Presentation on theme: "An overview of the process involved in collecting donor blood"— Presentation transcript:
1 An overview of the process involved in collecting donor blood I. Blood CollectionAn overview of the process involved in collecting donor blood
2 Donor ScreeningStarts with the donor and first impressions are criticalClean, well lit donation facility from waiting room to collection areaPleasant, professional staff who can ask the appropriate questions, observe and interpret the responses, and ensure that the collection process is as pleasant as possible
3 Blood Bank versus Blood Center Confusion exists and terms are sometimes used inappropriatelyBlood bank in a hospital is also known as the transfusion service, performs compatibility testing and prepares components for transfusionBlood Center is the donation center, screens donors, draws donors, performs testing on the donor blood, and delivers appropriate components to the hospital blood bank
4 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 patientsSome or all of the following agencies may be involved:AABB – American Association of Blood BanksFDA – Food and Drug AdministrationCAP – College of the American PathologistsJCAHO - Joint Commission on the Accreditation of Hospital OrganizationsNCCLS – National Committee for Clinical Laboratory Standards
5 Donor ScreeningMedical History based on a standardized questionnaire obtains critical information about the donor’s health and risk factors which may make it unsafe for donationPhysical Exam which includes blood pressure, temperature, pulse and screen for anemia are performed to ensure donor is healthy enough to donate.Two goals of screeningProtect the health of the potential donorProtect the health of the potential recipient
6 Donor Registration Donor signs in Written materials are given to the donor which explains high risk activities which may make the donor ineligibleDonor must be informed and give consent that blood will be used for others unless they are in a special donor categoryFirst 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
7 Frequency of donation Whole blood or red blood cells 8 weeks Plateletpheresis – up to 24 times/yearPlasmapheresis– once every 4 weeks, can be done twice a weekGranulocytes
8 Medical History A thorough history is obtained each time Standardized universal questionnaire is usedQuestions are asked that are very intimate in nature but are critical in assessing HIV or HBV risksMedications the donor taking are present in plasma, may cause deferralInfections the donor has may be passed to recipient, may be cause for deferral
9 12 Month DeferralAny intimate sexual relations with HIV positive, HBV positive, hemophiliacs, drug users or individuals receiving drugs/money for sex.Recipient of blood, components or blood products such as coagulation factorsSexually transmitted disease-if acquired indicates safe sex not practiced and donor at risk for HIV and HBVTravel to malarial endemic country
11 Permanent Deferrals HIV, HBV, or HCV positive Protozoan diseases such as Chagas disease or BabesiosisReceived human pituitary growth hormoneDonated only unit of blood in which a recipient contracted HIV or HBVWas the only common donor in 2 cases of post-transfusion HIV or HBV in recipientLived in a country where Creutzfeld-Jacob disease is prevalentMost cancers except minor skin cancer and carcinoma in-situ of the cervixSevere heart disease, liver disease
12 Helpful HintPermanent 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, Babesiosis12 month deferral – sex with any high risk group, any blood exposure, recipient of blood/blood products, STD, jail/prison, rabies vaccine after exposure, HBIG, malariaHave to memorize: medications and vaccinations
13 Self-Exclusion 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 recordIf “no” selected the unit is collected, fully tested, but not used for transfusionAllows donors who know they are at risk to “save face” if pressured to donate by friends and family
14 Donor Categories“Allogeneic”, “homologous” and “random donor” terms used for blood donated by individuals for anyone’s useAutologous – donate blood for your own use onlyRecipient Specific Directed donation – donor called in because blood/blood product is needed for a specific patientDirected Donor – patient selects their own donorsTherapeutic bleeding – blood removed for medical purposes such as in polycythemia vera. NOT used for transfusion.
16 Donor CategoriesSafest is autologous, blood is your own, no risk of disease acquisitionMost 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
18 Collection of Blood Materials used are sterile and single use. Most important step is preparing the site to a state of almost surgical cleanliness.Bacteria on skin, if present, may grow well in stored donor blood and cause a fatal sepsis in recipientUse gauge needle to collect blood from a single venipuncture within 15 minutesCollect 450 +/- 45 mLs of blood
19 Donor Reactions Syncope (fainting) Hyperventilation Nausea/vomiting Remove needle immediatelyHyperventilationHave donor rebreathe into paper bag.Nausea/vomitingTwitching/muscle spasmsHematomaConvulsions – rare, get immediate assistanceCardiac difficulties
20 Post-Phlebotomy Care Donor applies pressure for 5 minutes Check and bandage siteHave donor sit up for few minutesHave donor report to refreshment area for additional 15 minutes of monitoring
21 Post-Phlebotomy Instructions Eat/drink before leavingWait until staff releases youDrink more fluids next 4 hoursNo alcohol until after eatingRefrain from smoking for 1 hourIf bleeding continues apply pressure and raise armFaint or dizzy sit with head between kneesAbnormal symptoms persist contact blood center.Remove bandage
22 Testing Donor Blood CANNOT rely on previous testing Records must be kept for 5 years
23 Serological Testing ABO/D typing Antibody Screen – if positive, ID antibody, cannot make plasma productsAntibodies to other blood group antigens which are present in the donor may react with recipient red cells resulting in a reaction.
24 Disease Testing Disease testing include: HBsAG HBc HCV HIV 1&2 HTLV I/IIRPRNAT for HIV-1, HCV & WNV
25 Results of TestingTests for disease markers must be negative or within normal limits.Donor blood which falls outside these parameters must be quarrantined.Repeat testing, if still abnormal must dispose.
26 Transfusion Service Testing The only repeat testing required is:ABO on red cell productsD typing (IS) on D negative red cell productsPlasma products (FFP, CRYO, PLTS) do not require any testing.Donor samples must be stored at 1-6C for at least 7 days after transfusionADSOL unit transfused today must save sprig for one weekMany facilities will pull a sprig from each donor during processing and save all sprigs for 49 days, regardless of expiration of unit
27 Summary Blood collection starts with screening of the donor to: Ensure they are healthy enough to donateEnsure they do not have transmissible diseasesMany organizations set standards and monitor all aspects of blood collection and administration.Collection of blood must be done in such a manner as to ensure sterility of the component.Testing of donor blood includes serological testing for ABO/D typing, antibody screening, and testing for markers indicating infection.The blood supply is NOT safe, only careful screening and testing can prevent, as much as possible, disease transmission.