A donation that is given specifically for transfusion to a named
patient. Directed donors are friends or relatives who wish to give blood for a specific patient. In 2006, approximately 70,000 units of blood were donated as directed donor units. This represented 0.4% of the total available blood supply, which was a huge decrease from 1989. The appeal of directed donor blood is that the patient hopes those donors will be safer than the regular blood supply. However, this blood might be less safe than the general community supply because the donors would be under considerable pressure to donate and might not be candid about their medical and riskbehavior history. In general, the data do not indicate that directed donors are either more or less safe than regular donors. The use of directed donations has decreased over the last 10 years, but the ongoing demand from patients for transfusions from specific donors during scheduled surgeries likely still reflects the skewed perception among the general public of the risk for HIV associated with blood transfusion. Despite this, directed donor blood has considerable appeal to many patients. Some blood banks decline directed donations and some accept these donors as a service to the patients. Each hospital must also decide whether to sequester the blood and use it only for the intended patient or to allow the directed donor blood to become part of the communitys general blood supply if it is not used for the originally intended patient. If directed donor units are to be crossed over into the general supply, the donors must meet all the usual FDA requirements for routine blood donation. In either situation, directed donor blood requires additional attention and record systems for the blood center and hospital, thus increasing the cost and creating the possibility for errors to occur and the blood to be unavailable when desired for the particular patient.
Directed donations have higher viral marker rates than volunteer
donations, mostly but not entirely reflecting the higher prevalence of first-time donors among the former group. There is no evidence that directed donations are safer to use than donations from volunteer 1 community donors. On the contrary, some concerns persist that directed donors may feel unduly pressured to give blood, which could compromise blood safety.
Directed donors must meet the same criteria as voluntary
donors, and their blood can be used for other patients if not needed by the individual for whom the donations were initially intended. If collection of whole blood is required from a directed donor more than once in an 8-week period, the Code of federal regulations (CFR) requires that the donor be examined and certified to be in good health by a physician on the day of donation
The donor center should clearly communicate its directed-donation
procedures so that the expectations regarding the availability of directed donor units are known to the ordering physician and patient. The communication required includes defining the mandated interval between collection of the blood and its availability to the patient, mentioning the possibility that the patient will identify donors who are not ABO compatible or not otherwise acceptable blood donors and defining the policy for release of donor-directed units for transfusion to other patients. Additional information on the container can be conveyed using a tie tag. Tie tags are especially useful for autologous and directed donations. Tie tags include the patients identifying information, the name of the hospital where the patient will be admitted for surgery, date of surgery, and other information that may be helpful to the hospital transfusion service. Irradiation of blood components from directed donations especially from family members or other related donors PTP can be prevented by using antigen matched donors. Autologous donations and directed donations from antigen matched donors and family members may be appropriate
N.B: Patientspecific donation
* There are a few situations in which appropriate transfusion therapy involves collecting blood from a particular donor for a particular patient. Examples are donorspecific transfusions prior to kidney 2 transplantation, maternal platelets for a fetus projected to have neonatal thrombocytopenia or family members of a patient with a rare blood type. * In these situations, the donors must meet all the usual FDA requirements, except that they may donate as often as every 3 days so long as their hemoglobin remains above the normal donor hemoglobin requirements. * The units donated must undergo all routine laboratory testing.