blood donation and testing Flashcards
1
Q
who regulates blood donation
A
FDA
2
Q
what made blood safer
A
charitable donation and paid donation
3
Q
who writes testing protocols
A
AABB and CAP
4
Q
goals of blood donation
A
-donation does not harm donor
-transfusion does not harm recipient
5
Q
hemoglobin requirements
A
> 12.5 female
13 male
NOT MORE THAN 20
> 13.3 for 2x RBC
6
Q
hematocrit requirements
A
> 38% female
39% male
40% 2x RBC
7
Q
blood pressure requirements
A
systolic: 90-180
diastolic: 50-100
8
Q
temp requirements
A
<37.6 (99.6)
9
Q
pulse requirements
A
50-100 bpm
< 50 if athlete
10
Q
weight requirements
A
> 50 kg (110lb)
11
Q
age requirements
A
> 16
12
Q
height requirements for 2x RBC
A
female: 5’5
male: 5’1
13
Q
at registration required to confirm
A
donor ID and link to existing records
-must check ever donor against list of deferred people
collet: phone #, etc.
14
Q
malaria
A
living or traveling from area with endemic Plasmodium
15
Q
babesiosis
A
parasite carried by ticks in northeastern USA
16
Q
leishmaniasis
A
trypanosoma carried by phlebotomus sandflies endemic to north africa and middle east (iraq vets)
17
Q
creutzfeldt-jakob disease
A
prion disease; beef standards in europe were weird
-long incubating
18
Q
medications that affect product quality
A
aspirin
anticoag
19
Q
medications that indicate donor in risky group
A
PrEP
Hep B Ig
bovine insulin
HGH
20
Q
medications cause issues for recipient
A
immunosuppressive drugs
teratogens
allergens
21
Q
frequency for whole blood
A
56 days
22
Q
frequency for platelets
A
every 7 days (24x a year)
23
Q
frequency for plasma (occasional)
A
every 28 days (13x per year)
24
Q
frequency for plasma (serial)
A
up to 2 donations/ 7 days ; 48 hrs apart
25
frequency for double RBC
every 112 days (3x a year)
26
temporary deferral
unable to donate for limited period
27
indefinite deferral
cannot donate allogenic units unless requirements change
28
permanent deferral
allogenic donations are never acceptable
29
indefinite and permanent deferral examples
history of viral hep after 11th bday
-Hep b surface antigen
-more than 1 + for hep b core antibody
-history of hematologic cancer
-diagnosis or test confirm of Hep C, HTLV, HIV
-babesiosis or chagas disease
-family history of CJD
-reciepient of dura mater graft/ HGH from human, bovine insulin
-needles not prescrip
-tegison
30
temp deferral 2 weeks
vaccine- measles, mumps, polio, typhoid, yellow fever
-attenuated
31
temp deferral for 4 weeks
vaccine- rubella, chickenpox, hep b
32
temp deferral for 6 weeks
end of preg
-time to develop antibodies
33
temp deferral for 12 months (now 3)
tattoos
piercings
mucous membrane to blood
syphilus treatment completed
sex with high risk
transfusion
human tissue graft
rabies vaccine
72 hours in correctional facility
34
any other inactivated vaccine has what deferral
NONE if healthy
35
high risk for HIV/Hep
+ syphilis or gonorrhea test
-accidental needle stick
-men sex with men
-cryoprecipitate
-buying/ sell sex
36
isotretinoin (accutane) temp deferral
1 month
37
warfarin temp deferral
1 week
38
aspirin and piroxicam temp deferral
2 days
39
hep B immune globulin temp deferral
1 year
40
COVID has impact on
donor testing and screening
41
COVID deferall changed from 12 month to 3 month for
sex with high risk pop
accidental needle exposure
tattoo
piercing
graft
transplant
transfusion
travel to region with endemic malaria
42
no longer indefinite deferral
donors who received bovine insulin/ stationed at military base in UK fron 1980-1986
lived in europe from 1980-1996 except living in UK, france, or ireland - still deferred for mad cow
43
when does autologous donation require disease testing
if transfusion facility is different from collection facility
44
what is done for autologous donations
ABO/Rh typed by collection place and confirmed by transfusion place
-crossmatch optional
45
what MUST be done for autologous donations
labeled as autologous
separated from other units
NEVER release to another patient
46
when can autologous donations be done
5-6 weeks prior to surgery (earlier if frozen)
-do up to 72 hrs prior to surgery
hgb= 11
hct=33% single
35% -- double
47
ANH: acute normovolemic hemodilution
autologous donation during operation
-remove whole blood replace with crystalloid to preserve volume
-reinfuse RBC's at end of operation
DONE BY anesthesiology
48
autologous intraoperative collection
blood collected from surgical site, gets washed and concentrated RBC's and immediately reinfused
-useful if can't have preop but expensive
-can be done if person refused allogenic units
-can still get contaminated then what is purpose
49
what does autologous intraoperative collection get stored at
RT for 6 hours or 1-6 degrees for 24 hrs as long as refrigerated within 4 hours of collection
50
autologous post-operative blood salvage
blood collected from drainage tube at surgical site (usually diluted, hemolyzed, and defibrinated) and reinfused at end
-high risk of transfusion rxn because of damaged blood
-no change of clerical error (never leaves bed side)
51
when is autologous post-operative blood salvage reinfusion
within 6 hrs of collection
-low cost
52
apheresis donation
instrument is used to collect specific blood component and return the rest to donor
-same donor requirements for whole blood (not double tho)
53
only effective method for collecting WBC's and stem cells from whole blood
apheresis donation
-regulated by FDA
54
plasma donation is done by
apheresis used to make FFP
-can be infrequent or serial
-same requirements as whole blood
55
infrequent/occasional plasma donation
once per 4 week period
56
serial plasma donation
no more than every 48 hours and no more than twice in a 7 days period
57
platelet donation
one collective of apheresis platelets is = pooled unit from 6-8 donors
-reduces exposure to multiple donors
-allows for compatibility matching if person has plt antibody
58
platelet donation interval
once every 2 days
-can't exceed 2 donations per week or 24 donations every year
59
if donated plt frequently what needs to be plt count
>150
each unit must contain 3 x 10^11
-usually 1 donation can be spilt up into multiple
60
platelet deferral if donor has taken NSAIDs
2 days
61
if more than 2 mL of RBC's end up in platelet product what happens
pilot tube must be attached and type confirmed by blood bank like RBC unit and NEEDS to be ABO matched to recipient
62
leukocyte donation collection ??
100 x 10^9 granulocytes every day for 5 days
63
donors for leukocyte donation are given
agent to enhance granulocyte count and sedimentation
64
hydroxyethyl starch
colloid sedimenting agent can expand donor volume
65
corticosteroids
pull more granulocytes to circulating pool
66
G-CSF
growth factors
donor produces more cells
67
leukocyte donation must be
ABO/Rh and HLA matched
-donor is usually a family member
-same policy as RBC contamination to PLT unit
68
double RBC apheresis can be used
autologous or allogenic
-Hgb measured quantitatively
-interval depends on volume of RBC's removed
69
if more than 300 mL removed for double RBC apheresis deferred for
16 weeks
70
collection for donations
-verify with photo ID
-unique # link donor to their components
-IODINE USED TO CLEAN
-clean center outward 30 sec
-16 gauge needle (prevent hemolysis)
71
donor rxn mild
fainting, nausea, hyperventilation
stop donation, cold compress, legs above head
72
donor rxn moderate
same as mild plus decreased plus, systolic BP under 60
-check vitals and give O2
73
donor rxn severe
convulsions
-require assistance
-need open airway, maybe CPR
-doctor called
74
donor rxn hematoma
stop donation, apply ice, raise arm above heart
-caused by piercing both sides of vein
75
donor processing for ABO/Rh
forward and reverse typing, whole blood tubes with apheresis
-is D neg must weak D
-if weak D + label as Rh +
76
donor processing for antibody screen
only for multi preg donors and people who received transfusions
-but blood centers just do everyone (pool plasma and test with screening cells)
-if + platelet and plasma discarded, RBC needs antibody ID
77
why is culture of apheresis plts done by collecting facility
QC measure
-tested with eBDS, 18 hrs of growth (why it takes 1 day to release plts form quarantine)
78
whole blood- derived plts procedure thing
unit of pooled plts
-unit must be pathogen inactivated and transfused within 5 days or
-tested with pan genera detection if transfused on day 4 or 5 post-collection
(detects gram +/-)
-if PGD is performed w/in 24 hrs pretransfusion and -, PLT shelf life now 7 days
79
2 pathogen inactivation mechanisms
amotosalen
riboflavin
80
amotosalen
intercalates DNA upon UV exposure- DNA can't be replicated and will prevent pathogens from replicating AND lymphs (prevent GVHD)
81
riboflavin
similar to other
-damages nucleic acids when exposed to UV radiation
82
pathogen inactivation for US approved is
plasma and platelets
-studies show toxicity not a factor
83
confidential unit exclusion
-required for donors to have contract point to confidentially indicate if blood should be used for transfusion or not
YES/NO barcode
phone # to call
84
donor lookback performed when
repeat donor test + for infection when previously negative
-will check which people received transfusions from donor's products
-send letter to recipient's doctor advising how to proceed
