Blood Donation, Blood Collection & Transfusion
 Introduction:
In order to protect the donor as well as the recipient, each blood donor must be
screened by:
 Medical history.
 Limited medical examination.
 These 2 goals should be kept in mind:
 Safety of donor.
 Safety of recipient.
Early attempts to transfuse blood were sometimes successful
But sometimes the patient died
1- BLOOD DONATIONS
Becoming a blood donor
The Red Cross Blood Service says that anyone can become a blood donor, as long
as they are:
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In good health;
Able to meet the Blood Service’s medical guidelines:
o
o
o
o
o
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Aged between 16 and 70 years of age.
At least 50 kg in weight.
donors who are not pregnant
Temperature:37c or 99F
Pulse: 50-100 beats/ min/ regular.
Hemoglobin:
1. Male: not less than 13.5 g/dl
2. Female : not less than 12.5 g/dl
o Hct:
1. Not less than 41% = male.
2. Not less than 38% female.
o Specific gravity: > 1.055 = male and >1.o53 = female
o Blood pressure:
 Systolic = 90 -180 mmHg.
 Diastolic = 50 – 100 mmHg
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Deferral (not allowed for blood donation)
 Permanent:
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Viral hepatitis.
Jaundice of unknown cause.
Malignant tumors.
Leukemia.
Fainting
Abnormal bleeding tendency.
Known HBsAg tests.
Serious cardiopulmonary disease.
 Temporary: (conditions required rest or medications)
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Cold.
Flu.
Diabetes.
T.B.
Syphilis.
others
 3 years:
 Malaria.
 Anti-malaria.
 1 year: sever illness.
 6 months:
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 Major surgery.
 Injection of blood or components.
2 months: rubella vaccin.
8 weeks: previous blood donation.
6 weeks: after termination of pregnancy.
2 weeks:
 Small box.
 Measles.
 Mumps
 Yellow fever vaccine.
 Oral polio vaccine.
 72 hours:
 Oral dental.
 Minor surgery.
 48 hours:
 Aspirin consumption by donor who to be only the source for platelet .
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 Identifications:
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Name
Address
Tel No
Age
Sex
I.D No or Egama No
Other important considerations
 Consent : a written consent
 Preparation before donation:
 Eat a regular meal.
 Avoid fatty food.
 No alcohol.
What does it involve?
o Donating blood is safe and easy. It takes about an hour of your time altogether.
If you pass the screening tests, the actual donation process — which takes
between 7 and 10 minutes — begins.
You’ll be asked to sit in a reclining chair while a new, sterile needle connected to
a plastic tubing and blood bag is inserted into your arm vein. One unit of blood
(usually 450- 470 ml) is collected and sent to the laboratory for testing and
processing.
Phlebotomy
 Phlebotomy should be well-trained in a septic technique.
 Material should be sterile.
 The donor blood bags, sample tubes and donor record should be properly
identified and labeled before drawing blood.
The venipuncture site should be free of skin lesions. Plastic blood bags should be
used, with additional outpost bags should be selected according to need.
Each bags should examined for defect of bags and anticoagulants inside it.
 Also inspected for needle marks.
 For donor over 50 kg, amount of blood drawn should be 450ml.
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 A maximum of 30ml blood sample is allowed for additional tests.
After you have donated, you can sit back and relax with some light refreshments.
You don’t have to worry about ‘losing too much blood’ as you will have donated
only about 8 per cent of your total blood volume. Your body typically replenishes
the fluid lost in about 24 hours while the red blood cells lost are generally
replaced in a few weeks.
Plasma donation
Plasma donation is an automated process where the donor's blood is collected, the
red cells and plasma (the clear fluid left after removal of the blood cells) are
separated, and then the red cells are returned to the donor. If you donate plasma,
you can donate more frequently because you are not giving your red cells. Donors
can also donate platelets (fragments of larger blood cells which help the blood to
clot).
How often can I donate?
You can usually give whole blood every 12 weeks and plasma every 2 weeks. The
donor's body usually replaces the liquid part of blood (plasma) within 72 hours
after giving blood. It generally takes about 4–8 weeks to regenerate the red blood
cells lost during a blood donation. An iron-fortified diet plus daily iron tablets can
help rebuild a donor's red blood supply.
Dangerous of blood donation:
o Fainting of donor, occurs in 2% - 5% of donors in young, 1st time donation.
o Damage to vein-spasm, causing bruising of the vein.
o Donations more than three times in one year will lead to Iron Deficiency
Anaemia.
When you start collection:
o Aseptic condition to avoid infection, wash hands, clean the place with
alcohol, use one needle for one donor.
o Be careful in going in an artery.
Blood Transfusion: Blood transfusions, routine, fairly safe and sometimes
taken-for-granted lifesaving procedures, were not medical options until the early
20th century when the major blood groups were discovered and carefully studied.
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Blood group compatibility:
Before a transfusion is performed, blood is ‘cross-matched’ to ensure the donor's
blood is compatible with the recipient's blood. A person cannot safely be
transfused with blood of a group containing antigens to which he or she has
antibodies.
Autologous blood transfusions
An "autologous" donation occurs when a person donates his or her own blood for
personal use as who are expecting surgery. This means that, since the blood is not
be be used for anyone else, then units positive for infectious agents and units with
irregular blood group antibodies are still acceptable for autologous donation. Also
in the cases of the rare blood groups.
However, because of the potential risk for a clerical error with mistransfusion of
an autologous unit in the inventory, units positive for hepatitis B (HBsAg) and
human immunodeficiency virus (HIV) are not allowed into the Blood Bank. If an
autologous unit is collected but not used by the patient-donor, then it is destroyed.
There are three other ways, aside from the "predeposit" of blood as outlined above,
to make use of the patient's own blood:
1- Hemodilution: the patient's blood is collected prior to surgery and replaced
with a plasma expander. The theory is that any bleeding during surgery will lose
fewer RBC's. Then the previously collected, higher hematocrit blood can be given
back to the patient following surgery.
2- Cell Saver: this device is used to collect blood in the operative field during
surgery, wash it, and return it with saline to the patient. This will work as long as
the operative field is not contaminated with bacteria or with malignant cells.
3- Wound drainage: blood is collected from cavities (such as a joint space into
which bleeding has occurred) and returned through a filter (which removes big
items like thrombi and tissue fragments, but does not remove inflammatory
chemical mediators or cytokines).
Directed donation :
Another option for blood transfusions is called directed donation. This is when a
family member or friend donates blood specifically to be used by a designated
patient. For directed donation, the donor must have a blood type that is
compatible with the recipient’s. He or she must also meet all the requirements of a
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regular volunteer blood donor. There is no medical or scientific evidence that
blood from directed donors is safer or better than blood from volunteer donors. In
general, blood collected from directed donations is no safer than that of the
general blood supply because of the stringent screening and testing of volunteer
donors that ordinarily occurs.
Keeping Blood Transfusions Safe
All the donated blood should be detected for infectious and transmissible diseases.
Each unit must be tested for:
1. Hepatitis B and C viruses (HBV and HCV), which cause inflammation
of the liver. The three tests used identify current and previous infection
with HBV and HCV; detect a person who has recovered from a hepatitis B
infection but continues to be a carrier for HBV; and identify carriers of
even symptomless HCV, and also Hepatitis D, E using ELIZA or RIA.
2. Human Immunodeficiency Virus (HIV 1 and 2), which cause
immunodeficiency disease, or AIDS. One test detects antibodies to proteins
of both types of HIV virus, and another detects one of the viral proteins of
the HIV-1 virus.
3. Human T-Lymphotropic Virus, Types I and II, which can cause
infections that can lead to leukemia or a variety of neurologic diseases.
4. a history of intravenous drug abuse
5. Syphilis. The test detects ongoing and previous infections with the
bacterium that causes syphilis.
6. Cytomegalovirus: dangerous to immuno-compromised patients as
pregnant and patients with BM transplantation, new born baby and AIDS
patients.
7. Malaria.
8. ABO and Rh typing.
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Collection and storage of the donated Blood:
Anticoagulants:
1- Acid-Citrate-Dextrose (ACD):
• Considered the stander solution for collection blood for transfusion since
1943.
• Citrate chalets calcium, while dextrose provides the source of energy, and
citric acid gives the solution a pH of about 5 at R.T, and after addition of
blood the pH became 7.1 at R.T and about 7.4 at 4C.
• Shelf life is about 21 day.
2- Citrate-phosphate-dextrose + Adinine (CPDA).
o Citrate: Anticoagulant.
o Phosphate is a substrate which is used a source of energy (ATP)
required for RBC.
o Dextrose is used as substrate.
o Adenine: amino acid, required for RBC viability.
o This is the best anticoagulant for the blood transfusion, keeps the
blood for about 35 days.
3- Citrate-Phosphate-Dextrose (CPD):
 Replaced ACD.
 Phosphate is contribute to ATP pool and thus improves the viability of
RBC.
 The pH is about 5.5 before mixture and 7.5 at 4C with blood.
 Maintains the 2,3 DPG level for about one week.
 Shelf life is about 21 day.
 Optimal Additive Solution (OAS):
Contains saline, Adenine, Glucose and Manitol.
4- SAGM
provides good storage for RBC,
keeps blood for 35 days.
5. Heparin:
1. Anticoagulant but not preservative.
2. Must be used immediately, within 48h. And preferably within 24h.
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3. It’s was used for cardiopulmonory by pass surgery and for exchange
transfusion and now for removal of leukocytes by filtration.
4. Short half life of heparinzed blood.
5. Activate lipoprotien lipase, producing fatty acid.
6. ccasionally used for the use of pediatric surgery.
7. Advantage: no citrate toxicity.
Changes in stored blood:
1. Certain percent of RBC are destroyed, in good anticoagulant only 10-20 %
of RBC are destroyed.
2. Blood become acidic or acidotic.
3. Elevation in K concentration which is bad for heart.
4. Platelets will die within few hours after collection. So there will no Plts.
5. WBC are deteriorated also (no WBC in old blood).
6. Activity of coagulation factors will be grossly reduced (VIII, V).
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