1. VUMC Blood Bank Board Review
Garrett S. Booth, M.D., M.S.

2. PART 1
Blood Donation-lots of questions on this topic given the numerous regulations that surround blood donors/donations

3. Whole Blood
What is the standard deferral time period for whole blood donation?
How much can be donated?
Does this impact the donor deferral time period?

4. For single unit (500 mL) whole blood donation the deferral period is 8 weeks.
If someone donates by apheresis, for example, a double red blood cell donation, the deferral is 16 weeks
Yes, RBC and plasma products can be collected at the same time

5. Cryoprecipitate
Can you collect just cryoprecipitate from a blood donor?
Collection versus manufacture?

6. No
Cryo is a manufactured product
Must collect FFP and then freeze. Although to thaw in 1-6C refrigerator and isolate the supernatant
Cryo=fibrinogen, Factor XIII, Factor VIII, vWF, fibronectin

7. Platelet Donation
What is the maximum total number of times someone can donate apheresis platelets in a 12 month time period?
Can you give out of group platelet products?

8. 24 times
The time between donations is 48 hours, but cannot donate more than twice a week

9. Platelet
What is the minimum dose of an apheresis platelet?

10. 3.0 x 1011 platelets per product

11. Medication
Which of the following psoriasis medications results in a permanent deferral? Tegison or Soriatane

12. Tegison-Permanent deferral
Soriatane-three year deferal

13. Cohabitation
If you are living with a person with hepatitis C, how long are you deferred for?
What type of virus is hepatitis C?
What other question in the universal donor health questionnaire is designed to identify donors with hepatitis C?

14. 1 year
Flavivirus
IV Drug use

15. Blood Exposure
While working in surgical pathology you cut yourself while dissecting a liver. How long are you deferred for?

16. 1 year
Contact with blood is a one year deferral
So is tattoo, needle stick, sex with HIV person, rape victim, jail>72 hours, paying for sex, being transfused, travel to malaria region

17. A new mother presents for donation to show her community she is an “active contributor” and is “working to make the world for her new baby a better place”.
Despite her well intentions, how long following delivery is the standard deferral period?

18. 6 weeks

19. WNV deferral time period
What is the deferral time period for WNV in a US blood donor?

20. 120 days
This is a weird one, so remember it
WNV is only tested by NAT (MP vs IP depending on seasonality or positivity in your community)

21. Europe
My sister, Lynde, has lived in the UK for most of her life, if she ever decides to come visit me in Nashville, TN can she donate? Why/why not?

22. No, living in UK for more than 5 years is a permanent deferral.
Preventing TA-vCJD

23. MMR
An individual moves to the US from a non-malaria endemic region and begins her vaccination program. She is given the option of getting the MMR shots at once, but opts instead to get her Measles shot only. How long is she deferred for?

24. Measles- 2 week deferral
Mumps- 2 week deferral
Rubella- 4 week deferral

25. Influenza
VUMC recently completed the largest vaccination event for influenza ever. These super eager VUMC employees also wanted to make the world a better place and donate blood. Can you donate whole blood on the same day you get a flu shot?

26. Yes
There is no deferral for influenza vaccine
Also no deferral for HepA/HepB vaccine

27. Unlicensed Vaccine
A poor college student enrolls in a clinical trial at VUMC for the money. The subject is given an unlicensed vaccine as part of the trial. Six months later a blood drive comes to his dormitory, can he donate?

28. No
Unlicensed vaccine is a 12 month deferral

29. Hepatitis B
A donor presents for whole blood donation, but is unsure about his vaccination history. He knows that because he recently started nursing school that he received “a ton of shots”. What is the serologic pattern for an individual that has received the hepatitis B vaccine?
HBV DNA, HBsAg, Anti-HBc, Anti-HBsAg

30. Vaccinated individual should only have anti-HBsAg, unless you tested them immediately following the vaccine itself

31. Allogeneic Donor demographics
What are the minimum weight
Temperature
Pulse
Blood pressure
Hemoglobin

32. Weight >110 pounds
Temperature <37.5C (99.5F)
Pulse (50-100)
BP <180/100
Hemoglobin >12.5 g/dL
HCT >38%

33. Anticoagulant
What is the anticoagulant used in donated blood products?

34. Citrate

35. Storage Duration of Blood Products
Shelf LIfe of Red Blood Cells based on different anticoagulant/preservative solutions
Anticoagulant/Preservative Solution:
ACD/CPD/CP2D:     21 days
CPDA-1:     35 days
AS:     42 days

36. Autologous Blood Donation
What is the minimum hemoglobin for an autologous blood donor?

37. 11 g/dL (HCT 33%)

38. Specimen Retention
The pretransfusion sample (EDTA tube) must be kept in the blood bank following transfusion for what time period?

39. 7 days

40. Hepatitis
What type of hepatitis is a recipient most at risk of obtaining through transfusion in the US?
Hepatitis A
Hepatitis B
Hepatitis C
Hepatitis E

41. Hepatitis B
Risk of hepatitis B transfusion transmission is 1/300,000 to 1/400,000
Hepatitis C risk is ~1/1.5 million
Hepatitis E is not tested for, but has been shown to be transmitted in Europe. Yuck.

42. CMV
Is CMV testing required for all blood donors in the US?

43. NO
Leukocyte reduction and serologic testing of donors are considered equivalent in the US blood supply

44. Residual Leukocytes
What is the requirement to qualify as leukocyte reduced?

45. <5.0 x 106 residual leukocytes

46. Chagas Disease
What is the screening test for Chagas disease in the US?

47. T. cruzi is screened for by EIA

48. Finasteride
A balding elderly male returns to donate whole blood but appears to have a some new-found hair growth. He is excited to donate today because he is contributing another unit and is going to make the wall of fame for 4 gallon donor! When asked about medications he states he is taking something to help his hair grow back so he can look better for the photo opportunity. The pill box he carries his filled with vitamins and supplements, but there are also finasteride pills present. Can he donate? Is there a deferral?

49. Finasteride (Proscar, Propecia) is a 30 day deferral.

50. Other stuff Calculations Correct count increments (CCI)
Antigen frequencies
Number of units needed to be screened
Blood donor frequencies
In general need to know some high frequency antigens, typically designated with the superscript “b” and there antithetical counterpart, the low frequency antigen designated with the superscript “a”
RhIG dose calculations

51. Other Stuff Immunohematology panels Practice, practice, practice
You should have: ed practice panels, panels from and I have other practice books if you want (can make some photo copies).
The ASCP book has some refresher panel information (basics), these should be reviewed.
The Blood Bank Guy website ( also has some panels

52. Other Stuff
AABB Standards (28th ed.) has a few nice summary tables in the middle of the book which you can photo copy (the book itself is very small, but very expensive).
Ms. M. Johnson has a copy of this text and if you are nice she may let you make a copy, but do NOT remove from the blood bank and make sure you have her permission first!!!