BLOOD DONATION

Basic qualifications of the

potential blood donor
 Basic qualifications
1. Appears to be in good health
2. Age: 18 – 65 years old
3. Body weight
4. Temperature
5. Pulse
6. Blood pressure
7. Minimum hematocrit/ hemoglobin
 Age
• 18 – 65 years old
• < 18 years old – Needs parent’s consent
• > 65 years old – Needs physician’s
consent
 Body weight
• 110 lbs or 50 kgs
– 450 mL/blood + 30 mL blood (tubes of
blood bag)
• < 110 lbs
– Decrease volume of blood
– Decrease volume of anticoagulant
 Body weight
• Volume of blood to be drawn

DONOR WEIGHT Volume of

DONOR WEIGHT
IDEAL WEIGHT 450 mL Blood to
Draw
 Body weight
• Volume of anticoagulant needed

Volume of
VOLUME OF BLOOD TO DRAW
14 anticoagulant
100 needed
 Body weight
• Volume of anticoagulant (AC) to be
removed from the blood bag (Normal
amt of AC in a blood bag 63 ml )

63 – Vol of AC needed = Vol of AC to be removed from the blood bag

 Pulse
• 50 – 100 bpm.
• Lower pulse rate is acceptable for
athletes.
 Blood pressure
• Systolic 90 – 160 mmHg
• Systolic should not exceed 180 mmHg
• Diastolic 60 – 100 mmHg
• Diastolic should not exceed 100 mmHg
 Hematocrit and Hemoglobin
• Hct > or = 38%
• Hb > or = 12.5 g/dL
 Hematocrit and Hemoglobin
• Hemoglobin determination:
– CuSO4 method = Mass Blood Donation

• Acceptable drop of blood will sink in the

solution within 15 seconds

• Hb > or = 12.5 g/dL

 Hematocrit and Hemoglobin
• Hemoglobin determination:
– CuSO4 method (30 mL Container) = Mass
Blood Donation (30 test)
– Specific Gravity of CuSO4: 1.053
DEFERRAL (AABB
Standards)
 3 days Deferral
• Aspirin-containing medications if donor
is sole source of platelets
 2 weeks Deferral
• Measles
• Mumps
• Polio
• Yellow fever vaccines
 4 weeks Deferral
• Rubella vaccine
 6 weeks Deferral
• Pregnancy
 12 months Deferral
• Syphilis
• Gonorrhea
• Animal bite
• Hepatitis B Ig
• Tattoo
• Skin penetration with sharp contaminated
with blood
• Household or sexual contact with individual
with hepatitis, HIV
• Travel to area endemic for malaria
 3 years Deferral
• Malaria, or from an area endemic for
malaria.
 Permanent Deferral
• Parenteral drug use
• Family history of Creutzfeldt-Jakob
disease
• Treated with growth hormone
• Viral hepatitis after 11th birthday
• Repeatedly reactive anti-HBc, anti-HCV,
anti-HTLV, or anti-HIV
• Babesiosis
• Chaga’s disease
AUTOLOGOUS DONATION
 AUTOLOGOUS DONATION
• Donor is also the recipient of blood.
 AUTOLOGOUS DONATION
Advantage:
– No risk of disease transmission,
incompatibility, or immunization

Age limit:
– None
 AUTOLOGOUS DONATION
Hemoglobin:
– Not less than 11 g/dL
 AUTOLOGOUS DONATION
Contraindications:
– Bacteremia

Testing:
– ABO and Rh

Pretransfusion testing:
– ABO and Rh or recipient and unit
 TYPES OF AUTOLOGOUS
DONATION

1. Preoperative
2. Intraoperative
3. Immediate preoperative
4. Postoperative
 TYPES OF AUTOLOGOUS
DONATION
• Preoperative:

– Predeposit autologous donation.

– Blood is withdrawn before and anticipated
transfusion.
– Blood is stored until use.
 TYPES OF AUTOLOGOUS
DONATION
• Intraoperative:

– When blood is collected during surgical

procedure.
– Blood is reinfused immediately
 TYPES OF AUTOLOGOUS
DONATION
• Immediate preoperative hemodilution

– Place in operating room when 1 to 3 units

of whole blood are collected.
– Patient’s volume is replaced by colloid or
crystalloid.
– Blood is reinfused during the surgical
procedure.
 TYPES OF AUTOLOGOUS
DONATION
• Postoperative salvage

– Drainage tube is placed in the surgical

site and postoperative bleeding is
salvaged. Cleaned and reinfused.
 DONOR INFO

DONOR INTERVIEW
(MEDICAL HISTORY)

DONOR BLOOD TESTING

ACTUAL DONATION

COMPONENT PREPARATION

(ABO,Rh,ABS,infectious Screening)
• PRIOR TO BLOOD COLLECTION,
the intended venipuncture
site must be cleaned with a scrub
solution containing:
a. hypochlorite
b. isopropyl alcohol
c. 10% acetone
d. PVP iodine complex
Hemapheresis (9/00)
 APHERESIS/ HEMAPHERESIS
• Method of blood collection in which whole
blood is withdrawn, a desired component
separated, and the remainder of the tube
returned to the donor.
 APHERESIS/ HEMAPHERESIS

• Plasmapheresis
• Plateletpheresis/ Thrombocytapheresis
• Erythrocytapheresis
• Leukapheresis
 APHERESIS/ HEMAPHERESIS
• 2 TYPES:

• 1. Intermittent-flow centrifugation (IFC)

– Requires only one venipuncture
– Blood is withdrawn and re-infused through same
needle.
• 2. Continuous-flow centrifugation (CFC)
– Procedures withdraw, process, and return the
whole blood to the individual simultaneously.
– Two venipuncture sites are necessary.
 APHERESIS PROCEDURES

ACD (Acid Citrate Dextrose) – most common anticoagulant

used.
 THERAPEUTIC CYTAPHERESIS

1. Plateletpheresis
• Equivalent to 6-10 random platelet concentrates
• Contents: 3 x 1011 platelets
• Therapeutic Indications: Used to treat patients who
have abnormally elevated platelet counts (Polycythemia
vera)
 THERAPEUTIC CYTAPHERESIS

2. Leukapheresis
• HES (Hydroxyethyl starch) – sedimenting agent used
for granulocyte collection to be harvested more
efficiently.
• Corticosteroids – administered to the donors 12-24
hours before pheresis to increase the number of
circulating granulocytes.

• Therapeutic Indications: Used to treat patients with

leukemia (wbc >100,000/uL) such as Hairy cell leukemia,
AML, Cutaneous T cell lymphoma
3. Lymphocytapheresis
• Therapeutic Indications: means of producing
immunosuppression in conditions like RA, SLE, Kidney
transplant rejection and autoimmune and alloimmune dses.

4. Neocytapheresis - transfusion of young RBCs “neocytes”

• Therapeutic Indications: for young pxs with certain
hematologic disorders especially thalassemia syndromes

5. Erythrocytapheresis
• considered an exchange procedure
• predetermined quantity of red cells is removed from the
px and replaced with homologous blood
6. THERAPEUTIC PLASMAPHERESIS (Plasma
Exchange)

• Replacement Fluids Used: NSS, FFP

• Note:
• FFP has the disadvantage of possible disease
transmission, ABO incompatibility, citrate
toxicity and sensitization to plasma proteins
and cellular Antigens.
• Recommended for replacement fluid primarily
during plasma exchange for TTP and HUS.
Therapeutic Indications:

• To remove the offending agent in the plasma causing

clinical symptoms in cases of:
 Paraproteinemia (e.g. Multiple Myeloma, Waldenstrom
Macroglobulinemia, etc.)Familial
Hypercholesterolemia, etc.

• To collect rare red & white cell Abs

• Beneficial particularly in diseases that involve
malfunction of the immune system (SLE, RA)
BLOOD PRESERVATION:
ANTICOAGULANTS AND RED
CELL DERIVATIVES
 BLOOD PRESERVATION
• Citrate: Anticoagulant
• Dextrose: To provide energy
• Citric acid: (low pH) Prevent
caramelization
• Phosphate buffer: Increase ATP
• Adenine: for improved survival of red
cell
APPROVED PRESERVATIVES
• Acid-citrate-dextrose (ACD): 21 days
• Citrate-phosphate-dextrose (CPD): 21
days
• Citrate phosphate-adenine (CPDA-1): 35
days
• Citrate-phosphate-double dextrose:
(CP2D): 21 days
 ADDITIVE SOLUTIONS
• Additive solution consists of:
1. Saline = to suspend the solute
2. Adenine = for increase survival of RBC
3. Glucose = to provide energy for RBC
4. Mannitol = RBC membrane stabilizing
agent

• SAGM = 42 days
 ADDITIVE SOLUTIONS
NAME STORAGE
(days)
Adsol (AS-1) 42 – 49 days

Nutricel (AS-3) 42 – 49 days

Optisol (AS-5) 42 – 49 days

 REJUVENATION SOLUTIONS
• Used to regenerate ATP and 2,3-DPG
• PIGPA – Phosphate, inosine, glucose,
pyruvate and adenine
• PIPA – Phosphate, inosine, pyruvate and
adenine
– REJUVESOL – only FDA approve
rejuvenation solution in US
BIOCHEMICAL CHANGES
OCCURING DURING RBC
STORAGE
• pH: decrease
• ATP: decrease
• 2,3-DPG: decrease
• Plasma sodium: decrease

• Plasma potassium: increase

• Plasma hemoglobin: increase
 BLOOD COMPONENT PREPARATION

Fresh Whole Blood (450-500 cc)

Platelet Rich Plasma (200-250cc) PRBC (200-250cc)

Platelet Poor Plasma(200 cc) Platelet Concentrate (50-70cc)

FFP (200 cc)

Cryosupernate (180-200 cc) Cryoprecipitate (15-20cc)

Preparation of blood components
• Centrifugation

1. Heavy spin
2. Light spin
Preparation of blood components
• Centrifugation

1. Heavy spin
 5000 g for 5 minutes (packed RBC, platelet
conc)
 5000 g for 7 minutes (cryoprecipitate, cell
free plasma)
Preparation of blood components
• Centrifugation

2. Light spin
 2000 g for 3 minutes (platelet rich plasma)

 For preparation of platelet concentrate,

centrifugation is performed at 20 - 24°C
 For all other blood components,
centrifugation is carried out between 1 -
6°C
PREPARATION OF BLOOD
COMPONENTS
 Preparation of blood components
WHOLE
HEAVY BLOOD LIGHT
SPIN SPIN

PLASMA PRBC PRP PRBC

-18°C HEAVY
SPIN
FFP
PPP Plt.Conc
FFP
Preparation of blood components
• All components are prepares using
refrigerate centrifuge (1 - 6°C) except
when preparing platelet (20 - 24°C)

• Platelets must be separated from whole

blood within 6 to 8 hours.

• Platelets are prone to bacterial

contamination.
 Donation Process
1. Donor registration
2. Physical Examination interview
3. Donor selection and blood collection
 Blood/ Blood components
1. Whole blood
2. Packed RBCs
3. Leukocyte-Reduced RBCs
4. Washed RBCs
5. Frozen RBCs
6. Platelet concentrate
7. Platelet pheresis
 WHOLE BLOOD
Storage Temp: 1-6°C
Indications:
 Active bleeding
 Hemorrhagic shock
 Exchange transfusion
 Indicated when
• both oxygen-carrying capacity and volume
expansion are required.
Immediate Effect of one unit: Increase
hematocrit by 1-3%.
 PACKED RED BLOOD CELLS
Shelf-life: same with WB
Storage Temp: 1-6ºC
Contents:
– Hematocrit should be 80 % or less
Indication:
– Restore oxygen carrying capacity (anemia)
Immediate effect of one unit:
– Increase Hematocrit by 3% and increase
hemoglobin by 1g.
LEUKOPOOR RED BLOOD CELLS
Shelf-life:
 Closed system – same with Packed RBC
 Open System – 24 hours
Storage Temp: 1-6ºC
Contents: 5 x 106 residual WBC
Indications:
– Anemia with history of febrile reactions
– To decrease alloimmunization to:
 WBC or HLA antigens
 To decrease CMV transmission
LEUKOPOOR RED BLOOD CELLS
MEANS OF LEUKOCYTE REMOVAL

• Centrifugation
• Washing procedures using saline or glycerol
• Mechanical separation using leukoreduction
filters
 First generation filters-170 um
 Second generation filters-20-40 um
 Third generation filters (3-log filter)
 WASHED RED BLOOD CELLS
Shelf-life:
– Open System: 24 hours
Storage Temp: 1-6ºC
QC Requirement: Plasma removal
Indications:
 anemia with history of febrile reactions;
 PNH
 Pxs with plasma proteins antibodies to reduced
allergic reactions (for IgA-deficient pxs)
 FROZEN, THAWED,
DEGLYCEROLIZED RBC
Shelf-life:
1. Frozen – 10 years
2. Deglycerolized – 24 hours
Storage Temp:
• Freezing:
 - 65ºC (High Glycerol-40%),
 - 120ºC (Low Glycerol-20%),
 - 65ºC (using 79%glycerol with dextrose, fructose and
EDTA)
• Deglycerolizing Process - 1-6ºC
Indications:
 Anemia
 Long term storage of “rare” units and/or autologous
units
 PLATELETS (RANDOM DONOR,
prepared from whole blood)
Shelf-life: 3-5 days (5 days with continuous
agitation)
Storage Temp: 20-24ºC with constant agitation
Contents: 5.5 X 1010 platelets in 50-65 mL of
plasma
Indications:
 Thrombocytopenia, DIC, platelet disorders,
bleeding
Immediate effect: Increase platelet count by
5,000-10,000 per unit
 PLATELETS (SINGLE DONOR,
prepared by pheresis)
Shelf-life:
 Closed system – 5 days
 Open system - 24 hours
Storage Temp: 20-24ºC with constant agitation
Contents: 3.0 X 1011 platelets in approx. 300 mL
of plasma
Indications: Thrombocytopenia
Immediate effect: Increase platelet count by
30,000-60,000/unit
FRESH FROZEN PLASMA (SINGLE
DONOR, prepared fromwhole blood)
Shelf-life:
1. Frozen= 1 year
2. Thawed= 24 hours
Storage Temp:
1. Frozen= -18ºC
2. Thawed= 1-6ºC
Contents: All coagulation factors; 400mg
Fibrinogen
Indication: Treatment of multiple coagulation
factor deficiencies Also for treatment of
AntiThrombin III deficiency, TTP, HUS
 SINGLE DONOR PLASMA (SDP)
LIQUID/FROZEN
Shelf-life:
1. Liquid – 5 days beyond whole blood expiration
2. Frozen – 5 years
Storage Temp:
1. Liquid = – 1-6ºC
2. Frozen = -18ºC or colder
Indication: Treatment of stable clotting factor
deficiencies
 CRYOPRECIPITATE
Shelf-life:
• Frozen – 1 year
• Thawed – 6 hours
• Pooled – 4 hours
Storage Temp:
• Frozen = -18ºC or colder
• Thawed = 20 - 24ºC
 CRYOPRECIPITATE
Contents:
 Factor VIII:C 80-150 IU
 Factor VIII:vWF
 Fibrinogen – 150-250mg
 Factor XIII
Indications:
 Hemophilia A, von Willebrand’s dse, Fibrinogen
deficiency, Factor XIII deficiency
GRANULOCYTE CONCENTRATE
Shelf-life: 24 hours
Storage Temp: 20-24ºC without agitation
Contents: 1 x 1010 wbc
Indications:
 To correct severe neutropenia
 Fever unresponsive to antibiotic therapy
 Myeloid hypoplasia of the bone marrow
 IRRADIATED BLOOD
Shelf-life:
28 days or the normal dating period of the blood,
Which ever comes first

(irradiation uses Cesium-137 or Cobalt-60)

Indications:
GVH reactions, BM trnsplant,, exchange transfusion,
IUT, transfusion for immunocompromised patients
 PLASMA DERIVATIVES

PLASMA DERIVATIVES – are concentrates

of plasma proteins that are prepared from
pools (many units) of plasma.