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Transfusion Medicine Fellowship > Blood donation > Flashcards

Blood donation Flashcards

1
Q

How long must a pregnant patient wait to donate blood?

A

6 weeks postpartum

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2
Q

How long is the deferral for Hep B immunoglobulin?

A

12mo (given because of presumed exposure to HepB)

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3
Q

How long is the deferral for unlicensed vaccines?

A

1yr

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4
Q

How long is the deferral for transfusion or transplant

A

12mo (formerly; now 3mo in COVID)

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5
Q

What is the most challenging HIV virus to detect?

A

HIV-1 group O (missed by older testing methods)

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6
Q

What physical parameters (vitals) can result in deferral of a donor?

A

Weight less than 110lbs (>15% TBV blood loss)
HR outside of 50-100
BP outside of 100-180/50-100

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7
Q

What hematologic parameters can result in deferral of a donor?

A

Hemoglobin less than 13, 12.5 g/dL

Platelet count less than 150k

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8
Q

What are the limits for follow-up appointments of apheresis platelet donors?

A

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

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9
Q

Do apheresis donations or WB donations have more donor reactions?

A

WB (less experienced donors)

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10
Q

What is the strongest determinant of hematoma formation?

A

Phlebotomist skill and experience.

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11
Q

What are the essential components of post-donation care of donors?

A

Hold for 15min in canteen/lounge, encourage to eat/drink.

Provide contact info for donor room for later reactions and follow-up

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12
Q

What is the maximum amount of source plasma that can be donated in one visit? Per week? Per year?

A

1000mL per 48hours (1200 if >175lbs)
2000mL per week (2400 if >175lbs)
12L per year (14L if >175 lbs)

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13
Q

How often can apheresis donors donate RBCs?

A

56d for single units, 112d for double units.

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14
Q

What blood products have the highest profit margins to collect?

A

Platelets

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15
Q

Can hormonal agonists be used to increase yield from donors? Which?

A

Can, but not generally favored. EPO not generally used. TPO never used due to risk of antibody formation. DDAVP in cryo?…

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16
Q

How are whole-blood derived platelets gathered?

A

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?

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17
Q

Why are apheresis platelets superior to WBD platelets?

A

Only one donor exposure and better leukoreduction&raquo_space; less TRXN, less alloimmunization, less TTI. Also, allows for HLA matched selection.

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18
Q

If a donor cannot answer a question on the BDR/DHQ, how should this be handled?

A

The donor may be allowed to donate, but their eligibility must be determined within 24 hours.

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19
Q

What is the hemoglobin collection goal in red cell donation?

A

Goal is at least 60 grams of hemoglobin per unit.

Per AABB standards, 95% of units must have at least 50g.

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20
Q

What is the most common cause for deferral, and how can it be addressed?

A

Anemia; recommend iron supplementation (usually, simply informing donor of anemia corrects issue)

21
Q

Can patients with bleeding conditions donate?

A

No, with the exception of factor XII deficiency. Patients who are carriers/heterozygous may still donate.

22
Q

What classes of medications will cause deferral?

A

Teratogens (most hormonal drugs), antibiotics (because of their implication), anticoagulants/antiplatelet agents, anything relating to CJD risk (hGH)

23
Q

What is the “abbreviated DHQ”? Who can use it?

A

A shortened questionnaire appropriate for repeat donors. Donors must have donated twice before, at least once in the past 6 months.

24
Q

What is the relationship between directed donation and transfusion-transmitted infections?

A

Many requests are born out of fear of TTIs, when in reality directed donations confer a higher risk.

25
Q

What are the requirements for autologous transplant?

A

Order from an MD
Minimum hemoglobin of 11g / hematocrit 33%
At least 72hr gap before surgery
No symptoms concerning for bacteremia

26
Q

What donation materials must be labeled with the DIN? How should the DIN look?

A

The BDR, blood containers, and any tubes. The DIN should be barcode and eye-readable.

27
Q

What collection volume may count as underweight?

A

<405mL if collecting into 450mL bag

<450mL if collecting into 500mL bag

28
Q

What is the most common donor reaction? What predicts it and how does it manifest?

A

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.

29
Q

How can vasovagal reactions be prevented or treated?

A

Prevention: Education, fluids, and distraction.
Treatment: Trendelenberg, cold towels, fluids.

30
Q

What preservative solutions can whole blood be collected in? For how long?

A

ACD, CPD, CP2D (21d)

CPDA-1 (35d)

31
Q

What testing must be done on every donation?

A

ABO/Rh
Ab screen
TTIs
HLA serology if prior pregnancy

32
Q

What combinations of products can be collected via apheresis?

A 
2x RBC
RBC + plasma
RBC + platelets
RBC + platelets + plasma
Multiple platelets
33
Q

How many segments should be made for each pRBC unit?

A

13-15

34
Q

How are frozen red cells thawed and deglycerolized?

A

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!

35
Q

How quickly must FFP be frozen?

A

In 8 hours, or 6 if collected into ACD.

36
Q

How much fibrinogen is in cryo-poor plasma? What should be done with it following cryoprecipitation?

A

Still has 200mg/dL! Should be re-frozen.

37
Q

What is missing from thawed plasma?

A

Reduced fV and fVIII.

38
Q

What are the regulatory restrictions placed on source plasma donors?

A

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

39
Q

How much fibrinogen is in cryoprecipitate? Does ABO type matter?

A

Median is 388mg/unit (150 minimum)

Group A/B/AB have more fVIII than group O

40
Q

When must a plasma-rich product follow major ABO compatibility rules?

A

When RBC volume exceeds 2mL.

41
Q

What is the disadvantage in using PAS platelets?

A

Yields are slightly lower.

42
Q

What are the timing intervals and donor criteria for platelet donors?

A

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.

43
Q

How much plasma can be collected concurrently from a platelet donation?

A

500mL (or 600mL if donor weighs >175 lbs).

44
Q

What are the costs and benefits to hetastarch use in granulocyte collection?

A

Improves WBC yield. But takes a year or longer to clear, causes headaches and edema due to oncotic effect.

45
Q

What rules of compatibility should granulocytes follow?

A

RBC (major) rules, because RBC contamination is inevitable.

46
Q

What percentage of blood comes from repeat donors?

A

80%

47
Q

What devices are approved for collection of pheresis platelets?

A

Fenwal Amicus
Trima Accel
MCS+ LN9000

48
Q

What are the minimum requirements for a product label?

A

Collecting facility
DIN
Product Code (ISBT)
ABO/Rh

Transfusion Medicine Fellowship (34 decks)

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