1. Blood Donors, Blood Collection & Storage
Dr. Tariq M. Roshan
Department of Hematology
Dated 12/7/2004

2. List of criteria used for the selection of blood donors
List of instruments/materials used for the collection of donors blood
Definition
Plasmapheresis
Cytopheresis
Autologous donation
Heterologous donation
Steps in preparation of a donor prior to venisection and collection of blood
Pre and post donation care
Screening tests done
Common anticoagulants
Advantages and disadvantages
Changes that occur on blood during storage
Ethical issues related to donation
Concept of mobile blood bank and public relation in donor recruitment program

3. Screening test for donors blood prior to transfusion
Infection screening
VDRL
HbsAg
Anti HIV
Anti HCV
Malarial parasite
Grouping and reverse grouping
Cross matching

4. Storage of blood
Series of changes occur in vitro that alters the physiological properties
To ensure that blood retains its in vivo environment involves
Anticoagulants
Preservative
Characteristics of plastic bag
Storage temperature
Shipping and transport conditions

5. 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

6. Red cell anticoagulants and preservation
Citrate
Calcium-chelating agent
Prevents coagulation by interfering with calcium-dependent steps in the coagulation cascade
Citrate-dextrose
The dextrose provide nutrient for red cells
Support the generation of ATP by glycolysis thus enhancing red cell viability and extending shelf life
Acid-citrate-dextrose
Contains citric acid, sodium citrate, and dextrose
Shelf life of 21 days and now no longer use for red cells as other solution are available with extended shelf life of red cells
Acid pH does not help in maintaining 2,3-DPG levels
Used in apheresis procedure

7. Red cell anticoagulants and preservation
Citrate-phosphate-dextrose (CPD)
Alkaline pH helps in maintaining 2,3-DPG
Shelf life is extended to 28 days
CPD is not now commonly used
Citrate-phosphate-dextrose-adenine (CPDA-1)
Addition of adenine is associated with improved synthesis of ATP, allowing longer shelf life (35 days)
Other solutions
Adsol or AS-1
Nutricel or AS-3
Optiso or AS-5

8. Red cell anticoagulants and preservation
Saline-adenine-glucose-mannitol (SAGM)
After taking blood donation in CPD and separating red cells from plasma and platelets SAGM is added to the packed red cells
The resulting red cells have flow characteristics equivalent to plasma reduced blood and a storage life of days
Other advantage is by removing maximum amount of plasma from blood for the manufacture of factor VIII and albumin

9. 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 do help in reducing the changes but changes do occur and known as “storage lesion”

10. Storage changes in bloodpH
Glycolysis is slowed at temperature of 1 to 60C
Glycolysis results in the production of lactate and decrease in pH
Day 0 (CPD) pH = 7.20
Day 21 (CPD) pH = 6.84
ATP
ATP is closely associated with red cell viability
Loss results in rigidity and decrease deformability
ATP is also needed for Na+/K+-ATPase pump
ATP levels on day 35 of storage is 45% in CPDA-1

11. Storage changes in blood
2,3-DPG levels
Decrease in pH of stored blood results in low 2,3-DPG levels
With low levels there will be left shift of oxygen dissociation curve and increase affinity of oxygen
After transfusion the levels return to normal values within 24 hours
Na+ and K+ levels
Na+/K+ leak through the red cells
Cells lose potassium and gain sodium
Plasma Hemoglobin
Hemolysis results in raised plasma Hb

12. General requirements for Storage of Blood Products
Separate areas should be reserved for untested, tested, and quarantined products
Continual monitoring of temperature
Audible alarm signals
Emergency procedure power failure and power back-up

13. Appropriate storage temperatures
WB and packed RBC 1 to 60C
FFP ≤ -180C
Platelets 20 to 240C
Cryoprecipitate ≤ -180C

14. Ethical issues related to blood donation
Is blood donation ethically justified
Muslim prospective
Blood a dead element
Is blood donation from a female allowed to male
Other concerns
Jews prospective
Whether autologous is the only choice?
Other religions

15. Ethical issues of screening
What information should be given to donor?
How to ask personal questions?
Attitude during the interview
Data security

16. Ethical issues of screening
High risk group donors
Screening test results
Information to the spouse
Information to the employer

17. Ethical issues raised after transfusion of tainted blood
Information to the recipients
Treatment of the recipients
Recalling of all blood products

18. Blood mobiles & Public relations in donor recruitment
Mobile blood bank
Major contributor in blood stocks
Counseling of the first time donors
Good communication skills and public relations
Helps in recruiting new donor and for first time donor to become regular blood donors
Functions, parties in appreciation of regular blood donors and for departments helping in collecting maximum number of units

19. Thank you