Transcript I. Blood Collection - Austin Community College

Unit 1 Part 1 Blood Collection
Terry Kotrla, MS, MT(ASCP)
MLAB 2431 Immunohematology
Introductory Comments
An overview of the process involved in collecting donor blood
Donor Screening
 All blood comes from VOLUNTEER donors.
 Screening performed to ensure donor is healthy.
 Starts with the donor and first impressions are critical
 Clean, well lit donation facility from waiting room to
collection area
 Pleasant, professional staff who can ask the appropriate
questions, observe and interpret the responses, and
ensure that the collection process is as pleasant as
possible
Blood Bank versus Blood Center
 Confusion exists and terms are sometimes used
inappropriately
 Blood bank in a hospital is also known as the transfusion
service, performs compatibility testing and prepares
components for transfusion
 Blood Center is the donation center, screens donors,
draws donors, performs testing on the donor blood, and
delivers appropriate components to the hospital blood
bank
Standards, Regulations, Governing Bodies
 Strict guidelines exist and inspections are performed in both blood
centers and blood banks to ensure the safety of the donors and
patients
 Some or all of the following agencies may be involved:
 FDA – Food and Drug Administration – CBER and CFR
 AABB
 CAP – College of the American Pathologists
 Joint Commission – inspects hospitals, lab included
 CLSI – Clinical Laboratory Standards Institute
Donor Screening
 Two goals or purposes for screening
 Protect the health of the potential donor
 Protect the health of the potential recipient
 Four outcomes
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Acceptance
Temporary deferral
Indefinite deferral
Permanent deferral
 Three components of screening
 Registration
 Health history interview
 Limited physical examination.
Donor Registration
 Donor signs in
 Written materials are given to the donor which explains high risk
activities which may make the donor ineligible
 Donor must be informed and give consent that blood will be used
for others unless they are in a special donor category
 First time donors must provide proof of identification such as
SS#, DL#, DOB, address and any other unique information.
 Repeat donors may be required to show DL or some other photo
ID.
Donor Registration
 Additional useful information
 Name of patient or group to credit
 Race
 Unique donor characteristics
 Donor must be provided with
 HIV high risk activities
 Warnings about donor reactions
 Tests that will be performed and notification
 Post phlebotomy care instructions
Medical History
 Frequency of donation
 Whole blood or red blood cells 8 weeks
 Two unit red cell unit 16 weeks
 Plateletpheresis – up to 24 times/year
 Plasmapheresis– once every 4 weeks, can be done twice a week
Medical History
 A thorough history is obtained each time
 Standardized universal questionnaire is used
 Questions are asked that are very intimate in nature but
are critical in assessing HIV or HBV risks
 Has donor ever been deferred, if “yes”, why.
 Medications the donor is taking are present in plasma,
may cause deferral
 Infections the donor has may be passed to recipient, may
be cause for deferral
Permanent Deferrals
 Males who had sex with males OR engaged in sex for drugs or money since
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1977.
Used IV drugs even ONCE in lifetime.
Taking clotting factors.
Hepatitis after age 11.
Cancer deferrals vary, some accept after period of being disease free others
do not accept.
Lived in a country where Creutzfeld-Jacob disease is prevalent or family
member with CJD.
Protozoan diseases such as Chagas disease or Babesiosis
Received human pituitary growth hormone.
Positive test for: HBsAg, Hepatitis C, HTLV I/II or HIV.
Donated only unit of blood in which a recipient contracted HIV or HBV
Was the only common donor in 2 cases of post-transfusion HIV or HBV in
recipient
12 Month Deferral
 Recipient of blood, components or blood products such as
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coagulation factors
Sexually transmitted disease-if acquired indicates safe sex
not practiced and donor at risk for HIV and HBV
Received HBIG.
Accupuncture, tattoo, ear piercing
Needle stick
Rabies vaccine
Any intimate sexual relations with HIV or HBV positive,
hemophiliacs, drug users or individuals receiving
drugs/money for sex.
Temporary Deferrals
 Certain immunizations
 2 weeks -MMR, yellow fever, oral polio, typhoid
 4 weeks -Rubella, Chicken Pox
 2 months – small pox
 Pregnancy – 6 weeks upon conclusion
 Certain medications
 Proscar/Propecia, Accutane – 1 month
 Avodart – 6 months
 Soriatane – 3 years
 Tegison – permanent
 Feldene – no platelet donation for 2 days.
 Plavix and Ticlid – no platelet donation for 14 days
 Malaria 3 years
 West Nile virus 28 days
Helpful Hint
 Permanent deferral – any member of high risk group
such as: HIV/HBV/HCV pos, drugs/sex for money,
cancer, serious illness or disease, CJD, Chagas disease,
Babesiosis
 12 month deferral – sex with any high risk group, any
blood exposure, recipient of blood/blood products,
STD, jail/prison, rabies vaccine after exposure, HBIG,
malaria
 Have to memorize: medications and vaccinations
Physical Examination
 Evaluate general appearance
 Weight – 110 1bs national, 123 lbs. Austin – eff. Jan 2010
 Temperature 37.5 C OR 99.5F
 Blood pressure
 Systolic </= to 180 mm Hg
 Diastolic </= 100 mm Hg
 Hemoglobin and Hematocrit
 Allogenic 12.5 g/dL or 38%
 Autologous 11.0 g/dL or 33%
Self-Exclusion
 Rescinded by FDA in 1992 but some blood centers may still use.
 Two stickers
 “Yes, use my blood”
 “No, do not use my blood”
 After interview the donor will place the appropriate bar coded
label on the donation record
 If “no” selected the unit is collected, fully tested, but not used for
transfusion
 Allows donors who know they are at risk to “save face” if pressured
to donate by friends and family
Donor Categories
 “Allogeneic”, “homologous” and “random donor” terms used for
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blood donated by individuals for anyone’s use
Autologous – donate blood for your own use only
Recipient Specific Directed donation – donor called in because
blood/blood product is needed for a specific patient
Directed Donor – patient selects their own donors
Therapeutic bleeding – blood removed for medical purposes such
as in polycythemia vera. NOT used for transfusion.
Auto/Directed Blood Labels
Donor Categories
 Apheresis – removal of 1 component, return the rest
 Leukapheresis
 Plateletpheresis
 Plasmapheresis
 Stem cells
 Bone marrow
 Apheresis
Donor Categories
 Safest is autologous, blood is your own, no risk of disease
acquisition
 Most dangerous is Directed Donor, you select a donor who
may, unknown to you, be in a high risk category but feels
obligated to follow through and donate
References
 http://www.fda.gov/cber/dhq/dhq.htm
 AABB Technical Manual 17th edition.