Week 8

Question 1

Donor Eligibility…the basics

Answer 1

• Minimum age 17…no maximum
• Good health & feeling well on donation day
• No “unacceptable medications” –e.g. associated with toxicity,
  congenital defects, anticoagulants
• Hemoglobin minimums: F 125 g/L, M 130 g/L
• Weight: 50 kg minimum (correlation with blood volume)
• We’ll check your temp (<37.5C) …and on
  your 1st clinic visit, your BP*

Question 2

Donation frequency

Answer 2

• whole blood: F 84 days, M 56 days
• plasma: as short as 7 days
• platelets: 14 days

Question 3

Donor Eligibility: health assessment questionnaire…

Answer 3

asked about ~ 85 different items at each
donation related to donor and recipient safety:
* health (e.g. heart, lung, liver, kidney, blood)
* chronic disease (e.g diabetes, cancer)
* medication, immunizations
* travel
* lifestyle

Everyday stuff
-dentist visit
-piercing
-tattoo
-accupuncture
-vaccine

Not so everyday stuff
-jaundice
-malaria, babesiosis, chagas disease, simian foamy virus

Question 4

sensitive questions

Answer 4

-Received or given drugs or $ for sex in past year
-Positive HIV test?
-Injection drug use in past year?
-Treated for sexually transmitted infections?
New or >1 sexual partner past 3 months
-Won’t ask about non-injection “recreational”
drugs
-Pre- or Post-Exposure HIV prophylaxis
-sex partner questions

Question 5

Infectious disease testing

Answer 5

HIV
Hepatitis B virus
Hepatitis C virus
HTLV
West Nile virus: seasonal Nucleic acid testing – June-Nov: all donors; Dec-May: travel outside Canada
Syphilis
Cytomegalovirus: selective for intrauterine transfusions only
Chagas :selective donor testing – birth or lived for
> 6 mnths in Mexico, Central or S. America
B19 Parvovirus

Question 6

Platelets and Transfusable Plasma are
now pathogen-reduced

Answer 6

• platelets are pathogen-reduced, using
  amotosalen (a UV-light-activated
  synthetic psoralen)
• transfusable plasma is pathogenreduced by solvent-detergent treatment

Question 7

another process
safety measure =
leukoreduction

Answer 7

eliminates >99.9% of WBC’s
…many pathogens, such as
herpes viruses, HIV, HTLV are highly WBC associated

Question 8

Plasma product risks: zero/theoretical risk

Answer 8

how’d we do that?
….by robust pathogen inactivation

Question 9

What are Stem Cells?

Answer 9

immature cells derived from
bone marrow that can develop
into RBCs, WBCs, or platelets

Question 10

Who Needs Stem Cells?

Answer 10

Stem Cell Transplants are used to treat
multiple diseases and disorders:
* Blood cancers… leukemia, lymphoma
or myelomas
* Bone Marrow deficiency caused by
abnormal RBC production, such as
thalassemia or sickle cell disease
* Aplastic anemia (lack of normal blood
cell production)
* Inherited immune system and
metabolic disorders

Question 11

YOU Can Register to Donate Stem cells

Answer 11

• 17-34 yrs old
• good general health (1 minute online questionnaire)
• Contact info
• We’ll send you a swab kit in the
  mail to do a 4 mouth swabs…these are used to HLA (Human
  Leukocyte Antigen) tissue-type
  you…mail it back
• then you relax and enjoy life

…the excitement really begins when You Are a Match!!
…we’ll contact you and confirm you’re still interested and eligible

*Age 17-60 years
Health Screening Questionnaire – similar to regular blood donorHLA verification typing & infectious disease bloodwork
*If you are the selected donor, consent for further testing, physicaexam, collection
*Final eligibility from collection centre physician

Question 12

Donor Collection: Peripheral Blood Apheresis

Answer 12

• 80%
• Daily Granulocyte Colony Stimulating
  Factor injections for 4 days prior to
  donation
• Apheresis nurses prepare and care for
  donor during apheresis collection…only
  stem cells removed, and remainder of
  blood returned to donor
• Stem cell bag prepared and shipped to
  recipient center

Bone Marrow ~ 20%

Question 13

Laboratory test limitations

Answer 13

– Test sensitivity…may not detect:
– Very early infection
– Pathogen variants
* known (e.g. malaria, HIV)
* random (e.g. HBV, HIV)
– Low level infection in chronic disease -?transmissibility

• Low predictive value of positive screening tests –
  i.e. False positive
  – Low pre-test disease prevalence in donor population
  – Non-specific X-reactions
  – Donor re-entry after 6 months for some test results

Question 14

True or False: Vein-to-vein HCV transfusion safety process enhancement …a ‘repeat’ donor is (usually) safer than a ‘1st time’ donor

Answer 14

True

Question 15

True or False: …as blood gets safer, each subsequent increase in safety typically costs more - i.e. decreasing marginal cost-effectiveness

Answer 15

True