PATHOLOGY AND LABORATORY MEDICINE
DIVISION OF TRANSFUSION MEDICINE
STANDARD WORK INSTRUCTION MANUAL
Directed Donation Process
Approved By: Dr. Antonio Giulivi
Date Issued: 2004/04/05
Date Revised: 2009/12/31
1.0
Document No: A.007
Category: Administration
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Principle
Requests for directed donation are usually from a parent to a child.
However there are other situations in which a physician may require a
directed donation. These requests must be carefully reviewed and the
safety of both the donor and recipient taken into consideration.
2.0
Scope and Related Policies
2.1
2.2
The request for a directed donation must be received from the
attending physician. If a parent or another individual makes
inquiries, they should be referred to the patient’s attending
physician.
Acceptable Blood Groups:
The ideal directed donor is ABO identical and Rh compatible.
However, a blood group compatible but not identical is acceptable
for red cell transfusions ONLY.
i.e.
- Group O donor cells to non group O recipients
- Group A donor cells to group AB recipients
There will be no donor directed FP or platelets issued if the donors’
plasma is incompatible with the recipient. Incompatible directed
donor plasma is discarded. All plasma will be discarded unless
specifically requested in advance of collection.9.1
2.3
CMV Status:
CMV negative donor blood products will be given to:

A neonatal patient (< 4 months of age)

A potential transplant patient regardless of age/body weight
Ontario Regional Blood Coordinating Network
Standard Work Instruction Manual
A.007
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Directed Donation Process

An immunocompromised recipient
2.4 Irradiation:

2.5
All directed donation products are to be irradiated prior to issue
if obtained from a first degree relative
All directed donations including those for neonates (< 4 months of
age) are collected in regular packs with CPD with SAGM.9.1
3.0
Specimen – N/A
4.0
Material
Supplies:
Directed Donation Request Form
CBS Forms: F020913 and F020915
5.0
Quality Control – N/A
6.0
Procedure
6.1
6.2
The attending physician must complete the request form F020915.
This includes the following demographic information:
-
Demographics of patient
-
Date of birth
-
Hospital identification number
-
Diagnosis
-
Reason for transfusion
-
Number of donation units required
-
Date units required
-
Special requirements, i.e., Neonatal quad units
-
Medical screening history of parent(s)
The attending physician will:
Ontario Regional Blood Coordinating Network
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A.007
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Directed Donation Process
6.2.1 Discuss the risks of transfusion and the viral testing protocol.
6.2.2 Order the following laboratory tests on each potential
donor(s):
-
CBC
-
Blood group and antibody screen
-
CMV testing (see section CMV status)
6.3
The form F020915, for each parent/donor, will be forwarded to TML
on completion.
6.4
Testing, recording and reporting of directed donation requests
6.4.1 On completion of the above laboratory tests on the
parents/donors, they will be reviewed by the laboratory for
compatibility with the patient. The forms for all compatible
cases, as determined by the TML policy, will be forwarded to
the blood supplier. If the Physician's copy is received by TML
this will be sent to Health Records and a copy kept in the
directed donation file in TML. Laboratory reports of
incompatible directed donors are sent to the attending
physician and the original request form is sent to Health
Records. A record of all directed donation requests
regardless of the outcome is maintained in TML.
6.5
The blood supplier will perform all viral testing on the donor blood
as per the current policy. The donated blood will be sent to TML
where it is entered into inventory as a directed donation unit with a
28 day dating if the units are irradiated. Crossmatching is
performed as per routine procedures with the patient’s sample to
confirm compatibility. The units are then ready for use.
6.6
Unused directed donation units are kept until the end of their shelf
life and discarded. They must not be given to another recipient or
returned to the blood supplier.
6.7 Allogeneic Blood Products:
In the event that allogeneic blood products are required for a
directed donation recipient, these will be issued according to the
existing transfusion policies for either neonates (< 4 months),
children or adults.
Ontario Regional Blood Coordinating Network
Standard Work Instruction Manual
A.007
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Directed Donation Process
7.0
Reporting – N/A
8.0
Procedural Notes
8.1
Acceptable shelf life of directed donor units of packed cells for
pediatric cardiology patients is dependent on the age of the
recipient:
8.1.1 < 4 months of age: Red cell units with a shelf life < 8 days is
ideal.
8.1.2 Red cell units with a shelf life of 8 – 28 days are acceptable
providing that the unit is washed in normal saline and
reconstituted with FP or normal saline, to its original volume.
8.1.3 Washed units to be identified by “USE FIRST”.
8.1.4 > 4 months of age: Red cell units with a shelf life up to 14
days are acceptable.
9.0
References
9.1
Customer Letter #2005-03, Buffy Coat Production Method, Ottawa,
ON: Canadian Blood Services, 2005.
9.2
Circular of information for the use of human blood and blood
components, Ottawa, ON: Canadian Blood Services, 2005.
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