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Compendium Blood banking/transfusion > Blood donation > Flashcards

Flashcards in Blood donation Deck (24)
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1

Registration and donor ID

Donors required to provide form of ID

2

Donor medical history

  • History (and physical) must occur on day of donation
  • Demographic info: name, DOB, address
    • Most states allow donation at age 17
    • Some states allow donation at age 16 with parental permission
    • Donor must provide written consent
  • Medical information
    • Must be free of major diseases (heart, liver, lung), cancer, and have no abnormal bleeding tendency
      • unless cleared by medical director
    • Donor asked to report 
      • any illness developing within a few days after donation
      • positive HIV or hepatitis result within 12 months after donation

3

Indefinite donor deferrals

Indefinite

  1. Viral hepatitis after 11th birthday
  2. family history of CJD
  3. travelers who have spent >3 months in the UK or 5 years total in Europe due to risk of variant CJD
  4. Used a needle to administer nonprescription drugs
  5. Male who has had sex with another male since 1977
  6. Receipt of dura mater or pituitary growth hormone of human origin
  7. Confirmed positive test for HBsAg or repeatedly reactive test for anti HBc
  8. Lab evidence of HCV
  9. Lab evidence of HTLV-1
  10. Have donated the only unit of blood to a patient who developed HIV or HTLV and had no other probable cause of infection
  11. Use of bovine insulin manufactured in UK
  12. Etretinate (Tegison)
  13. History of babesiosis
  14. History of chagas disease
  15. stigmata of parenteral drug use or use of a needle to administer nonprescription drugs
  16. receiving money or drugs for sex

 

4

Allowable minimum blood donor intervals

  • >= 16 weeks for 2 unit red cell donation by apheresis
  • >= 8 weeks for single unit whole blood donation
  • Plasmapheresis
    • donor must weigh >= 110 lb (50 kg)
    • "frequent" donor program: <= 2 donations/week, at least 2 days apart
    • others: 4 weeks apart

5

Donor deferral for 3 years

Deferred for 3 years after last dose:

Acitretin (Soriatane)

Deferred for 3 years:

  1. Malarial infection (after becoming asymptomatic)
  2. lived for > 5 years in  malaria endemic areas (after departure, if symptom free), regardless of prophylaxis

 

6

Donor deferral for 1 year

  1. paying for sex
  2. history of syphilis or gonorrhea, treatment for these infections, or positive syphilis screening test after completion of therapy
  3. Receipt of blood products, human tissue, or plasma derived clotting factors
  4. Hepatitis B immune globulin administration
  5. Any other unlisted vaccine
  6. Mucous membrane exposure to blood
  7. Nonsterile skin penetration, including tatoos or permanent makeup, unless applied by a state regulated entity with sterile needles and ink that has not been reused
  8. Residing with or having sexual contact with an individual with HIV or at high risk for HIV
  9. Incarceration for > 72 consecutive hours
  10. Travelers to malaria endemic areas after departure, if symptom free regardless of prophylaxis

7

Deferral period for person taking Dutasteride (avodart)

6 months after last dose

8

Blood donation physical exam

  • Temperature measured orally <= 37.5 (99.5)
  • Pulse: 50-100 (if athlete then can be less than 50)
  • Blood pressure: no higher than 180 systolic and 100 diastolic
  • Skin of venipuncture site must be free of lesions 
  • Hemoglobin and hematocrit must be >= 12.5 or 38% with blood taken at time of donation and cannot be obtained by earlobe puncture

9

Autologous donor requirements

  • Physician order
  • Hemoglobin >= 11 or hematocrit >=33%
  • absence of any condition that places autologous donor at risk for bacteremia
  • Blood must be collected > 72 hours prior to surgery
  • unit can only be used autologously

10

Plasmapheresis volumes

  • For automated instruments the allowable volume is predetermined by the FDA
  • Manual separation procedures:
    • no  more than 500 ml of whole blood should be removed at one time unless the donor weighs >= 80 kg (175 lb); in this case as much as 600 ml can be removed at a time

11

Plateletpheresis 

- interval for donation

- count required

  • Interval <= 2/week, at least 2 days apart, <= 24 in 12 months
  • If there is whole blood donation or if red cells cannot be returned to a donor during apheresis then 8 weeks must elapse before repeat apheresis
  • Platelet count >= 150,000/ul

12

RBC apheresis and multicomponent donations

  • if giving a single unit of RBCs with platelets and/or plasma, defered for 8 weeks
  • if giving a double RBC donation by apheresis, deferred for 16 weeks

13

Blood obtained from therapeutic phlebotomy

  • not used for allogeneic transfusion unless donor meets all requirements for allogeneic donation
  • donors with MPN or hemoglobin synthesis disorders (e.g., PCT) are not acceptable donors
  • Hemochromatosis
    • if donor has no other medical conditions, the medical director may allow these units to cross over into blood supply; must be clearly labeled wtih donor condition

14

Information given to donor

  • risks of phlebotomy
  • infections transmitted by transfusion
  • signs and symptoms of AIDS
  • importance of giving accurate information 
  • importance of not donating if they have increased risk of infection
  • reporting requirements of positive results to federal or state health authorities

15

What happens to units that donors request not be used?

These excluded units are still subjected to screening procedures

16

Notification of abnormal results from donors

Donors are notified of significantly abnormal results; if donation is autologous the physician is also notified

17

How are platelets prepared from whole blood?

  • Diversion pouch must be used to divert first 30 ml of blood (contains skin plug)
    • decreases bacterial contamination in blood components by as much as 50%

18

Volume of blood drawn

  • Maximum is 10.5 ml/kg of donor weight, including samples for testing (amounts to ~15% of whole blood volume)
  • must be collected within 15 minutes if platelets or plasma are to be made
  • typical collection bag has volume of anticoagulant appropriate for 450+/-45 ml of whole blood (some can accomodate 500+/- 50)
  • when 300-404 ml whole blood is collected in a 450 ml bag or 333-449 in a 500 ml bag it must be labeled as "Red blood cells low volume"; this unit cannot be used for preparation of other components

19

Processing of unit

  • Unit must be processed within 8 hours if to be used for fresh FFP and platelets
  • If transported from collection facility
    • must be at 1-10 degrees if the unit will be used only to create red cells
    • if platelets are to be made, units are allowed to cool to room temp (20-40)

20

Donor adverse reactions

  • Vasovagal reaction
    • slow heart rate, dizzy, sweating, pallor, N/V, hypotension, syncope
    • elevate feet, loosen clothes, apply cold compresses to head
  • Hypovolemia
    • fast heart rate with hypotension and possible nausea and syncope
    • give fluids by mouth or IV
  • Hyperventilation
    • hypocapnea
    • facial twitching
    • seizures
    • for mild symptoms slow infusion rate and give oral calcium carbonate
    • if severe, stop infusion and give oral calcium carbonate
  • Hematoma

21

ABO and Rh testing

  • Forward typing
    • ABO testing of donor RBCs with anti A and anti B reagents
  • Reverse typing
    • ABO testing of donor serum with A1 and B reagent red cells
  • Rh type
    • determined with anti D reagent
    • if anti D test is negative, then testing must be performed for weak D including extended incubation and addition of antihuman globulin (AHG)
    • If both are negative, label as Rh-
    • If either is positive, label as Rh+
  • At receiving blood bank, ABO/Rhmust be confirmed (repeat weak D testing not required)
  • Strength of reaction is graded 0 to 4+ and mf (mixed field)
  • Mixed field is best seen microscopically: it implies that 2 populations of red cells are present

22

Antibody screen required for

Donors with a history of transfusion or pregnancy

23

Infectious disease screening

  • HB surface antigen
  • anti HBc
  • anti HCV
  • HCV nucleic acid (HCV RNA)
  • anti HIV1/2
  • HIV1 nucleic acid (HIV1 RNA)
  • HTLV-I/II
  • serologic testing for syphilis (RPR)
  • West Nile RNA required during times of disease activity in affected areas
  • Trypansoma cruzi (not required)
  • Platelets must be tested for bacterial contamination

24

Infectious disease screening exceptions

  • A false positive syphilis test that is demonstrated to be false is ok
  • Certain tests can be bypassed in an emergency
    • omission must be indicated on the label
    • medical director of donor center must sign a release
    • medical director of transfusion service must sign release
    • testing must still be completed as soon as possible
  • directed apheresis donors and autologous donors may be tested initially and at 30 day intervals thereafter