Donor Screening

8/9/2019 Donor Screening

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Encompasses the medical history

requirement for the donor, physical

examination and serologic testing of thedonor blood

May preclude a potential donor from the

donation process


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Three types of donors

Voluntary / non-remunerated blood donor Family / replacement donor

Professional / commercial blood donor


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Donates blood of their own will

Advantages:

Lower incidence and prevalence of transfusiontransmissible infection

Absence of risk anemia on part of donor

Donors have expressed a commitment to donate

blood during emergency situations


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Required to donate blood when a member of

the patients family requires it


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Only donates blood when compensation isgiven in exchange of the donation

Disadvantages:

Increase prevalence of transfusion transmissible

infection Donors may be undernourished


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Minimum of 110 pounds (lbs) / 50 kg

If the donors weight is below 110 pounds,

Amount of blood collected and anticoagulantused must be proportionately reduced.


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Amount of blood to be drawn:

Allowable amount in mL

Donors weight (lbs) X 450 mL

110 lbs

Amount of anticoagulant

needed in mL:Allowable amount X 14

100

Amount of anticoagulant to be

removed:

63 mL anticoagulant needed

92 lbs X 450 mL

110 lbs

376.36 mL X 14 mL

100

63 mL 52.69

= 376.36 mL

= 10.31 mL

= 52.69 mL


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Hematocrit

Greater than or

equal to 38%

Skin Lesions Medical history


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Severe

Moderate

Mild


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DonorReactions

Mild

Donor exhibits sign ofshock but does not

show loss ofconsciousness

Nausea or vomiting,hyperventilation,twitching and musclespasm, sweating,dizziness

Syncope or faintingmay be idiopathic

Moderate

Donor exhibits signsand symptoms similarto mild reaction andloss of consciousness

atients mayhyperventilate andexhibit fall in systolicpressure to mm g

Severe

Donor exhibits signsand symptoms of

shock and loss ofconsciousness

Convulsions can becaused by cerebralischemia, markedhyperventilation


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To provide viable and functional blood

components for patients requiring blood

transfusion

Viability

Measure of in-vivo RBC survival following

transfusion wherein 75% of cells transfused

should remain viable for 24 hours

Blood is stored in liquid state between 1C to

6C


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Approved AnticoagulantPreservative Solutions

Abbreviation Days

Acid Citrate Dextrose ACD 21

Citrate PhosphateDextrose

CPD 21

Citrate Phosphate

Dextrose Adenine

CPDA-1 35

Citrate Phosphate

Double Dextrose

CP2D 21


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Added to RBCs after removal of the plasma

with/without platelets

Removal of plasma component duringpreparation ofRBC concentrates removed

much of the nutrients needed

To maintain RBC during storage


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Additive Solutions

Abbreviation Days

Adsol AS-1 42

Nutricel AS-3 42

Optisol AS-5 42

Composition of Additive Solutions(mg/100mL)

AS-1

(Adsol)

AS-3

(Nutricel)

AS-5

(Optisol)

Dextrose 2200 1100 900

Adenine 27 30 30

Monobasic

sodium

phosphate

0 276 0

Mannitol 750 0 525

Sodium

chloride

900 410 877

Sodium citrate 0 58 0

Primary bag

anticoagulant

preservative

CPD CP2D CPD


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Biochemical Characteristics

AS-1

(Adsol)

AS-3

(Nutricel)

AS-5

(Optisol)

Storage period

(days)

42 42 42

pH at 37C 6.6 6.5 6.5

24-hour survival 83 85.1 80

ATP (% initial) 68 67 68.5

2,3 DPG (%

initial)

6 6 5

Hemolysis (%) 0.5 0.7 0.6


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Used for autologous units and storage of

rare blood types

Involves addition of cryoprotective agent tothe RBCs that are less than 6 days old

Glycerol

Most commonly used and is added to RBCs

slowly with vigorous shaking


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Advantage High Glycerol Low Glycerol

1. Initial freezing

temperature

- 80C - 196C

2. Need to control freezing

rate

No Yes

3. Type of freezer Mechanical Liquid nitrogen

4. Maximum storage

temperature

- 65C - 120C

5. Shipping requirements Dry ice Liquid nitrogen

6. Effect of changes instorage temperature

Can be thawed andrefrozen

Critical


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RBC Freezing

Advantages Disadvantages

Long term storage (10 years) Time consuming process

Maintenance ofRBC viability

and function

Higher cost of equipment and

materials

Low residual leukocytes and

platelets

Storage requirements (-65C)

Removal of significant

amounts of plasma proteins

Higher costs of product


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Used to salvage O-type and rare RBC units

that are at outdate

Initial rejuvenation solution containedphosphate, inosine, glucose, pyruvate and

adenine (PIGPA)

Accomplished by incubating RBC unit at

37C for 1 hour with 50mL of the

rejuvenating solution


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Donor Screening

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