Donor Selection Flashcards
What information is requested during donor registration?
Donor First and Last name and middle initial or name
Date of Birth
Unique identifying number
Contact information
What’s the minimum age to be a donor?
16 or whatever state law states
Whats the minimum weight to be a donor?
50kg or 110 lbs
Weight may be self reported unless doing a plasmapheresis collection
What education materials are required to be given to the donor?
Infectious diseases transmitted by blood donation and the importance of providing accurate info
- Must not donate for HIV disease testing
- Must notify if they believe their blood is suitable
- Iron deficiency
- Must acknowledge
What is the donor consent?
Must be signed the day of donation Must be understandable Informed of risk of procedure Info on Inf. disease test provide and mandated reporting if positive Must be able to ask questions
What does AABB and FDA require for autologous donor?
A prescription or order from the patient’s physician to collect autologous blood Minimum hgb concentration of 11 g/dL (hct 33%) Collect unit(s) at least 72 hours before surgery or transfusion Defer donor for conditions presenting risk of bacteremia The unit is reserved for the donor-patient only, no “crossing over” into the regular blood supply
What testing is required on Autologous units?
Autologous units receive the same testing as allogeneic units if they are transfused outside the collection facility. There are still hospitals that have their own donor services and if drawn and transfused under the same roof, only ABO/Rh testing is mandatory.
Only required once every 30 days.
*If any test results are reactive, the patient’s physician and donor-patient must be notified.
Can autologous units be drawn from patients of known infectious disease testing?
Yes but depends on SOP of collection center and if hospital will accept known positive units
How many days before surgery should auto units be collected?
3 days or 72 hours
What pretransfusion testing is required for Auto donations?
Only ABO/RH is required however its good idea to do ABS in case patient needs bank units
What are the risk of transfusion auto units?
Bacterial contamination Cytokine mediated reactions circulatory overload TRALI ABO incompatibility due to identification error
What is a designated donor?
Patient needs blood from a specific donor for medical reasons
- Multiple antibodies or high incidence
- Neonate with NAIT required PLT from mother
What are the requirements for designated donors?
Request from pt’s Dr. and approval from Donor center Dr.
Donor must meet all allogenic donor requirements
Can donate every 3 days if Hgb level meets requirement
Frequent donors only need testing done on the 1st donation in each 30 day period
What are directed donors?
Patients may request a specific person to donate for them
Directed units may cross over into general inventory if not used by the patient
Must meet same qualifications as allo donors
What is therapeutic phlebotomy?
removal of whole blood to decrease elevated iron stores to decrease iron toxicity such as liver, cardiac, and endocrine gland function
Only performed with a Dr. order
According to the standards when can therapeutic units be used for allo donation?
Individual meets all allogenic criteria and unit is labeled with donor disease
or if patient has HH or other FDA approved condition
What is Hemochromatosis?
gene results in increased Iron absorption form GI tract
Iron toxicity results in liver disease, diabetes, and gonadal and cardiac dysfunction.
People usually donate once per week until iron stores are depleted and then every 3-4 months to maintain normal ferritin levels.
What changes can be made to the DHQ?
Minor changes that are more restrictive
add local questions but must be at the end
How long is the deferral for pregnancy?
6 weeks after pregnant
1st and 2nd trimester terminations have no deferral
How long is the deferral for receipt of blood component?
12 month deferral for blood components, human tissue, and plasma derived clotting factor concentrates
How long is the deferral for family hx of Creutzfeldt-Jakob disease (CJD)?
Indefinite
Includes receipt of dura mate or pituitary growth hormone of human origin
10-15% of cases are familial
What is CJD?
rare degenerative fatal brain disease caused by prions
Long incubation, appears in 60’s and fatal in a year
Belongs to a class of brain disorders called transmissible spongiform encephalopahthies (TSE)
What drugs are teratogens or risk to fetus?
Etretinate* (Tegison) - permenant Acitretin* (Soriatane) Dutasteride* (Avodart, Jaylyn) Finasteride*(Proscar, Propecia) or Isotretinoin* (Accutane)
How long is the deferral for Finasteride* (Proscar, Propecia) or Isotretinoin* (Accutane)? (Used for treatment of acne, hair loss or prostate)
1 month
How long is the deferral for Etretinate* (Tegison)? (Treatment for Psoriasis)
Permenant - Eternity
How long is the deferral for HBIG
1 year
This is given after blood exposure and is different than the hep b vaccine which has no deferral
How long is the deferral for Dutasteride* (Avodart, Jaylyn)?
6 months
What drugs inhibit platelet function and cannot be used as sole source of platelets?
Aspirin and piroxicam (Feldene) = 48 hrs
Prasugrel (Effient) and Ticagrelor (Brilinta) = 7 days
Clopidogrel (Plavix), Ticlopidine (Ticlid) and Vorapaxar (Zontivity) = 14 days
What is the deferral for Warfarin and Heparin?
7 days for plasma products for transfusion
What is the deferral for bovine insulin manufactured in the UK?
Indefinite deferral because no reliable test for CJD
What common drugs have no defferals?
Antibiotics taken for acne (defined by MD), vitamins, birth control, hormone replacements, or blood pressure meds.
Which vaccines have no deferral
Receipt of toxoids, synthetic or killed viral, bacterial or rickettsial vaccines if donor is symptom-free and afebrile.
Example: Anthrax, cholera, hepatitis A, hepatitis B, influenza, tetanus, typhoid (by injection), Polio (Salk / injection).
What vaccines have a 2 week deferral?
Receipt of live attenuated viral and bacterial vaccines
Example: Measles (rubeola), Mumps, Polio (Sabin/oral), Typhoid (oral), Yellow fever
What vaccines have a 4-week deferral?
Receipt of live attenuated viral and bacterial vaccines.
Example: German measles (rubella), chickenpox /shingles (varicella zoster).
12-Month deferral – Receipt of other vaccines, including unlicensed vaccines.
What will cause a permeant deferral?
Confirmed positive test for HBsAg
Reactive NAT test for HCV or HIV
Taking the medication Tegison (etretinate)
What will cause an indefinite deferral?
Repeatedly reactive test for anti-HBc on more than one occasion
Positive HBV NAT result
Repeatedly reactive test for anti-HTLV on more than one occasion
Any evidence of infection with HIV, HCV, HTLV or T. cruzi as excluded by current FDA regulations
A history of Babesiosis
Positive test for HIV
Exchanged sex for money or drugs
Ever engaged in injection drug use not prescribed.
What is the deferral period for individuals who were diagnosis with malaria?
Must wait 3 years after become symptom free
What is the deferral for individuals who lived in an malaria endemic area for more than 5 years?
3 years after leaving endemic area
What is the deferral for period from someone who traveled to a malaria endemic area?
12 months
What are causes for a 12 month deferral?
Blood exposure
Sexual contact or lived with an individual who has hepatitis B (positive HBsAg test, HBV NAT) or symptomatic hepatitis C, used IV drugs, or a man who had sex with man
Incarceration in a correctional institute for more than 72 consecutive hours.
After completing treatment for syphilis or gonorrhea.
Is there a deferral for tattoos or body piercing’s?
If done in a licensed facility there is no deferral
What does the FDA recommend for transgender individuals?
Male or female gender should be self-identified and self-reported for the purpose of blood donation
How long are donors travelling to areas at risk of vCJD deferred for?
Indefinite
Living in the UK for ≥ 3 mo from 1980-1996
Living in Europe for ≥ 5 yr from 1980-Now
US military bases in Europe ≥ 6 mo from 1980-1996
What is the deferral for xenotransplantation?
Permante
What is the min Hgb/Hct for women to donate?
12.5 g/dL or 38%
What is the min Hgb/Hct for men to donate?
13.0 g/dL or >/= 39%
What is the min Hgb/Hct for autologous
11 g/dL or 33%
What is max temp to donate?
99.5 F or 37.5 C
What does the FDA require the BP to be?
Systolic – Between 90 - 180 mm mercury
Diastolic – Between 50 - 100 mm mercury
What is the pulse required by the FDA?
50-100 bpm
If less than 50 bpm and donor is an athlete a Dr can determine in Donor is healthy to donate
What is the deferral for infrequent plasmapheresis>
4 weeks
What is the deferral for after plasma-, platelet-, or leukapheresis?
At least 2 days
No more than 2x per week or 24 times in one year
Double or triple PLT = 7 days
What is the expiration of RBC’s collected in ACD and CPD anticoagulant?
21 days
What is the expiration of CPDA-1?
35 days
What is the expiration of AS-1, AS-2, and AS-3 units?
42 days
What are the FDA approved skin scrubs?
Chlorhexidine and iodophor (iodine) compounds.
The site is scrubbed at least 4 cm (1.5 inches) in all directions for a minimum of 30 seconds
Per OSHA when are gloves required?
Gloves are not required when drawing allogeneic donors. They must be worn when drawing autologous or when in phlebotomy training
In a whole blood if platelets are to be used what temp is unit stored and how long?
Not chilled but in a way to reach 20-24C
Platelets must be separated with in 8 hours
What temp is whole blood stored at if not making platelets?
1-6 C unless off site then 1-10C in a cooler
Define a temporary deferral
Donor is unable to donate for a limited amount of time
Define indefinite deferral
Donor is unable to donate for and undetermined amount of time due to current regualtions
Define permeant deferral
Donor is never able to donate
ex) HBsAg reactive
What is the minimun PLT ct to donate apheresis platelets?
150
How much plasma can be removed in an aphersis plt donation?
500 ml
Unless donor weighs 175 = 600 ml
What is post operative blood collection?
collected from a drainage tube placed at the surgical site. It is reinfused, with or without processing, via a microaggregate filter to screen out any debris. This blood is characterized as being dilute, partially hemolyzed, and defibrinated. It is
recommended that no more than 1,400 mL be reinfused. Must be infused within 6 hours.
What is Intraoperative autologous collection?
collecting shed blood from the surgical site; processing the blood through an instrument that washes it with saline to remove tissue debris, free hemoglobin, and plasma that may contain activated coagulation factors; concentrating the residual red cells (to a hematocrit of 50% to 60%); and then reinfusing those cells immediately
What if the intraoperative collect blood is not used?
if some of the blood is to be stored postoperatively, it must be labeled with the patient’s full name, medical record number, date and time of collection, and with “For Autologous Use Only.” The blood may be stored at room temperature for up to 4 hours or at 1°C to 6°C for up to 24 hours, as long as the latter temperature has begun within 4 hours from the end of collection
What is Acute normovolemic hemodilution (ANH)?
collection of whole blood with the concurrent infusion of crystalloid or colloid
solutions, thus maintaining a normal blood volume but decreasing the patient’s hematocrit. Patient should have 12 g/dl Hgb at beginning
How long is the ANH blood stored for?
8 hours at room temp or 24 hours at 1-6 from start of collection
How often can serial plasma donors donate?
Serial donors may donate more frequently than 4 weeks but no more than every 48 hours and no more than two donations in a 7-day period
What are the requirements for a serial plasma donor?
The red cell loss must not exceed 25 mL/week or 200 mL in an 8-week period. As with any pheresis procedure, if the donor’s red cells cannot be returned, the donor must be deferred for 8 weeks before returning to a plasma pheresis program. At the start of a serial pheresis program and at 4-month intervals, the donor must be tested for total serum/plasma protein levels and quantitative immunoglobulin levels, and protein electrophoresis must be performed
What is the deferral for receiving growth hormone from human pituitary gland or insulin from Bovine manufactured in the UK?
Permanent due to risk of vCJD
What volume of RBC’s can be lost in a cytapheresis procedure and not be deferred for 8 weeks?
Less than 200 mL of RBC’s equal 2 day deferral
What is the deferral after donating Whole blood can cytapheresis be performed?
If ECV RBC volume of machine is less than 100 mL then 2 days otherwise 8 weeks.
What is deferral for taking direct thrombin inhibitors or Xa inhibitors?
7 days for plasma donation
What is the deferral for travel too or living in a country with Ebola?
8 weeks
What is deferral for travel to Iraq?
1 year to prevent leshmaniaisis
