LECTURE 5 BLOOD BANK Blood Donors, Blood Collection & Storage Dr. Dalia Galal Hamouda

DEFINITIONS Autologous derived from organisms of the self; same individual; "autologous blood donation" Heterologous derived from organisms of a different but related species; "a heterologous blood donation”

DEFINITIONS Apheresis Greek work meaning “take out” The process of removal of whole blood from a donor or patient, separating out specific portions, and returning the other portions to the donor/patient – Can be done for » Harvesting specific components for transfusion (plasma, platelet, red cells) » Removal of specific pathologic substances Cytapheresis To harvest specific cellular components such as platelets, granulocytes or red cells. Plasmapheresis To harvest plasma only and return back the cellular components to the donor/patient

I- TYPE OF BLOOD DONATION Blood are collected in the blood bank and there are three blood types: 1.WHOLE BLOOD DONATION 2.APHERESIS DONATION 3.AUTOLOGOUS BLOOD DONATION

II- DONOR SECLECTION Two crucial factors for safe blood products Accurate donor screening or selection Accurate laboratory testing on each unit collected PRINCIPLES OF DONOR SELECTION Giving blood does not harm the donor (must be in a good health) Donated blood loss is restored rapidly and completely The blood must not harm the recipient

III- DONOR SCREENING (1,2,3) 1. Registration of the donor Demographic date: Full name, address, Gender, Age (18-55 years) Date of last donation if any » Whole blood should be 3 months » Apheresis 2 weeks » Autologous depends on the requirement Weight » Should be >45 Kgs

2. Medical history Medical history should be taken by trained health care professional Who CANNOT donate? Life long1 year6 Months х Abnormal bleeding disorder х Heart, Kidney, Liver Disorder х Thyroid disorder х Mental disorders х Tuberculosis х Asthma х Cancer х Insulin dependent diabetics х Uncontrolled High blood pressure (BP) o Surgery o Typhoid o Dog bite o Unexplained weight loss o Continuous low grade fever o Tattooing or body piercing o Dental extraction o Root canal treatment o Malaria o Vaccination

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

3. Physical examination Determination of hemoglobin Males Hb: >12.5 g/dl Males Hb: >12.5 g/dl Females Hb: >12.0 g/dl Females Hb: >12.0 g/dl ( beats/min) Pulse ( beats/min) (Maximum 140/90 mm Hg) Blood pressure (Maximum 140/90 mm Hg) (Maximum C) Temperature (Maximum C) Donor weight 1. Minimum 45 Kgs 2. Amount of blood to be drawn: (Donor wt. in Kg÷50) X 450 (Donor wt. in Kg÷50) X 450

IV- Venipuncture » Selection of the arm and vein » Skin preparation, scrubbing of the area » Local anesthesia » Venipuncture » Samples for the screening tests » End of procedure

V- POST DONATION INSTRUCTIONS After donation, please rest in the donation chair for 10 minutes before getting up Eat and drink something before leaving and during the next 4 hours If there is bleeding from the site where the needle was placed raise your arm and apply pressure If you feel dizzy or faint, lie down or sit down, placing your head lower than your knees If either bleeding or faintness persists, return to blood bank

VI- Screening tests for the blood donated Testing at Blood Bank for Transfusion Transmissible Infections (TTIs) Blood collected is screened using highest quality screening tests for 5 TTIs HIV Hepatitis B Hepatitis C VDRL (syphilis) Malaria

VII- Blood Products / Components & their uses Blood collected is screened for TTIs (infections) & SAFE blood, is separated into components & stored for issue to patients. Used of Whole blood – For Exchange Transfusion in Babies – Accident Victims – Complicated Delivery cases – Some specific surgeries Uses of Blood Components – Red Cells (for anemia) – Fresh Frozen Plasma (for clotting disorders, burns) – Platelets/Platelet rich plasma (for cancer) – Cryoprecipitate (for clotting disorders) – Cryosupernatant (for burns)

VIII- Screening test for donors blood prior to transfusion Infection screening VDRL (syphilis) HbsAg Anti HIV Anti HCV Malarial parasite Grouping and reverse grouping Cross matching

IX- Storage of blood Series of changes occur in vitro that alters the physiological properties to ensure that blood retains its in vivo environment These physiological changes involve: Anticoagulants Preservative Characteristics of plastic bag Storage temperature Shipping and transport conditions

Anticoagulation and preservatives for blood products To ensure the viability and stability of the products To inhibit growth of microorganisms To prevent clotting of the product Examples for anticoagulants and preservation: Citrate, Citrate-dextrose and Acid-citrate-dextrose

Storage changes in blood In vivo, red cells are carried and protected by the plasma, which helps Regulated temperature Controlled pH Adequate glucose supply Removal of metabolic waste – In protected environment life span is days – Lowering of temperature and preservatives help in reducing the changes but changes do occur and known as “storage lesion”

Appropriate storage temperatures WBC and packed RBC 1 to 6 0 C Plasma ≤ C Platelets 20 to 24 0 C

Benefits to Donor of blood donation Health benefits: Regular donation (2-3 times a year….) – Lowers cholesterol – Lowers lipid levels – Decreases incidence of heart attacks, strokes Donor is also eligible to receive one FREE unit of blood if needed for – Self – Spouse/ Child/ Parents, and – Even friends