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Donor Screening and component

preparation
Chapter 13
Part 1

Blood Donation and Donor Selection

Blood Donation
Donor screening and some Necessary information
1) Full name
2) Home and/or work address
3) Date of birth/age: Donor should be over 17
unless otherwise stipulated by state law
4) Reasons for previous deferral
5) Date of last donation (> 8 weeks for whole
blood, > 2 days for apheresis procedures)

Blood Donation and Donor Selection

Deferrals based on history
Permanent deferrals
Viral hepatitis (B or C)
History of Hepatitis of unknown cause
High-risk behavior for AIDS
Serologic positive for HBc, HCV, HIV, HTLV
Leukemia or Lymphoma
IV drug use even ONCE in lifetime
Taking clotting factors
One year deferrals
Needle sticks or other contact with blood
Tattoos, Acupuncture, ear piercing
Travel to malaria-endemic areas
Syphilis or gonorrhea
Living with person with active hepatitis
Rabies vaccine

Blood Donation and Donor Selection

Immunization Deferrals
Four Weeks:
Rubella, chicken pox
Two Weeks:
Measles
Mumps
Oral Polio
Yellow Fever
Oral typhoid
Others:
Pregnancy 6 weeks after delivery

No Deferral:

Hepatitis A and B
Influenza
Anthrax
Polio (injection)
Typhoid (injection)

Blood Donation and Donor Selection

Donor screening by physical criteria
General appearance (presence of anxiety, alcohol or
drugs influence, nervousness).
Arm check: Check both arms for evidence of IV drug use
and for venous access
Physical requirements
Weight: > 110 lbs (50 Kg)
Temperature: < 37.5 C
Pulse: 50-100 bpm (unless athlete)
Blood Pressure: < 180/100
Hemoglobin or Hematocrit: > 12.5 g/dl or 38% (for
both sexes)

Whole Blood Collection

Blood is collected in a primary
plastic bag that may have
satellite bags connected with a
long tube with a 16 or 17 gauge
needle
Everything is connected and is
considered a CLOSED
SYSTEM (remains sterile)
Most important step is preparing
the site to a state of almost
surgical cleanliness: Scrub with
iodophor scrub solution (0.7%).
Iodophor is a polyvinyl
pyrrolidone iodine complex
(PVP-Iodine)

Remains in a
closed
system!
(except when
needle is
removed from
arm)

Tubes for
testing

Bag OBlood

Donor Reactions
Donor room staff must be well trained to
handle and take care of donor reactions.
Donor reactions include wide spectrum:
from nervousness and hematomas to
convulsions and loss of consciousness.
Reactions can be divided into three
categories: mild, moderate and severe

Donor Reactions (Cont.)

Mild Reactions
Syncope or fainting
Nausea or vomiting
Hyperventilation
Twitching and muscle spasm
Sweating, dizziness, pallor

In case of fainting for example:

Remove tourniquet and withdraw needle

Place cold compresses on donor forehead
Raise the donors legs above the level of the head
Loosen tight clothing and secure airways
Monitor vital signs

Donor Reactions (Cont.)

Moderate Reactions
May include the above listed reactions in addition to LOSS
OF CONSCIOUSNESS. The donor may have decreased
pulse rate and fall in systolic blood pressure to 60 mm Hg.
In such case, the following applies
Check vital signs
Administer 95% oxygen and 5% carbon ddioxide

Severe Reactions
Characterized by experiencing convulsions.
In such case, the following should be done
Call for help (notify blood bank physician)
Restrain donor from injuring himself or others
Ensure adequate airway

Donor Reactions (Cont.)

Hematomas
Localized blood accumulation under the skin.
Caused by needle going through vein with
leakage of blood into the tissue.
In such case, the following should be done:
Remove the tourniquet and needle from donor
arm
Apply pressure with sterile gauze for 7-10 minutes
Apply ice to the area for 5 minutes

Blood Collection
Whole blood is collected in clear plastic
bags that contain different mixtures of
anticoagulants:
Citrate chelate calcium, preventing
coagulation
Phosphate prevents pH from dropping
Dextrose provides nutrients to RBCs during
storage
Adenine amino acid that maintains ATP

Anticoagulants
Anticoagulants:
CPD
Citrate, Phosphate, and Dextrose
21 day shelf life (at 1-6C)

CP2D
Citrate, Phosphate, and 2Xdextrose
21 day shelf life (at 1-6C)

CPDA-1
Adenine added
35 day shelf life

63 mL in 450 mL bag
70 mL in 500 mL bag

Additive Solutions (AS)

http://www.health.gov.mt/nbts/bldprocatpro.htm

Additional solutions may be added after

the primary bag is filled
Red cell preservation systems contain a
primary bag with anticoagulant and usually
2 satellite bags (1 empty & 1 with AS)

Before

After

Additive Solutions
Additive Solutions prolong red cell survival for 42 days
AS is added to primary bag after plasma is removed
(100mL in 450-mL bag; 110mL in 500-mL bag)
Final hematocrit should be between 55-65%
All contain varying concentrations of substances like
dextrose, adenine, sodium chloride and others
AS-1 (Adsol)
AS-3 (Nutricel)
AS-5 (Optisol)

Donor Processing
Testing donor blood
a. ABO grouping (forward and reverse)
b. Rh typing (anti-D)
c. Antibody screen (mainly for donor with history of
transfusion or pregnancy)
d. Infectious disease screening:
1) HBsAg (ELISA and NAT)
2) Anti-HBc (indicate HBV infection: either acute or chronic
infection)
3) Anti-HCV and NAT (for HCV RNA)
NAT will detect small amounts of viral nucleic acid before
antibodies form.
4) Anti-HIV-1/2 and NAT: Screening by ELISA. (if positive,
confirm with Western Blot)
5) Serologic test for syphilis

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