6. Donor selection & processing

Question 1

donor temperature requirement

Answer 1

≤37.5° C or ≤99.5° F

Question 2

HR requirement

Answer 2

50-100 bpm, or 40-49 if a healthy athlete

Question 3

BP requirement

Answer 3

90-180 systolic/50-100 diastolic

Question 4

hemoglobin requirement

Answer 4

≥12.5 g/dL (female) or ≥13 g/dL (male)

Question 5

hematocrit requirement

Answer 5

≥38% (female) or ≥39% (male)

Question 6

vCJD permanent deferral

Answer 6

Lived in the UK from 1980-1996

Question 7

receiving …… results in permanent deferral (4)

Answer 7

stem cell transplant
dura mater
human pituitary GH
xenotransplant product

Question 8

infectious disease permanent deferrals (4)

Answer 8

HBsAg confirmed positives
Repeat reactive anti-HBc
Infection with HIV, HCV, or HTLV
History of babesiosis

Question 9

aseptic technique is most important for which blood products?

Answer 9

platelets
stored at room temp

Question 10

aseptic technique procedure (4)

Answer 10

1. Scrub venipuncture site 2 inches in all directions from center for 30 seconds with iodine swab. For allergic donors, you can use chlorhexidine.
2. Using a second swab, start at the center and move outward in a concentric spiral 1.5 inches in all directions.
3. Let stand for at least 30 seconds to allow for bactericidal action.
4. Cover the prepped skin site with on sterile 2x2 gauze.

Question 11

cannot be made from long draw (15-20 mins)

Answer 11

FFP

Question 12

common donor reactions

Answer 12

lightheadedness
dizziness
nausea
skin rash/irritation

Question 13

donor reactions causing the donation to be stopped

Answer 13

vomiting
chills
hyperventilation
fainting
convulsions

Question 14

uncommon adverse donor events

Answer 14

hematoma
arterial puncture
nerve injury

Question 15

hemoglobin requirement for autologous donation

Answer 15

11 g/dL

Question 16

autologous donor units do not require normal infectious disease testing if…

Answer 16

staying at the same facility

Question 17

irradiating directed donations from blood relatives prevents…

Answer 17

transfusion-associated graft vs host disease (TA-GVHD)

Question 18

Performed to decrease the red cell volume

Answer 18

therapeutic phlebotomy

Question 19

therapeutic phlebotomy indications

Answer 19

polycythemia
hemochromatosis

Question 20

therapeutic phlebotomy blood can be used for donations if patient has…

Answer 20

Hereditary hemochromatosis

Question 21

indications for therapeutic apheresis for plasma

Answer 21

Goodpasture’s
TTP
acute Guillian-Barre

Question 22

indications for therapeutic apheresis for red cells

Answer 22

sickle cell
methemoglobin

Question 23

ALL infectious disease testing required on donor units (8)

Answer 23

• 3 Hepatitis B tests (HBV DNA, HBsAg, Anti-HBc)
• 2 Hepatitis C tests (HCV RNA, Anti-HCV)
• 2 HIV tests (HIV-1 RNA, Anti-HIV-1/2)
• Syphilis (RPR)
• HTLV (Anti-HTLV I/II)
• Trypanosoma cruzi; at least once per donor
• West Nile Virus (WNV-RNA)
• Babesias; endemic states only

Question 24

HLA 1/2 testing female donors prevents…

Answer 24

transfusion-related acute lung injury (TRALI)

Question 25

donors 16-18 years of age special test

Answer 25

ferritin

Question 26

pRBC (AS) shelf life

Answer 26

42 days

Question 27

pRBC (CPDA-1) shelf life

Answer 27

35 days

Question 28

pRBC (CPD) shelf life

Answer 28

21 days

Question 29

frozen RBC with 40% glycerol shelf life

Answer 29

10 years

Question 30

thawed frozen RBC shelf life

Answer 30

24 hours

Question 31

washed RBCs shelf life

Answer 31

24 hours

Question 32

FFP & plasma frozen w/i 24h shelf life (frozen)

Answer 32

1 year

Question 33

FFP & plasma frozen w/i 24h shelf life (thawed)

Answer 33

24 hours

Question 34

thawed plasma shelf life (not "FFP")

Answer 34

5 days

Question 35

liquid plasma shelf life

Answer 35

CPD: 26 days CPDA1: 40 days

Question 36

cryo AHF (frozen) shelf life

Answer 36

1 year

Question 37

cryo AHF (thawed) shelf life

Answer 37

6 hours in same bag 4 hours pooled

Question 38

platelet concentrates shelf life

Answer 38

5 days

Question 39

pooled platelet concentrates shelf life

Answer 39

4 hours

Question 40

apheresis platelets shelf life

Answer 40

7 days

Question 41

granulocytes shelf life

Answer 41

24 hours

Question 42

products stored at 1-6° F (6)

Answer 42

* pRBCs * thawed frozen RBCs * washed RBCs * thawed FFP & plasma frozen w/i 24h * thawed plasma * liquid plasma

Question 43

products stored at ≤ -65° (1)

Answer 43

* frozen RBCs

Question 44

products stored at ≤ -18° (3)

Answer 44

* FFP (frozen) * plasma frozen w/i 24h (frozen) * cryo AHF (frozen)

Question 45

products stored at 20-24° (3)

Answer 45

* cryo AHF (thawed) * platelet products (in continual motion) * granulocytes

Question 46

products stored at 1-6° can be shipped at ------°, using...

Answer 46

1-10° wet ice

Question 47

frozen products shipped to maintain frozen state use...

Answer 47

dry ice

Question 48

desired unit volume

Answer 48

450-550 mL

Question 49

low volume unit product prepared

Answer 49

342-449 mL pRBCs only

Question 50

unexpected conditions that can affect donations (4)

Answer 50

Severely **lipemic** units may not be able to be tested Long draw may cause **clots** in pRBC **Hemolysis** **Foreign objects** (ie broken cannula)

Question 51

WBCs in leukocyte-reducted product

Answer 51

< 5 x 10^6

Question 52

Platelets collected by apheresis are WBC reduced by...

Answer 52

the continuous flow separation process

Question 53

CMV safe if filtered within-----days of collection

Answer 53

3-5

Question 54

leukocyte reduction reduces risk of... (3)

Answer 54

febrile nonhemolytic transfusion reactions CMV transmission HLA alloimmunization

Question 55

Explain process for making pRBCs, platelets from WB, and FFP (6)

Answer 55

1. Start with WB at RT—light spin 2. PRP (platelet rich plasma) is expressed into 3rd bag 3. AS is added to RBCs; **pRBC** bag is cut off 4. Heavy spin on PRP bag 5. Plasma is expressed into 2nd bag; **FFP** bag is cut off and frozen 6. **Platelet** bag rests for 1 hour and is massaged; then put on rotator

Question 56

female plasma

Answer 56

salvaged plasma

Question 57

long draw, low volume, not processed within 24 hours plasma

Answer 57

salvaged plasma liquid

Question 58

names for platelets from WB

Answer 58

“Random donor platelets” ”WB-derived platelets”

Question 59

Explain process for making cryoprecipitate via separation-insolubility at low temperatures

Answer 59

1. Allow FFP to thaw at 1-6° until slushy; cryo precipitates out 2. Hard spin 3. 2nd bag hangs off counter, and CP (cryo-poor) plasma rapidly flows into it, leaving **cryo** and **15 mL plasma** in the 1st bag 4. CP plasma is discarded (usually) 5. Cryo is frozen

Question 60

name of the process for making cryo

Answer 60

separation-insolubility at low temperatures

Question 61

open system expirations

Answer 61

24-hour expiration at 1-6° 4-hour expiration at 20-24°

Question 62

4 things required on each donor unit label

Answer 62

Unit number Component code ABO/Rh type Expiration date

Question 63

Explain parts of the unit number

Answer 63

W — collected in the USA Next 4 numbers — facility code Next 2 numbers — year Sequential number for each unit collected in one year 00 and boxed number are for lab process control

Question 64

pRBC indications (2)

Answer 64

symptomatic anemia reduced O2 carrying capacity

Question 65

function of glycerol in freezing RBCs

Answer 65

**protects the RBCs from freezing injury** by reducing the formation of **ice crystals** and preventing **intracellular dehydration** and volume reduction

Question 66

RBC units for freezing are frozen within ---- days of collection placed in freezer within ---- hours of glycerol addition

Answer 66

6 days 4 hours

Question 67

Bacterial contamination management of ------ is required

Answer 67

platelets

Question 68

expected count for random donor platelets

Answer 68

> 5.5 x 10^10

Question 69

storage volume of apheresis platelets

Answer 69

100-400 mL

Question 70

explain bacterial contamination management for apheresis platelets

Answer 70

Blood cultures collected 24-36 hrs Initial results for labeling after 20 hrs

Question 71

apheresis platelet count

Answer 71

3 x 10^11

Question 72

aphereis platelets approximately equal to ----- random donor platelets

Answer 72

4-8

Question 73

apheresis platelets are visually inspected for...

Answer 73

platelet clumps, discoloration, or excessive lipemia

Question 74

platelets indications (4)

Answer 74

thrombocytopenia abnormal platelet function DIC prevention of bleeding from bone marrow hypoplasia

Question 75

expected platelet increment after one transfusion of random donor platelets

Answer 75

5,000 to 10,000/uL

Question 76

granulocyte indications (2)

Answer 76

low WBC count infection that does not respond to antibiotics

Question 77

average FFP volume

Answer 77

250 mL

Question 78

FFP indications (4)

Answer 78

general coagulation deficiency liver disease TTP massive transfusion

Question 79

only difference plasma frozen w/i 24h has from FFP in composition

Answer 79

reduction in levels of labile coagulation **factors V and VIII**

Question 80

cryo indications (2)

Answer 80

**decreased fibrinogen** (DIC or massive bleeding) secondary tx for hemophilia A & vonWillebrand disease if specific factors are not available

Question 81

given for volume replacement

Answer 81

albumin

Question 82

albumin lacks...

Answer 82

Ig coagulation factors

Question 83

IVIg indications

Answer 83

weakened immune systems (lupus, multiple sclerosis, etc)

Question 84

factor concentrate indications

Answer 84

Factor deficiencies (FVIII, vWF, FXIII, etc)