 The following information should be Known

for each donor:

 Name of donor
 Donor’s address and phone number
 Additional identification e.g. license number
 Gender ( if female ask about pregnancy)
 Date of birth and age
 Date of last donation
 Donor occupation (pilots, fire fighter ,heavy
machinery operator)
 Time of last meal: fasting not more than 4h
 Age: 17-70 years (not 60 or above at first donation)

 General appearance: Good

 Weight : above 50 kg .

 Temperature: Not >37.5o C

 Pulse: 50-100; if more than 100 deferral .

Blood pressure: Systolic ≤180, Diastolic ≤ 100

 Hb: > 13 g/dL for men, 12 g/dL for women(both ≥12.5 now)
Exclusion of
 women because of high iron requirements
 Any donor returning to such as driving
bus, plane or train, heavy machine operator, etc. because
*delayed faint would be hazardous.

1. cardiovascular disease, including hypertension
2. Significant respiratory disorders
3. Epilepsy and other CNS disorders
4. Gastrointestinal disorders with impaired absorption
5. Insulin-dependent diabetes
6. Chronic renal disease
 The blood bags for
collection of blood should
be:
 Sterile
 Pyrogen free
 Disposable
 With a closed system of
collection.
 Multiple interconnected
plastic bags should be used for
blood component preparation
(closed system).
Volume of blood taken
 Whole blood: every (8weeks) three donations per year
maximum.
 2 units of RBC by apheresis: every 16 weeks (4 months)
 plasma pheresis: every 4 weeks.
 Platelets : Plateletpheresis donors must have at least 48
hours between donations. Plateletpheresis donors may
donate a maximum of two times in a seven-day period; not
to exceed 24 times in a year.
 (which may be repetitive): this is the most
common adverse effect .Common in young people and
in those donating for the first time.
occurring after a donor has left the
clinic

Treatment

_ Stop the donation; remove the tourniquet and needle

…from the donor's arm.
_Have the donor breathe into a paper bag,
_ Loosen any tight clothing
Treatment of fainting

_ Rest in a horizontal position and elevation of the

legs is usually sufficient.
.........

_ Delayed faints are potentially hazardous. For this

… reason, those donors who are drivers, machine
… operators, pilots and so on should not return to on
…

the day of donation.

2. Nervousness, anxiety.
3. Convulsions .
4. Cardiac and/or Respiratory Problems.
5. Complaints of feeling warm or sweating.
6. Pallor, Nausea and possibly vomiting.

3,4 call emergency help, maintain airway.

5,6 Elevate feet , lower head. Apply cold compresses to
forehead and back of neck
................
 occurs when venous
access has been difficult
Treatment
1. Remove the tourniquet and the needle.

2. Apply pressure to the venipuncture site

and raise the arm for 5 to 10 minutes.
3. Make sure the bleeding has completely
stopped, then apply a bandage.
4. If the arm is stiff or sore, a cold (ice)
pack can be used over the dressing.
Treatment
 Elevation of the limb and firm pressure over the site for
10-15 min combined with prolonged rest if a whole
donation has been taken, as.

: resulting in pain and

numbness
Treatment
 Symptoms generally resolve in a few days, but very rarely
may take several months of recovery.
 It should be avoided by

 meticulous attention to skin cleansing and aseptic techniques.

 All blood collection packs are manufactured as integral sets,

 each needle is sterile, to be used only once.

 No pack should be reused (even on the same donor) if the

initial venepuncture attempt fails.

Treatment

 Local antibiotics and may be systemic if fever develops

 Donor selection

 Microbiological-serological- testing of donations

 Immunohaematological testing of donations

 Stringent arm cleansing

 Hepatitis B \
Hepatitis C \
HIV1 & 2 Both causes AIDS, HIV-2, mainly occurs in West Africa
HTLV1 HTLV-1causes adult T cell leukemia and tropical spastic
Viruses paraparesis
HTLV2 Not clear
CMV Immuno-suppressed individuals can get fatal pneumonitis or
disseminated CMV infection
EBV Latent infection in WBCs
Bacterial Syphilis organism died at 4 °C but in platelets transfusion it survive

Malaria remain viable at 4 °C

Parasites
Chagas’ disease cause problems for the blood transfusion in Latin America
Prions vCJD the human form of bovine spongiform encephalopathy
 (defer indefinitely)
1. History of viral hepatitis after the age of 11 Years
2. A confirmed positive test result for Hepatitis B
surface antigen (HBsAg) (Currently has or previously
exposed)
3. More than one reactive test result for hepatitis B core
antibody (anti-HBc)
4. Has present or past evidence (either clinical or
laboratory) of hepatitis C infection
5. Presents with an elevated alanine aminotransferase
(ALT) level.
defer 12 months for:
1. Close contact with hepatitis patient (close contact is
defined as sexual contact or sharing same household,
kitchen, and/or toilet facilities).
2. Someone who is a current inmate of a correctional
institution (including jails, prisons or detention centers) .
3. Following blood transfusion, blood injections, tattoo,
non-sterile needle stick/body piercing or blood contact
with open wound, non-intact skin or mucous membrane
4. Following human bite that resulted in a wound which
broke the skin
5. Intranasal use of cocaine or any street drug
 Donors had a positive test for AIDS (HIV) or AIDS antibody
or antigen, should be permanently deferred

 Those at risk of HIV through lifestyle (sexual practices,

piercing, tattooing, abuse of self-injected drugs) should not
donate blood

 defer 12 months if health care worker exposed to blood of

patients with HIV infection by a needle stick or open wound
defer indefinitely if

 At increased risk, a history of, diagnosed, or if

any relatives have been diagnosed

 During 1980 - 1996 spent 6 months or more in

the United Kingdom
 Defer 3 years after last symptom
 Defer 3 years to visitors (stayed 1 year), immigrants or
from endemic area of malaria (unless antibody test available)
 Defer 12 months for travel into areas with a risk of malaria
 Chagas’ disease: deferral of those with travel history places them at risk
of Chagas' disease (unless antibody test available)
 Syphilis/Gonorrhea: Defer if treated in last 12 months or positive test
for syphilis in past 12 months
 Influenza: Defer temporarily for active cold or flu symptoms on day of
donation
 Infectious mononucleosis: Accept after recovery
 defer 3 weeks for exposure to the following (unless immunized or had
the disease): Red Measles, German Measles , Chicken Pox, Mumps or
meningitis
 Defer permanently for donor who has had filariasis, bilharzias,Q fever
or SARS.
 usually deferred as the general condition is usually
bad and we should defer any case with
 leukemia or lymphoma
 Receiving chemotherapy or irradiation

 Accept :
 if 5 years from date of surgery, last radiation treatment
or chemotherapy without recurrence.
 Defer indefinitely for Pituitary-Derived Human Growth
Hormone
 Defer 8 weeks for injections of radioactive material
 Donor administrate regular drugs based on the
underlying illness, e.g. cardiovascular, diabetes,
malignancy, anemia or bleeding problems.
 Defer for 2 days from last dose of antibiotics , antifungal
or antiviral, donors must have completed his treatment
and free from illness.
 Aspirin :Acceptable for whole blood donations. Platelet
donors must wait three days after last dose.
 Defer 12 months for allogeneic transplants, blood transfusion
or blood products
 Permanent defer if received dura mater transplant
 Accept autologous transplants.

 Permanent defer e.g. autoimmune diseases,…

 Phlebotomy site must be free of rash/skin disease

 Accept diabetics on Oral medication

 Insulin dependent diabetics are eligible for whole blood
donation only as long as blood sugar is well controlled.
 Defer while pregnant
 Defer 6 weeks after term delivery or caesarean
section
 Defer 12 months if delivery required a blood
transfusion

 If received a blood transfusion : Eligible 12 months

after transfusion
 If no blood transfusion : Generally accepted after
released from physician’s care, healed wound, fell
well, and resumed full activity
 Minor red cell abnormalities, such as Thalassaemia trait
and hereditary spherocytosis, are acceptable, providing that
there is no anemia.
 Red cells containing HbS have a limited survival under
reduced oxygen tension and so should not be transfused to
newborn , patients with hypoxia or sickle cell disease
Blood from donors with G6PD deficiency survives normally,
unless the recipient is given oxidant drugs.
 HIV : (combined HIV Ag & anti-HIV1 and anti-HIV2)by ELISA.
Positive results should be confirmed due to probability of false
positive results
 HBV : HBs Ag by sensitive ELISA (may be also HBc
antibodies)
 HCV: Anti-HCV by ELISA
 HTLV: Anti-HTLV by ELISA
 CMV : Anti-CMV for immunosuppressed recipients only.
 Malaria: Antibody screening of potentially exposed donors
 Chagas' disease: Antibody screening of potentially exposed
donors
 Syphilis: antibody test to syphilis
 is determined routinely on each
occasion.

 Typing for other Rh antigens (C, E, c and e) and K is now

routinely performed.

 Ideally, girls and women of childbearing age should be

matched for c and K, as anti-c and anti-K are after anti-D the
major causes of severe HDN.

 All donations are also screened for the presence of atypical

red cell by testing against group O red cells.
Advantages
 Autologous blood is the safest transfusion possible.
 There is no risk of disease transmission.
 There is no alloimmunization to RBCs, platelets, WBCs, or
plasma proteins; or transfusion reactions.
 The phlebotomy process stimulates the bone marrow to
increase cell production.
1- Predeposit donation :
 Blood is drawn sometime before the anticipated transfusion
and stored, usually liquid but occasionally frozen, in the
blood bank.
 It is usually performed in elective operations.

1. Age: no age limits exits

2. Weight: no strict weight exits. if <50kg, volume will be
taken according to the formula of weight.
3. Hb not < 11g/dl and Hct not< 34%
4. Medical history: The donor will be the recipient so no
cause for deferral
2- Intra-operative autologous transfusion :
 Blood is collected during a surgical procedure and usually re-
infused immediately
3- Preoperative hemodilution.
 Once the patient is in the operating room, 1 to 3 units of WB
are collected and the volume is replaced with colloid or
crystalloid, or both.
 The patient's hemoglobin level is reduced by about 1 to 3 g/dl.
 The blood remains in the operating room and is used for
transfusion during the surgical procedure.
Table 1. Autologous Blood Donation

Disadvantages:
Advantages:

1. Prevents transfusion-transmitted 1. Does not affect risk of bacterial

disease. Contamination.
2. Prevents red cell 2. Is more costly than allogenic blood.
alloimmunization. 3. Can subject patients to
3. Supplements the blood supply. perioperative anaemia and increased
4. Provides compatible blood for likelihood of transfusion.
patients with alloantibodies.
5. Prevents some adverse
transfusion reaction.
6. Provides reassurance to patients
concerned about blood risks.
 The process of apheresis involves removal of
whole blood from a patient or donor. Within an
instrument that is designed as a centrifuge, the
components of whole blood are separated.
One of the separated portions is then
withdrawn and the remaining components are
re-transfused into the patient or donor.
Principle of apheresis: Conical centrifugal separation chamber

Anticoagulants is continuously pumped through the process to

Ensures extracorporeal blood remains in fluid state, we may use
1- Anticoagulation-citrate-dextrose solution (ACD-A)
2- Heparin
3- Combination of ACD-A and Heparin
1. Plasmapheresis: removal of the liquid portion of
blood to remove harmful substances( auto
antibodies , Ag/Ab complex, excess or abnormal
proteins or lipids, drugs and toxins bounded to
albumin).
 Examples of these diseases include:
 Hyperviscosity Syndromes
 Paraproteinemia
 Cryoglobulinemia
 The plasma is replaced with a replacement solution:
 The best choice is 5% Albumin dilute with saline
2. Plateletpheresis: removal of platelets in
people with symptoms from extreme elevations
in platelet count such as Essential
Thrombocythemia

3. Leukapheresis: removal of malignant white

blood cells in people with leukemia and very
high white blood cell counts causing symptoms.
To provide specific blood components for therapy.
Examples include:
1. Plateletpheresis: Plateletpheresis (thrombapheresis,
thrombocytapheresis) – blood platelets. Plateletpheresis is
the collection of platelets by apheresis while returning the
RBCs, WBCs, and component plasma.
2. Plasmapheresis: the plasma can be removed to supply
blood components such as clotting factors. Donors can give
plasma once/month or more.
3. 3. Leukopheresis: the granulocytes can be harvested from a
donor to help fight infection in neonates.
1. Hypocalcemia due to citrate toxicity.

2. Hypotension

3. Bleeding or thrombocytopenia, or both.

4. Fluid retention problems.

5. More removal of fluids from the donor .

 The donor selection requirements for apheresis donor are
generally the same as those for a whole blood (WB) donor.
 Past history of complication due to previous apheresis
donation should be evaluated carefully and may lead to
deferral from apheresis donation
e.g.
1. Possible adverse reactions to heparin.
2. A history of bleeding problems or thrombocytopenia, or
both.
3. history of fluid retention problems.
5. Medications: Use of any medication that might increase
the donor's risk or decrease the effectiveness of the
product. E.g. aspirin (or aspirin-containing substances): The
donor should stop aspirin ingestion for 3 to 5 days before
platelet pheresis or leukopheresis.
 Depending on which pheresis procedure is being
performed, the following additional laboratory tests must be
performed before each donation:

1. Hemoglobin and hematocrit must be normal

2. Serum protein must be normal

3. Platelet count (not less than 50,000/ml)for plateletpheresis

4. White blood cell (WBC) count and differential (for

Leukapheresis)
1. Hemoglobin and hematocrit

2. Platelet count

3. White blood cell count

4. Protein electrophoresis should be done every 4

months if the donor is biweekly plasma donor or
give 12L plasma /year