DONOR SELECTION, BLOOD COLLECTION AND COMPONENT PREPARATION

Governing agencies in Blood AABB U.S. Food and Drug College of American Pathologist
Collection Administration
DONOR SELECTION
Encompasses: Medical history information and I. Personal Information Age:
1. Medical history of patients Physical examination answers 1. Donor’s name - Allogenic donation: 17 years old,
2. Physical examination the questions: 2. Donor’s address, phone must have a parent’s consent
3. Serological testing of blood 1. Will a donation of number - Autologous donation: no age
approximately 450 mL of 3. Sex restriction
▪ Signature should be attached whole blood be harmful 4. Age
indicating the consent to donate a to the donor? 5. Date of donation Consent to donate:
blood 2. Could blood drawn from 6. Donor’s consent - Donors should be informed of
- Usually seen at the end of this donor at this time 7. Donor’s occupation the potential risk of donation
Donor History Questionnaire potentially transmit a 8. Race - Educational materials about sign
(DHQ) disease to the recipient? 9. Time of last meal and symptoms of HIV infections
▪ Additional information may be and AIDS
useful: - Behaviors that put them at risk of
a) Name of the patient whom the infection
blood is intended
b) Race of the donor for
matching specific phenotypes
c) Cytomegalovirus (CMV) status
of neonates require CMV-
negative blood in some
circumstances.
Medical History Questionnaire
• It is designed to ensure • Self-administered must be Three types of deferral
protection of the donor and reviewed by the trained 1. Temporary: donor cannot donate for a specified time period
benefit the recipient. personnel. 2. Indefinite: prohibited from donating blood to another person for an
• A standardized medical history • The medical history unspecified period of time
questionnaire was developed. questionnaire is 3. Permanent: may never donate blood on the other person
• it is designed as self- conducted on the same
administered. day as the donation

- Asked by medical technology or any authorized staff

Interval for every blood donation
o Blood donation: 3-4 months
o Donate twice a year
 o Whole blood donation: 8 weeks
o Apheresis: 48 hours
HISTORY OF BLOOD - Blood transfusion, o Hemophilia
TRANSFUSION/ORGAN Organ transplantation, o Received red cell concentrates
TRANSPLANTATION/INTAKE OF Intake of medication: o Human-derived growth hormone
MEDICATION Permanently deferred o Undergone tissue transplantation
o Given bovine insulin
HISTORY OF SERIOUS HEALTH - This part tells us the ▪ Are you feeling well today? : Donor is deferred temporarily and is
CONDITIONS health status No advised to come back another day
- Donor has suffered from ▪ Currently suffering for:
any of the following - AIDS
disease or currently - Cancer: Leukemia/Lymphoma
infected : Permanently - Heart disease: Arrythmia/Congestive heart failure
deferred - Lung disease: Complicated asthma/bronchiectasis
- Liver disease: Viral hepatitis/Cirrhosis
- Kidney disease
- Sexually transmitted disease: AIDS, gonorrhea, syphilis
• Yes: With syphilis and gonorrhea will be deferred for 12
months after completion of therapy.
- Blood disease: Hemophilia, Von Willbrand disease, Sickle cell
anemia, Kaposi’s sarcoma, Polycythemia
- Parasitic disease: Babesiosis caused by Babesia microti
Chaga’s disease caused by Trypanosoma cruzi
- Malaria
• Yes: Donor will be deferred for 3 years after having
received treatment and recovered from illness.
- SARS-COV 2
• Yes: Recovered from infection will be deferred for 14 days
after full resolution of symptoms.
HISTORY OF TRAVEL TO AN - Idea that donor may ▪ Malia-endemic places: Visited an endemic place: Deferred for 1
ENDEMIC PLACE FOR A SPECIFIC have acquired a disease Africa, Palawan, Mindoro, year
DISEASE despite being Cagayan: Yes Immigrant or citizen of the endemic
asymptomatic place: Deferred for 3 years after
- Related to length of departure
exposure to an endemic ▪ Toronto, Canada; Hanoi, Did not contact any infection: Will be
place Vietnam; Guangdong, deferred for 14 days
China; Singapore and others If infected donor: He/She will be
affected by SARS: Yes deferred for 28 days after recovery
 ▪ North America Diagnosed and treated for West Nile
Virus: Deferred for 14 days after
recovery
Donor is infected and not treated:
Deferred for 28 days after onset of
illness.
▪ African country since 1977 Deferred permanently
and had sexual contact: Yes
▪ Sexual contact to someone Deferred permanently
who has travelled to African
country since 1977: Yes
▪ Have been to Iraq Deferred for 1 year from departure
because of the possible transmission of
leishmaniasis.
PROSPECTIVE HIV DONOR - Donor who has HIV ▪ Have you experienced the following:
infection: Deferred - Unexplained fevers, weight loss, and night sweats
permanently - Persistent diarrhea and skin rashes
- Any activity that increase the - Enlargement of lymph nodes
risk may be ground deferral - White spots or mouth sores
- Yes on following questions - Shortness of breath
are Deferred permanently ▪ Have you had
- Homosexual contact
- Heterosexual contact
- Bisexual contact
▪ Have you had sexual contact with illegal drug users
▪ Have you ever taken money or drugs for sex any time since 1977?
HISTORY OF DRUG INTAKE AND - Donor can be temporarily or Following drugs: Have been vaccinated:
VACCINATIONS permanently deferred if 3 days – Aspirin 2 weeks: Mumps, Oral polio, Rubeola,
taken medication or 1 month – Proscar, Propecia, Yellow fever, Animal serum products
vaccines. Accutane
- If not deferred, donated 6 months – Avodart 4 weeks: Rubella (German measles)
blood might contain 3 years – Soriatane
metabolites that cause birth Indefinite – Tegison-severe 12 months: Hepatitis B immune
defects to the unborn baby if psoriasis globulin, Gamma globulin, Rabies
transfused to a pregnant
woman.
POST-BLOOD DONATION PLANS - Main purpose of asking ▪ Intend to ride an airplane within next 24 hours
about his/her plan after ▪ Intend to drive a heavy transport vehicle within the next 12 hours
blood donation to ensure ▪ Intent to engage in any strenuous activities after blood donation
 safety. Donor is advised to
reschedule his/her blood
donation if he/she answers
YES to any of following
FOR FEMALE BLOOD DONORS - Applicable to female ▪ Currently pregnant: Yes 9 months after childbirth or 3 months
donors after weaning
- Main purpose is to ▪ Have you had blood Donor is deferred for 12 months if
prevent untoward transfusion during your transfused during her pregnancy
incidents especially if pregnancy? Yes
the woman is pregnant ▪ Did you recently deliver a Donor is deferred 9 months after
baby? Yes childbirth or 3 months after weaning
▪ Abortion or Miscarriage in First and second trimester abortions or
the past 6 months? Yes miscarriage is not for deferral.
OTHER CONSIDERATIONS - Asked if donor will have ▪ Tattoo, ear piercing or Deferred for 12 months
other concerns that will acupuncture? Yes
seriously affect his/her ▪ Imprisoned? Yes Deferred for 12 months
health status after blood ▪ Dental extraction or tooth Deferred for 12 months
donation. extraction?
- Predict if the donor has ▪ Taken alcohol in the past 12 Deferred for 12 hours after the last
acquired certain hours? Yes alcohol intake
infections which will
make his or her blood
unsafe.
PHYSICAL EXAMINATION
I. General appearance If donor is less than 110 lbs: Amount of blood to be drawn: Copper Sulfate Method (CuSO4)
II. Weight: 110 lbs (50 kg) Principle: A drop of whole blood when
III. Temperature: Orally should Allowable Amount:
𝐷𝑜𝑛𝑜𝑟 ′ 𝑠 𝑤𝑒𝑖𝑔ℎ𝑡 (𝑙𝑏)
𝑥 450 𝑚𝐿 dropped in a solution of CuSO4, which
not exceed 99.5F or 37.5C 110 𝑙𝑏 has a given specific gravity, will maintain
IV. Pulse: 50 to 100 beats per its desnity for approximately 15
Anticoagulant needed:
minute seconds.
𝐴𝑙𝑙𝑜𝑤𝑎𝑏𝑙𝑒 𝑎𝑚𝑜𝑢𝑛𝑡
V. Blood pressure: Systolic no 𝑥 14
greater than 180 mmHg, 110 Specific gravity of CuSO4 is 1.053 which
Diastolic no greater than 100 is equivalent to 12.5 g/dL
mmHg Anticoagulant to remove:
VI. Hematocrit and Hemoglobin: 63 mL – Anticoagulant needed
38% Hct (12.5 g/dL Hb)
HEMAPHERESIS DONOR SELECTION
- Type of blood donation 1. Plasma Additional Donor Guidelines
where whole blood is 2. Platelets 1. At least 48 hours is the elapsed time after hemapheresis donation
withdrawn either from a 3. Granulocytes 2. A donation must not exceed more than 2 times in a week or 24 times
donor or patient wherein 4. Lymphocytes in a yr unless otherwise allowed by bloodbank physician.
after removal, separation 5. Stem cells 3. A donor must be tested to detect cytopenia
and retention of the 6. Red cells 4. If a donor donates whole blood, at least 8 weeks must be elapsed
desired cellular elements before he can donate against
or plasma, the remaining 5. Extracorporeal blood must not exceed 15% of the donor’s total blood
products are recombined volume
and returned to the donor 6. If platelet pheresis is to be performed, a donor must have above 150
or patient. x 10^9/L platelet count
7. Possible adverse reaction to HES, steroids, and/or heparin must be
determined. These substances are used in the apheresis procedures.
AUTOLOGOUS DONOR Autologous: who is donating blood • No risk of disease transmission; CRITERIA
SELECTION for his or her own future use alloimmunization to red cells, 1. No age limit
- Safest blood possible for platelets, WBC, or plasma 2. No strict weight requirement
transfusion proteins; transfusion reactions 3. Hemoglobin/Hematocrit –
• Phlebotomy process stimulates should not less than 11 g/dL
the BM to increase cell production and 34%
• Decrease the need for allogeneic
blood and may actually increase Frequency – donations should not
the supply for allogeneic blood be more frequent than every 3 days
supply. and the final donation must be
completed at least 3 days prior to
the scheduled surgical procedure.
Types of Autologous Donation/transfusion
Redeposit donation Intraoperative autologous Immediate preoperative Post-operative salvage
transfusion hemodilution
refers to the blood that is It is collected during the surgical takes place in the an autologous donation in which
drawn some time before the procedure and usually reinfused operating room when 1-3 units of a drainage tube is placed in the
anticipated transfusion and immediately. WB are collected and the surgical site and postoperative
stored, usually patient’s volume is replaced with bleeding is salvaged, cleaned
liquid but occasionally colloid or crystalloid. The and reinfused.
frozen. blood is reinfused during the
surgical procedure
COMPONENT PREPARATION AND INDICATION
Prior to blood collection, the Principle 1: The cause of the Principle 2 Blood components:
intended venipuncture must deficiency to tbe editable Oxygen Carrying Components/Products
must be cleaned with. Princple 2: The deficient compony • Red cell concentrates
1. Hypochlorite and should be replcace • Leukocyte-poor red blood cells
2. Isopropyl alcohol Principle 3: Blood product should be • Frozen-thawed red cells
3. 10% acetone as possible Platelet Products
4. PVP iodine complex • Platelet rich plasma (PRP)
• Platelet concentrates (PC)
Plasma Products
• Fresh frozen plasma (FFP)
• Frozen plasma (FP)
• Cryoprecipitate
• Stored plasma

Plasma derivative: NSA, PPF,ISH, Rhogam.

Component Transfusion - one unit may be used for multiple transfusion expanded:
Therapy - it is the effective utilization of a limited natural resource by providing therapeutic material to several
patients from a single donation

WHOLE BLOOD PACKED RBC LEUKOPOOR RED BLOOD CELLS REJUVENATED RED BLOOD CELLS
Shelf-life Shelf life: same with whole blood Shelf life Addition of Rejuvenation solution
• CPD – 21d Storage temperature: 1-6C • Closed system – same with (PIGPA: Phosphate, Inosine,
• CPD-A1 – 35d Contents: packed RBC Glucose, Pyruvate, Adenosine) to
• CPD-AS – 42d - Hematocrit should be 80% • Open system – 24 hours regenerate ATP and 2,3-DPG.
• ACD – 21d or less
• CP2D – 21d Indication: Restore oxygen carrying Storage temperature: 1-6C Shelflife: can be prepared 3 days
• Heparin – 2d capacity (anemia) Contents: 5x10^6 residual WBC after expiration date
Indications: anemia with history of Storage temeperature: 1-6C
Characteristics: Immediate effect of one unit: febrile reactions; to decrease
- WBCs and platelets no increase of hematocrit by 3% and alloimmunization to WBC or HLA Rejuvenasol: the only FDA-approved
longer viable after 24 increase hemoglobin by 1g. antigens or CMV transmission. rejuvenation solution.
hours of storage
- Labile factor
significantly decreased
after 2 days of storage

Storage temperature: 1-6C

Indications:
▪ Active bleeding,
hemorrhagic shock and
exchange transfusion.
▪ Indicated when both
oxygen-carrying capacity
and volume expansion are
required.

Immediate effect on one unit:

increase hematocrit by 1-3%
FROZEN FROZEN -> THAWED -> PLATELETS (RANDOM DONOR, PLATELETS (SINGLE DONOR,
DEGLYCEROLIZED RBC prepared from whole blood) prepared by pheresis)
Shelf life: Open system: 24 Shelf life: Shelf-life: 3-5 days (5 days with Shelf-life: Closed system – 5d
hours - Frozen: 10 years continuous agitation) Open system – 24 hrs
Storage temperature: 1-6C - Deglycerolized: 24 hours
QC requirement: Plasma Storage temp: 20-24C with constant Storage temperature: 20-24C with
removal Storage temperature: agitation constant agitations
Indications: Anemia with history Freezing:
of febrile reactions, PNH; for • -65C: High glycerol – 40% Contents: 5.5x10^10 platelets in 50- Contents: 3.0x10^11 platelets in
patients with plasma proteins • -120C: Low glycerol – 20% 65 mL of plasma approximate 300 mL of plasma
antibodies to reduced allergic • -65C: using 79% glycerol
reactions (IgA-deficient with dextrose, fructose, EDTA Indications: thrombocytopenia, DIC, Indications: Thrombocytopenia; for
patients) platelet disorders, bleeding patients refractory to random
Deglycerolized process: 1-6C platelets due to platelet antibodies
Immediate effect: increase platelet
Indications: anemia, long-term count by 5000-10000/uL Immediate effect: increase platelet
storage of rare units and/or by 30,000 – 60,000/uL
autologous units. Corrected Platelet Count:
𝑃𝑜𝑠𝑡 𝑡𝑟𝑎𝑛𝑠𝑓𝑢𝑠𝑖𝑜𝑛 𝑃𝑙𝑎𝑡𝑒𝑙𝑒𝑡 − 𝑃𝑟𝑒𝑡𝑟𝑎𝑛𝑠𝑢𝑠𝑖𝑜𝑛 𝑃𝑙𝑎𝑡𝑒𝑙𝑒𝑡 𝑥 𝐵𝑆𝐴
𝑁𝑜 𝑜𝑓 𝑏𝑎𝑔𝑠 𝑥 0.55
FRESH FROZEN PLASMA SINGLE DONOR PLASMA (SDP) CRYPRECIPITATED GRANULOCYTE CONCENTRATE
(SINGLE DONOR, prepared LIQUID/FROZEN ANTIHEMOPHILIC FACTOR
from whole blood) (CRYOPRECIPITATE)
Shelf life: Shelf life: Shelf life: Shelf life: 24 hrs
- Frozen: 1 year - Liquid: 5 days beyond whole - Frozen: 1 yr Storage temperature: 20-24C
- Thawed: 24 hours blood expiration - Thawed: 6 hours without agitation
- Frozen: 5 years - Pooled: 4 hpurs Contents: 1x10^10 WBC
Storage temperature:
 - Frozen: -18C Temperature: Storage temperature: Indications: To correct severe
- Thawed: 1-6C - Liquid: 1-6C - Frozen: -18C or colder neutropenia, fever unresponsive to
- Frozen: -18C or colder - Thawed: 20-24C antibiotic therapy and myeloid
Contents: All coagulation hypoplasia of the bone marrow.
factors; 400 mg Fibrinogen Indication: Treatment of stable Contents:
clotting factor deficiencies. ▪ Factor VIII: 80-15 IU Plasma Derivatives: concentrate of
Indications: treatment of ▪ Factor VIII: vWF plasma proteins that are prepared
multiple coagulation factor ▪ Fibirinogen: 150-250 mg from pools of plasma.
deficiencies. ▪ Factor XIII
➢ Caused by massive
blood loss, trauma, liver Indications: Hemophilia A, Von
disease, DIC) Willbrand’s disease, Fibrinogen
➢ Treatment for deficiency, Factor XIII deficiency
AntiThrombin III
deficiency, TTP, HUS
FACTOR VIII CONCENTRATE FACTOR IX CONCENTRATE FACTOR IX CONCENTRATE IMMUNE SERUM GLOBULIN (ISG)
(PROTHROMBIN COMPLEX) (PROTHROMBIN COMPLEX)
Shelf life: varies on expiration Shelf life: varies on expiration date Shelf life: varies on expiration date on Shelf life:
date of vial on vial vial - Intramuscular: 3 years
Storage temperature: 1-6C Storage temperature: 1-6C - Intravenous: 1 year
Storage temperature: 1-6C (lyophilized) (lyophilized)
(lyophilized) Indication: hemophilia A Indication: hemophilia B Indications: Prophylactic treatment
to patients exposed to hepatitis,
Indications: hemophilia A measles or chickenpox; treatment
of congenital
hypogammaglobulinemia
NORMAL SERUM ALBUMIN PLASMA PROTEIN FRACTION SYNTHETIC VOLUME EXPANDERS Rho (D) Ig (Rhogam)
(NSA)
Shelf life and Storage temp: Shelf life and Storage temp: NSS Shelf life and Storage temp:
- 3 years at 20-24C - 3 years at 20-24C Ringer’s disease 3 years at 1-6C
- 5 years at 1-6C - 5 years at 1-6C Electrolyte solution
Dextran Contents:
Contents: 96% Albumin and 4% Contents: 80-85% Albumin and 15- Hydroxyethyl starch (HES) Full dose: 300ug Anti-D
Globulin 20% Globulin Mini dose: 50ug Anti-D
Indications: Plasma volume
expansion: surgery, trauma, Indication: Plasma volume Indication: Prevention of Rho(D)
burns expansion immunization
 IRRADIATED BLOOD
Shelf life: 28 days or the normal
dating period of the blood,
whichever comes first

- Irradiation uses
Cesium-137 or Cobalt-
60

Indications: GHV reactions, BM

transplant, direct donation from
a blood relative, exchange
transfusion, IUT, transfusion for
immunocompromised patients
THERAPEUTIC CYTAPHERESIS
PLATELETPHERESIS Equivalent to 6-10 random platelet Therapeutic indications: Used to treat patients who have abnormally
concentrates elevated platelet count (plt ct >1,000,000/uL) such in the case of
Polycythemia vera
Contents: 3x10^11 platelets
LEUKAPHERESIS HES (Hydroxyethyl starch) – Corticosteroids: administered to the Therapeutic indications: used to
sedimenting agent used for donors 12-24 hours before pheresis to treat patients with leukemia (WBC
granulocyte collection which causes increase the number of circulation >100,00/uL) such as Hairy cell
red cells to form rouleaux this granulocytes by pulling them from the leukemia, AML, cutaneous T cell
allowing WBCs to be harvested more marginal pool lymphoma
efficiently.
LYMPHOCYTAPHERESIS Therapeutic Indications: means of producing immunosuppression in conditions like RA, SLE, Kidney
transplant rejection and autoimmune and alloimmune disease

NEUCYTAPHERESIS Transfusion of young RBC Therapeutic Indications: for young pxs with certain hematologic disorders
“neocytes” especially thalassemia syndromes

ERYTHROCYTAPHERESIS Considered exchange procedure Therapeutic Indications: Used to treat various complications of Sickle cell
disease, such as priapism and impending stroke
Predetermined quantity of red - Also in pxs with severe parasitic infections from malaria and babesia
cells is removed from the
patients and replaced with
homologous blood
 THERAPEUTIC Replacement fluids: NSS, NSA, ▪ FFP has the disadvantage of Therapeutic Indications:
PLASMAPHERESIS (PLASMA PPF, FFP possible disease transmission, 1. To remove the offending agent
EXHANGE) ABO incompatibility, citrate in the plasma causing clinical
toxicity and sensitization to symptoms in cases of
plasma proteins and cellular Ags. Paraproteinemia (e.g. Multiple
plasma 2. Myeloma, Waldenstrom
▪ FFP is now the recommended Macroglobulinemia, etc.),
replacement fluid primarily during Familial Hypercholesterolemia,
exchange for TTP and HUS.) etc.2. To collect rare red & white
cell Abs
3. Beneficial particularly in
diseases that involve
malfunction of the immune
system (SLE, RA)