Donor Screening & Blood Collection

1. Donor Screening & Blood Collection

2. 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

3. 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

4. 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

5. 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.

6. 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.

7. 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

8. 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

9. 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

10. Blood Donation Identification Questionnaire – used by MOH – King Khalid Blood bank. • Body recovers the Blood very quickly: • Blood plasma volume– within 24 - 48 hours • Red Blood Cells – in about 3 weeks • Platelets & White Blood Cells – within minutes

11. 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. 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.

13. 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

14. 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

15. 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%

16. 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.

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

18. PHELEBOTOMY • Preparation for the venipuncture • Re-identification of the donor to avoid errors • Selection of the arm and vein • Skin preparation, scrubbing of the area • Local anesthesia (not always) • Venipuncture • Mixing of the blood during the procedure • Samples for the screening tests • End of procedure

19. Electronic Donor Couch Blood collection Monitor

20. 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 10-20 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.