Blood donation Flashcards
How long must a pregnant patient wait to donate blood?
6 weeks postpartum
How long is the deferral for Hep B immunoglobulin?
12mo (given because of presumed exposure to HepB)
How long is the deferral for unlicensed vaccines?
1yr
How long is the deferral for transfusion or transplant
12mo (formerly; now 3mo in COVID)
What is the most challenging HIV virus to detect?
HIV-1 group O (missed by older testing methods)
What physical parameters (vitals) can result in deferral of a donor?
Weight less than 110lbs (>15% TBV blood loss)
HR outside of 50-100
BP outside of 100-180/50-100
What hematologic parameters can result in deferral of a donor?
Hemoglobin less than 13, 12.5 g/dL
Platelet count less than 150k
What are the limits for follow-up appointments of apheresis platelet donors?
Post-procedure plt should be >100k
Cannot lose more than 100mL blood to circuit
Need 2+ days between procedures, no more than 2 per week, 24 per year
Do apheresis donations or WB donations have more donor reactions?
WB (less experienced donors)
What is the strongest determinant of hematoma formation?
Phlebotomist skill and experience.
What are the essential components of post-donation care of donors?
Hold for 15min in canteen/lounge, encourage to eat/drink.
Provide contact info for donor room for later reactions and follow-up
What is the maximum amount of source plasma that can be donated in one visit? Per week? Per year?
1000mL per 48hours (1200 if >175lbs)
2000mL per week (2400 if >175lbs)
12L per year (14L if >175 lbs)
How often can apheresis donors donate RBCs?
56d for single units, 112d for double units.
What blood products have the highest profit margins to collect?
Platelets
Can hormonal agonists be used to increase yield from donors? Which?
Can, but not generally favored. EPO not generally used. TPO never used due to risk of antibody formation. DDAVP in cryo?…
How are whole-blood derived platelets gathered?
US: Soft spin blood to make RPR, hard-spin to make platelet pellet.
EU: Hard spin blood to make buffy coat, collect and then leukoreduce?
Why are apheresis platelets superior to WBD platelets?
Only one donor exposure and better leukoreduction»_space; less TRXN, less alloimmunization, less TTI. Also, allows for HLA matched selection.
If a donor cannot answer a question on the BDR/DHQ, how should this be handled?
The donor may be allowed to donate, but their eligibility must be determined within 24 hours.
What is the hemoglobin collection goal in red cell donation?
Goal is at least 60 grams of hemoglobin per unit.
Per AABB standards, 95% of units must have at least 50g.
What is the most common cause for deferral, and how can it be addressed?
Anemia; recommend iron supplementation (usually, simply informing donor of anemia corrects issue)
Can patients with bleeding conditions donate?
No, with the exception of factor XII deficiency. Patients who are carriers/heterozygous may still donate.
What classes of medications will cause deferral?
Teratogens (most hormonal drugs), antibiotics (because of their implication), anticoagulants/antiplatelet agents, anything relating to CJD risk (hGH)
What is the “abbreviated DHQ”? Who can use it?
A shortened questionnaire appropriate for repeat donors. Donors must have donated twice before, at least once in the past 6 months.
What is the relationship between directed donation and transfusion-transmitted infections?
Many requests are born out of fear of TTIs, when in reality directed donations confer a higher risk.
What are the requirements for autologous transplant?
Order from an MD
Minimum hemoglobin of 11g / hematocrit 33%
At least 72hr gap before surgery
No symptoms concerning for bacteremia
What donation materials must be labeled with the DIN? How should the DIN look?
The BDR, blood containers, and any tubes. The DIN should be barcode and eye-readable.
What collection volume may count as underweight?
<405mL if collecting into 450mL bag
<450mL if collecting into 500mL bag
What is the most common donor reaction? What predicts it and how does it manifest?
Vasovagal reaction; manifests with hypotension and bradycardia, sometimes nausea/vomiting or defecation, even convulsions. Risk factors include young age, low blood volume, and first-time donation.
How can vasovagal reactions be prevented or treated?
Prevention: Education, fluids, and distraction.
Treatment: Trendelenberg, cold towels, fluids.
What preservative solutions can whole blood be collected in? For how long?
ACD, CPD, CP2D (21d)
CPDA-1 (35d)
What testing must be done on every donation?
ABO/Rh
Ab screen
TTIs
HLA serology if prior pregnancy
What combinations of products can be collected via apheresis?
2x RBC RBC + plasma RBC + platelets RBC + platelets + plasma Multiple platelets
How many segments should be made for each pRBC unit?
13-15
How are frozen red cells thawed and deglycerolized?
Thawed at 37C for 10min (water bath)
Deglycerolize with serial dilutions of glycerol solution, then suspend in 0.2% dextrose to rejuvenate. This system is open–24hrs to transfuse or re-freeze!
How quickly must FFP be frozen?
In 8 hours, or 6 if collected into ACD.
How much fibrinogen is in cryo-poor plasma? What should be done with it following cryoprecipitation?
Still has 200mg/dL! Should be re-frozen.
What is missing from thawed plasma?
Reduced fV and fVIII.
What are the regulatory restrictions placed on source plasma donors?
Limit RBC loss to <200mL per 8wks (reinfuse red cells)
Allow 48hrs between donations
Test for plasma proteins and immunoglobulins
Have access to an MD
How much fibrinogen is in cryoprecipitate? Does ABO type matter?
Median is 388mg/unit (150 minimum)
Group A/B/AB have more fVIII than group O
When must a plasma-rich product follow major ABO compatibility rules?
When RBC volume exceeds 2mL.
What is the disadvantage in using PAS platelets?
Yields are slightly lower.
What are the timing intervals and donor criteria for platelet donors?
Need at least 2 days between donations, no more than 2 per week and 24 per year.
Defer if RBC loss (8wk if >100mL), 2d for ASA/piroxicam, 14d for P2Y12 inhibitors.
How much plasma can be collected concurrently from a platelet donation?
500mL (or 600mL if donor weighs >175 lbs).
What are the costs and benefits to hetastarch use in granulocyte collection?
Improves WBC yield. But takes a year or longer to clear, causes headaches and edema due to oncotic effect.
What rules of compatibility should granulocytes follow?
RBC (major) rules, because RBC contamination is inevitable.
What percentage of blood comes from repeat donors?
80%
What devices are approved for collection of pheresis platelets?
Fenwal Amicus
Trima Accel
MCS+ LN9000
What are the minimum requirements for a product label?
Collecting facility
DIN
Product Code (ISBT)
ABO/Rh
