Nada Mohamed Ahmed , MD, MT (ASCP)i Blood transfusion Nada Mohamed Ahmed , MD, MT (ASCP)i

Objectives Definition of BLOOD TRANSFUSION Blood Facts Why we Donate Blood Health Benefits of Blood Donation Selection of blood donor Blood Donation Type . Deferral Criteria… The Anticoagulants and Storage of Blood Laboratory test in donor and recipients

Why You ShouldDonate Blood? 1. There isno substitute for Blood. 2. Every 3 seconds someone needs a blood transfusion! 3. Your donation will help save the life of up to3 people! 4. Blood is the most precious gift that anyone can give to another person —The Gift of Life.

Definition of BLOOD TRANSFUSION It is a procedure in which a patient receives a blood product through an intravenous line. It is the introduction of blood components into the venous circulation.

Blood Facts The average adult has about FIVE liters of blood inside of their body, which makes up 7-8% of their body weight. Blood is living tissue that carries oxygen and nutrients to all parts of the body, and carries carbon dioxide and other waste products back to the lungs, kidneys and liver for disposal. It also fights against infection and helps heal wounds, so we can stay healthy. There are about one billion red blood cells in two to three drops of blood. For every 600 red blood cells, there are about 40 platelets and one white cell.

Why we Donate Blood Blood is always needed for, accident victims cancer patients blood disorder patients surgery patients Pre-mature, pre term babies and many others……. 1 of out 10 hospital patients needs a blood transfusion

Health Benefits of Blood Donation 1.The Joy of Saving Human Lives! 2.Free Health Check Up! 3.Reduce the risk of Heart Diseases! 4.Burn Calories! 5.Reduces the risk of Cancer!

Selection of blood donor Eligibility Criteria Who can donate? Age: 18 - 60 years Weight : > 45 kgs Hemoglobin level: >12 gms/dl for men and 12.5 gms/dl for women In good health Wt > 45 Kg

Pulse, Blood pressure & Temperature: Pulse between 60-100 per minute acceptable. Systolic pressure between 90 and 180 mmHg acceptable Diastolic pressure between 50 and 100 mmHg acceptable A donor’s temperature must not exceed 37.5oC

Weight: proportionally, calculated as follows: If between 45-50 kgs can donate 350 ml of blood If above 50 kg can donate 450 ml of blood - Donors with unexplained weight loss of a significant degree (more than kg) are not acceptable to donate. If a prospective donor weighs less than 50 kg, a lesser amount of blood may be collected, and the amount of anticoagulant in the collecting bag must be reduced proportionally, calculated as follows: Volume of blood to draw = Donor’s weight in kg x 450 ml 50 Amount of anticoagulant = Volume of blood to draw 450

Surgery: If the surgery is minor (such as tooth extraction) a Pregnancy: pregnant women excluded from donating for 1 year after the conclusion of their pregnancy. Surgery: If the surgery is minor (such as tooth extraction) a donor is excluded until healing is complete and full activity has been resumed. Vaccinations: Persons recently immunized with toxoids and killed viral, bacterial and rickettsial vaccines (such as for anthrax, cholera, diphtheria, influenza, polio, tetanus, typhoid, typhus) are acceptable, - A donor who has received an attenuated live virus vaccine such as mumps or yellow fever is deferred for 2 weeks after the last immunization. - If rabies vaccination has been given following a bite by a rabid animal, the donor must be deferred for 1 year after

Blood Donation Process 1. Registration You will read informationabout donating blood, and will be asked to show a donor card, driver's license, or other form(s) of ID. 2. Health History & Mini-Physical Check your Temperature,Pulse, Blood Pressure andHemoglobin level present ina sample of blood. 3. The Donation Donationtakes about 8-10 minutes, during which you will be seatedcomfortably. When approximately a pint of blood has been collected,the donation is complete. 4. Refreshments After donating, you should have a snack and something to drink in the refreshments area.You can leave the site after 10-15 minutes and continue with your normal daily activities.

Tips for a Successful Blood Donation Before Your Donation Maintain a healthy iron level in your diet by eating iron rich foods, such as red meat, fish, poultry, beans, spinach,iron-fortified cereals and raisins. Get a good night's sleep. Drink an extra 16 oz. of water or nonalcoholic fluids before the donation. Eat a healthy meal before your donation. Avoid fatty foods, such as hamburgers, fries or ice cream before donating. (Fatty foods can affect the tests we do on your blood. If there is too much fat in your blood, your donation cannot be tested for infectious diseases and the blood will not be used for transfusion.) If you are a platelet donor, remember that your system must be free of aspirin for two days prior to donation. Remember to bring your donor card, driver's license or two other forms of ID.

Remember! The Donor Must …. have had good rest / sleep have had light meal be mentally prepared

Blood Donation Type & Frequency Whole Blood Platelets Plasma • Every 56 Days • Every 7 Days, Up to 24 times/year • Every 28 Days, Up to 13 times/year Packed Red Cells • Every 112 Days, Up to 3 times/year

I Give Blood, Will You?

Someone has to give blood in order for someone to receive blood.

DR.VINAMRA DHARIWAL MDS . Deferral Criteria… Postpone donation for 6 months if you have risk factors for HIV/AIDS , such as.. Intravenous drug abuse Having sex with a person who could have the above risk factors. DR.VINAMRA DHARIWAL MDS

Deferral Criteria… Female donors cannot donate blood…… During pregnancy After delivery for one year When lactating During menstrual period and for 7 days thereafter. Male donors cannot donate blood…… If consumed Alcohol in the previous 24 hours.

Infectious diseases: A donor must be free from infectious diseases that can be transmitted by blood such as hepatitis, HIV & malaria. - Persons at high risk for acquiring or transmitting AIDS should not donate blood. - Donors who have a history of malaria, or were previously resident in an endemic area, should be deferred for 3 years after becoming symptomatic or after leaving the endemic area. Previous donation: If a person has donated blood, an interval of at least four months for men and six months for women is required before the next donation.

The Anticoagulants and Storage of Blood Anticoagulant is a substance that prevents the clotting of blood some anticoagulants contain preservatives that provide proper nutrients for metabolism in the red cell during storage. Anticoagulants maintain red blood cells hemoglobin function and viability and the biochemical balance of certain elements: glucose, ATP, 2,3 diphosphoglycerate (2,3DPG) and PH, so that the red cells will maintain the means of delivering oxygen to the tissues of the recipient. Anticoagulants and/or anticoagulant preservation for whole blood and red cell concentrate storage include: ACD(acidcitrate-dextrose), CPD(citrate- phosphate dextrose). CPD-A1and CPD-A2(citrate phospate dextrose adenine) and heparine.

The Anticoagulants and Storage of Blood 1. ACD - Acts as an anticoagulant by binding Ca - Composition: Trisodium citrate- binds Ca Citric acid:- maintains PH Dextrose: acts as a nutrient & preservative - Shelf life: 75% survival after 21 days of storage.

2. CPD - Acts by binding Ca. - Composition: In addition to the composition of ACD, CPD contains sodium phosphate, which maintains ATP levels in the red cells. - Advantages of CPD over ACD. • Contains less acid. • Gives less hemolysis. • Smaller leak of K from the red cells. • Prolonged post- transfusion survival of red cells. - - Shelf life: 21 days The composition of two anticoagulant preservative solutions(CPD and CPDA1) is presented comparison purpose

3. CPD-A: It is a combination of CPD and adenine. Adenine provides a substrate from which red cells can synthesize ATP during storage. - Survival of red cells after 35-days storage. 4. EDTA and Heparin: are not commonly used in Blood Banking. Whole blood or red cell collected and stored in heparin solution must be used within 48 hours of phlebotomy. collected, processed and stored under conditions, which maximize its storage capacity.

Laboratory test in donor and recipients 1- ABO grouping 2-ABO sub grouping 3- Rh grouping 4- cross matching 5- serum screening for irrgular Abs 6- Ab identification 7-Serological test for HIV & Hepatitis 8-Serological test for parasitic diseases

Donated blood is tested by many methods, but the core tests recommended by the World Health Organization are these four: Hepatitis B Surface Antigen Antibody to Hepatitis C Antibody to HIV, usually subtypes 1 and 2 Serologic test for Syphilis