circ}F$), $90-180/50-100\,mmHg$ blood pressure, $110\,lbs$ ($50\,kg$) weight, and the specific $Hgb/Hct$ requirements for males ($\ge 13.0\,g/dl$ / $\ge 39\%$) and females ($\ge 12.5\,g/dl$ / $\ge 38\%$).

• Blood Pressure Recording: When documenting blood pressure, remember "Sky is above Dirt," signifying that the Systolic value is recorded over the Diastolic value.

• Suitability Evaluation: A critical "TEST Alert" emphasizes that the primary responsibility of blood collection staff is to evaluate the suitability of every potential donor based on the aggregated medical and physical criteria provided.