Whole Blood & Apheresis Collection of BC intendent for Transfusion

Question 1

Blood centers are required to obtain donors’ written acknowledgement of the following elements:

Answer 1

1) donor provided & reviewed info regarding the risks & hazards of specific donation procedure
2) donor has reviewed the educational material regarding relevant transfusion-transmitted infections.
3) A sample of the donor’s blood is tested for specified transfusion-transmitted pathogens
4) if the donation is determined to be unsuitable or is deferred from donation, the donor’s record will identify the donor as ineligible to donate and will be notified of the basis of the deferral and period of deferral
5) the donor has the opportunity to ask questions and withdraw from the donation procedure

Question 2

Informed consent for plateletpheresis

Answer 2

must be performed before first donation and annually thereafter

Question 3

Informed consent for plasmapheresis

Answer 3

must be performed before first donation and annually thereafter unless more than 6 months elapse between plasmapheresis collections

Question 4

Adverse donor reactions - broad categories

Answer 4

1) Needle-related injuries (bruise/hematoma, local nerve injury, arterial puncture)
2) Systemic Reactions (vasovagal reactions, citrate reactions)

Question 5

Local nerve injuries

Answer 5

relatively uncommon
inevitable due to anatomic variation of close assoc. nerves & veins
c/o sensory changes away from phlebotomy site (forearm, wrist, hand, upper arm, or shoulder)
usually transient, followed by full recovery (7% may take 3-9 months) severe cases –> neurologist

Question 6

Vasovagal reactions

Answer 6

Dizziness, sweating, nausea, vomiting, weakness, apprehension, pallor, hypotension & bradycardia –> may progress to syncope, convulsions, loss of bladder/bowel function
*** distinguished from orthostatic BP changes by LOW PULSE RATE
severe reactions or prolonged recovery times may need short-term observation or IVF admin in ER

Question 7

Risk factors for vasovagal reactions

Answer 7

young age, low estimated blood volume (<3.5 L), fear and first-time donation status

Question 8

Therapeutic phlebotomy

Answer 8

d/o: hemochromatosis, polycythemia vera & other conditions associated with erythrocytosis such as testosterone supplementation
generally units rom therapeutic donors intended for allogeneic transfusion must be labeled with disease or condition requiring therapeutic phlebotomy.
This can be waived (labeling and frequency requirements) with FDA variance - hereditary hemochromatosis or individual with erythrocytosis from testosterone therapy

Question 9

Goal for therapeutic phlebotomy

Answer 9

titrate hematocrit of patient attempting to maintain levels

males: <=52%
females: <=48%

Question 10

WB collection time

Answer 10

Average time for 500 mL is less than 10 min
Draw time longer than 15-20 min may not be suitable for collecting platelets or plasma for transfusions, as determined by blood center policy

Question 11

Expiration dates for WB

Answer 11

ACD, CPD, CP2D = 21 days at 1-6 C

CPDA-1 = 35 days

Question 12

Platelet prep from WB

Answer 12

WB should be not cooled less than 20 C

Must be separated within 8 hours of collection

Question 13

Expiration of components prepared with open system

Answer 13

RBCs (stored at 1-6C): 24 hours
WB, RBCs & plts (stored at rm temp): 4 hours
Thawed cryo & plasma: 4 hours