Donor Screening & Blood Collection

Donor Screening All blood comes from VOLUNTEER donors. Screening performed to ensure donor is healthy. Starts with the donor and first impressions are critical Clean, well lit donation facility from waiting room to collection area Pleasant, professional staff who can ask the appropriate questions, observe and interpret the responses, and ensure that the collection process is as pleasant as possible

Blood Bank versus Blood Center Confusion exists and terms are sometimes used inappropriately Blood bank in a hospital is also known as the transfusion service, performs compatibility testing and prepares components for transfusion Blood Center is the donation center, screens donors, draws donors, performs testing on the donor blood, and delivers appropriate components to the hospital blood bank

Standards, Regulations, Governing Bodies Strict guidelines exist and inspections are performed in both blood centers and blood banks to ensure the safety of the donors and patients Some or all of the following agencies may be involved: MOH – Ministry of Health – General Directorate for Medical Laboratories Local Blood bank Bodies (inside KSA) Saudi Commission For Health Specialists AABB - American Association of Blood Banks CAP – College of the American Pathologists

Donor Screening Two goals or purposes for screening Protect the health of the potential donor Protect the health of the potential recipient Four outcomes Acceptance Temporary deferral Indefinite deferral Permanent deferral Three components of screening Registration Health history interview Limited physical examination.

Donor Registration Donor signs in Written materials are given to the donor which explains high risk activities which may make the donor ineligible Donor must be informed and give consent that blood will be used for others unless they are in a special donor category First time donors must provide proof of identification such as ID card, citizen number, address and any other unique information. Repeat donors may be required to show photo ID.

Donor Registration Additional useful information Name Race Unique donor characteristics Donor must be provided with HIV high risk activities Warnings about donor reactions Tests that will be performed and notification Post phlebotomy care instructions

Medical History Frequency of donation Whole blood or red blood cells 8 weeks (sometimes 12 wks) Two unit red cell unit 16 weeks Plateletpheresis – up to 24 times/year Plasmapheresis– once every 4 weeks, can be done twice a week

Medical History A thorough history is obtained each time Standardized universal questionnaire is used Questions are asked that are very intimate in nature but are critical in assessing HIV or HBV risks Has donor ever been deferred, if “yes”, why. Medications the donor is taking are present in plasma, may cause deferral Infections the donor has may be passed to recipient, may be cause for deferral

Blood Donation Identification Questionnaire – used by MOH – King Khalid Blood bank.  Body recovers the Blood very quickly:  Blood plasma volume– within hours  Red Blood Cells – in about 3 weeks  Platelets & White Blood Cells – within minutes

Permanent Deferrals Immoral activities. Used IV drugs even ONCE in lifetime. Taking clotting factors. Hepatitis after age 11. Cancer deferrals vary, some accept after period of being disease free others do not accept. Protozoan diseases such as Chagas disease or Babesiosis Received human pituitary growth hormone. Positive test for: HBsAg, Hepatitis C, HTLV I/II or HIV. Was the only common donor in 2 cases of post-transfusion HIV or HBV in recipient Medications like : Tegison

12 Month Deferral Recipient of blood, components or blood products such as coagulation factors Sexually transmitted disease-if acquired indicates safe sex not practiced and donor at risk for HIV and HBV Accupuncture, tattoo, ear piercing Needle stick Rabies vaccine Any intimate sexual relations with HIV or HBV positive, hemophiliacs, drug users or individuals receiving drugs.

Temporary Deferrals Certain immunizations 2 weeks -MMR, yellow fever, oral polio, typhoid 4 weeks -Rubella, Chicken Pox 2 months – small pox Pregnancy Certain medications Proscar/Propecia, Accutane – 1 month Avodart – 6 months Soriatane – 3 years Feldene – no platelet donation for 2 days. Plavix and Ticlid – no platelet donation for 14 days Malaria 3 years West Nile virus 28 days

Female donors cannot donate blood…… During pregnancy After delivery for one year When lactating During menstrual period and for 7 days there after Male donors cannot donate blood…… If consumed Alcohol in the previous 24 hours

Physical Examination Evaluate general appearance Weight – : > 45 kgs (18 – 60 years) Temperature 37.5 C OR 99.5F Blood pressure Systolic </= to 180 mm Hg Diastolic </= 100 mm Hg Hemoglobin and Hematocrit Allogenic 12.5 g/dL or 38% Autologous 11.0 g/dL or 33%

Donor Categories “Allogeneic”, “homologous” and “random donor” terms used for blood donated by individuals for anyone’s use Autologous – donate blood for your own use only Recipient Specific Directed donation – donor called in because blood/blood product is needed for a specific patient Therapeutic bleeding – blood removed for medical purposes such as in polycythemia vera. NOT used for transfusion.

Donor Categories Apheresis – removal of 1 component, return the rest Leukapheresis Plateletpheresis Plasmapheresis Stem cells Bone marrow Apheresis

PHELEBOTOMY Preparation for the venipuncture oRe-identification of the donor to avoid errors oSelection of the arm and vein oSkin preparation, scrubbing of the area oLocal anesthesia (not always) Venipuncture Mixing of the blood during the procedure Samples for the screening tests End of procedure

Blood collection Monitor Electronic Donor Couch

Post Donation Advice Drink lots of fluids for next 24 hours Avoid smoking for one hour & alcohol till after a meal Don’t use elevator to go up immediately after donation as it will make blood rush to your feet & make you dizzy! Avoid highly strenuous exercises & games for a day If you feel dizzy, lie down & put your feet up. You will be alright in mins. Remove band-aid after 4 hours. If it bleeds, apply pressure & reapply band-aid. If bruised and painful, apply cold-pack 4 to 5 times for 5 mins each. The bruise is due to blood seeping into the surrounding tissue. It will take a few days to get reabsorbed.