Learning Objective 1: Donor Recruitment and Blood Donation
System used for the registration and correct identification of allogeneic donors and donation:
In transfusion medicine, an efficient and accurate registration system is crucial for the
identification and management of allogeneic donors (those who donate blood for transfusion
to another individual). This system typically involves the collection of personal details, medical
history, and blood typing. The registration process ensures accurate identification of donors
and facilitates tracing of donated units in case of adverse events or infectious disease concerns.
Importance of donor educational material and self-exclusion:
Donor educational material plays a vital role in providing potential donors with information
about the blood donation process, including eligibility criteria, potential risks, and benefits. Selfexclusion refers to the voluntary withdrawal of an individual from being a donor based on
personal factors that may compromise donor or recipient safety, such as recent travel to highrisk areas for infectious diseases. By providing comprehensive educational material and
encouraging self-exclusion, the safety and suitability of donated blood can be maximized.
Importance of pre and post-donation counseling:
Pre-donation counseling involves assessing the medical history and current health status of
donors before blood donation. This step helps identify any potential risks associated with
donation and provides an opportunity for donors to ask questions or address concerns. Postdonation counseling is equally crucial as it allows donors to receive information regarding postphlebotomy care, potential adverse reactions, and guidance for a smooth recovery. Counseling
enhances donor safety, satisfaction, and encourages future donations.
Minimum acceptable values for allogeneic blood donation tests:
Before blood donation, certain laboratory tests are performed to determine donor eligibility
and ensure a safe transfusion. These tests may include hemoglobin/hematocrit levels, blood
typing, screening for infectious diseases (e.g., HIV, hepatitis B and C), and other relevant
parameters. Minimum acceptable values are set based on established guidelines to ensure that
donated blood meets necessary quality and safety standards.
Differentiate between acceptable donation and types of deferral and medical conditions:
Acceptable blood donation refers to the donation process in which a donor meets all eligibility
criteria and can safely donate blood. Types of deferral may occur when a donor is temporarily
or permanently restricted from donating due to certain medical conditions (e.g., recent surgery,
infection, medication use), travel history, or lifestyle factors. Differentiating between
acceptable donations and deferrals is crucial to maintain the integrity and safety of the donated
blood supply.
The importance of maintaining adequate donor records:
Keeping comprehensive and accurate donor records is vital for transfusion medicine. Donor
records document relevant information including personal details, medical history, previous
donations, test results, and any adverse reactions. These records assist in donor management,
eligibility assessment, traceability of blood units, and tracking potential infectious diseases or
adverse events related to donated blood.
The donation procedure including arm preparation, blood collection, and post-phlebotomy
care:
The donation procedure starts with the careful preparation of the donor's arm, which involves
disinfection with an antiseptic and selecting an appropriate vein for blood collection. Blood is
then collected through a sterile needle inserted into the vein, usually in the antecubital fossa.
After donation, post-phlebotomy care, such as applying pressure to stop bleeding and providing
refreshments, is provided to ensure the donor's well-being.
Differentiate between mild, moderate, and severe donor reactions:
During and after blood donation, donors may experience different reactions. Mild reactions
typically include dizziness, lightheadedness, or feeling faint. Moderate reactions may involve
nausea, vomiting, or hypotension. Severe reactions are rare but can manifest as syncope
(fainting), seizures, or anaphylaxis. It is essential to differentiate between these reactions to
provide appropriate medical intervention promptly.
List recommended treatments:
Treatment for donor reactions may vary depending on the severity and nature of the reaction.
For mild reactions, the donor is usually placed in a reclining position and provided with proper
hydration and reassurance. Moderate reactions may require additional interventions such as
administering antiemetic medications, intravenous fluids, or oxygen therapy. Severe reactions
necessitate immediate medical attention, including cardiac monitoring, administration of
epinephrine for anaphylaxis, and potentially hospital admission for further management.
Learning Objective 2: Special Blood Donation Procedures
Autologous Donations:
Autologous donations refer to the process of individuals donating their own blood for future
use. These donations are commonly performed prior to scheduled surgeries or medical
treatments to ensure that the patient receives their own blood if a transfusion is needed.
Types of Autologous Blood Donations:
There are several types of autologous blood donations, including preoperative autologous
donations, where blood is donated before a planned surgery, and perioperative autologous
donations, where blood is collected during surgery and returned to the patient.
Autologous Blood Donation Criteria:
To be eligible for autologous blood donation, individuals must meet certain criteria, typically
including a minimum hemoglobin level and overall good health. The specific criteria may vary
depending on the individual's medical condition or the requirements set by the healthcare
facility.
Advantages and Disadvantages of Autologous Blood Donation:
The advantages of autologous blood donation include a decreased risk of transfusion reactions
and transmission of infectious diseases, as well as potential cost savings. However,
disadvantages may include the need for extra planning and resources, as well as the possibility
that the donated blood may not be suitable for transfusion due to changes in the patient's
health or treatment plan.
Apheresis:
Apheresis is a special blood donation technique that allows the selective collection of specific
blood components while returning the remaining components back to the donor. This
procedure is performed using an apheresis machine, which separates blood into its various
components through centrifugation or filtration.
Types of Apheresis Procedures:
There are different types of apheresis procedures, including platelet apheresis (where only
platelets are collected), red blood cell apheresis (where only red blood cells are collected), and
plasma apheresis (where plasma is collected while returning other blood components to the
donor).
Donor Criteria for Apheresis Donation:
Donors for apheresis procedures must meet specific criteria, including adequate venous access,
satisfactory hematologic parameters, and overall good health. The eligibility requirements may
vary depending on the type of apheresis procedure and the specific guidelines of the blood
collection center.
Instruments and Systems for Donor Apheresis Collections:
Various instruments and systems are used for apheresis collections, including apheresis
machines equipped with centrifugation or filtration capabilities, collection kits, and sterile
tubing sets. These instruments and systems are designed to ensure the safety and efficiency of
the apheresis procedure.
Advantages and Disadvantages of Apheresis Blood Donation:
The advantages of apheresis blood donation include the ability to collect specific blood
components as needed for patient transfusions, higher donation yields per procedure, and the
ability to potentially treat certain medical conditions by removing specific components.
Disadvantages may include longer procedure times, the need for specialized equipment and
training, and potential risks associated with prolonged venous access.
Learning Objective 3: Blood and Blood Components Processing, Storage &
Transportation.
Blood and Blood Component Preparation, Storage, Transportation, and Indications for Use:
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Concentrated Red Cells:
Concentrated red cells are prepared by removing a portion of plasma and preserving red
blood cells. They are stored at refrigerated temperatures and used to treat anemia or
replace lost blood volume.
Plasma:
Plasma can be prepared in different forms, including diagnosed, fresh frozen, or freezedried. Diagnosed plasma is collected from individuals who have tested negative for
certain infectious diseases. Fresh frozen plasma is frozen shortly after collection and
used to replace clotting factors in patients with bleeding or clotting disorders. Freezedried plasma is stored in a dehydrated form, providing a longer shelf life for military or
emergency use.
Platelets:
Platelets are prepared by centrifugation from whole blood or through apheresis. They
are stored at room temperature with gentle agitation and used to prevent or treat
bleeding in patients with low platelet counts or platelet function disorders.
Cryoprecipitate:
Cryoprecipitate is prepared from frozen plasma, which is thawed slowly, allowing the
precipitation of clotting factors. It is used to treat specific clotting factor deficiencies or
conditions, such as hemophilia or von Willebrand disease.
Fibrinogen:
Fibrinogen is a clotting protein isolated from fresh frozen plasma. It is used to treat
patients with low fibrinogen levels or specific bleeding disorders.
Leucocyte Poor Blood:
Leucocyte poor blood is prepared by filtering or washing red blood cells to reduce the
number of white blood cells. It is used in patients who are at increased risk of
transfusion reactions or complications related to white blood cells.
Frozen Red Cells:
Frozen red cells are red blood cells that are preserved at very low temperatures using
glycerol and frozen storage techniques. They have a longer storage life compared to
refrigerated red cells and can be used in certain situations such as rare blood types or
long-term storage for patients with specific needs.
Preservatives Used in Freezing Red Cells:
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Liquid Nitrogen:
Liquid nitrogen is a commonly used cryoprotectant for freezing red blood cells. It
provides very low temperatures, effectively preserving cells for long-term storage.
Glycerol:
Glycerol is a cryoprotectant commonly used in freezing red blood cells. It helps protect
the cells by reducing ice crystal formation during the freezing process.
Removal of Preservatives Before Use:
Before transfusion, red cells frozen with glycerol need to undergo a process called
deglycerolization, which involves gradually removing the cryoprotectant from the red
cells using appropriate washing and reconstitution techniques. This ensures that the red
cells are free from excess glycerol and safe for transfusion.
Advantages and Disadvantages of Using Frozen Cells for Transfusion:
Advantages of using frozen cells include the extended shelf life, the ability to store rare
blood types, and the availability of blood for patients with specific transfusion needs.
Disadvantages may include the need for proper storage facilities, specialized techniques
for thawing, and potential damage to the red cells during the freezing and thawing
process.
Safe Storage and Transportation of Blood and Blood Products:
Blood and blood products must be stored and transported under controlled conditions to
maintain their quality and efficacy. This includes appropriate temperature control, preventing
exposure to direct sunlight, maintaining proper inventory management, and ensuring
adherence to relevant regulations and guidelines.
The Blood Cold Chain:
The blood cold chain refers to the process of maintaining proper temperature control during
the storage and transportation of blood and blood products. It involves monitoring and
recording temperatures at various stages, including collection, processing, storage, and
distribution, to ensure the integrity of the blood products.
Effects of Storage in Blood and Blood Components:
Storage of blood and blood components can have various effects, including changes in cellular
integrity, glucose and pH levels, and depletion of labile factors like clotting factors or
coagulation inhibitors. Storage conditions and duration should be carefully managed to
minimize these effects and ensure the quality and efficacy of the blood products.
Hemo-therapies and Blood Substitutes:
Hemo-therapies involve the use of blood components or substitutes to manage specific medical
conditions or support certain therapies. This may include the use of erythropoietin for
stimulating red blood cell production, plasma exchange for removing harmful substances from
the blood, or the development of synthetic blood substitutes to replace or supplement blood
products.