OVERVIEW OF THE BLOOD DONATION PROCESS
Introduction: The Journey of a Unit of Blood
1. Donor presents to the donation facility or mobile blood drive
2. Donor completes the donor history questionnaire
• (Refer to UCLA Uniform Donor History Questionnaire in Block 1)
3.
Historian reviews questionnaire with the donor, performs mini-physical and
screens the donor’s hemoglobin level.
4. Blood product is collected from the donor
5. Unit is sent to Component Processing for fractionation into components, labeling,
and entry into the inventory
6. Secondary processing such as leukofiltration, irradiation, and washing may occur
7. Clinician orders unit for patient
8. Blood bank performs necessary pre-transfusion compatibility tests; unit is issued
to the patient
9. Transfusion at bedside
Block 1 Blood Donation and Donor Eligibility
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Last Updated 2/8/2011
OVERVIEW OF THE BLOOD DONATION PROCESS
Type of Blood Donation Defined by Collection Methods
1.
Whole Blood
• One unit of whole blood is collected from donor
• Unit can be fractionated to produce a unit of RBC, platelet concentrate,
and plasma
a. Plasma can be
i. Frozen (Fresh Frozen Plasma, Frozen Plasma)
ii. Frozen, then thawed at 4-6C to produce one unit of
cryoprecipitate, and one unit of “cryo-poor” plasma,
iii. Fractionated into various plasma protein products (IVIG,
albumin, etc)
• Whole blood donation specifics
a. Volume
i. Standard: 450 +/- 45 ml per donor.
ii. If only able to collect 300-405ml, unit needs to be labeled
low volume.
iii. If <300ml collected, amount of anticoagulant preservatives
in collection bag must be adjusted
b. Whole blood drawn cannot exceed a maximum of 10.5 ml/kg of
donor body weight, which includes blood samples taken for testing
c. Donation duration: cannot exceed 15 minutes
2.
Apheresis Donation
• Automated collection instruments (i.e. Trima, Cymbal) can separate
whole blood into its major components (RBC, platelets, and plasma) by
density. This is achieved by centrifugation.
• The desired component(s) is/are removed, and the unneeded
components are returned to the donor.
• Granulocytes and peripheral blood stem cells are also collected by
apheresis.
• Donation duration varies depending on products collected, donor size, cell
counts, instrument type, donor venous blood flow, etc, usually 45-90
minutes
• Specific criteria for donation interval apply, and specific physical criteria
apply for double RBC unit donors (Refer to section on Additional Eligibility
Criteria for Apheresis Donors)
• For frequent donors, annual RBC and plasma losses need to be tracked
Block 1 Blood Donation and Donor Eligibility
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OVERVIEW OF THE BLOOD DONATION PROCESS
Type of Blood Donation Defined by Donor
1.
2.
3.
Allogeneic Donation
• Volunteer donor, unit can be used for any patient
• Unit is assigned into the general inventory
Directed Donation
• Unit is intended for a specific patient, but may be crossed into the general
inventory if unused/not usable by the intended recipient
• Donor may be patient’s friend/family member, or specifically selected for
the patient due to HLA type or RBC antigen status
• Donor undergoes the same screening and testing process as the
allogeneic donor
• Unit specifically labeled
Autologous Donation
• Donor is the patient
• Donor screening process is more lenient (i.e. low hemoglobin requirement
of 11.0 g/dL)
• Unit NEVER crossed into general inventory
• Infectious disease testing not required unless unit shipped to another
facility,
a. Positive infectious disease test results do not preclude donation or
use of unit.
b. Patient’s physician notified of the results.
• Unit specifically labeled
•
Order of transfusion: Use autologous unit(s) first, then directed donor unit(s),
then allogeneic unit(s) from the general inventory.
•
Confidential Unit Exclusion
• Opportunity for donor to indicate that their blood is unsuitable for
transfusion
• Often done by asking donor to choose one of the two barcode stickers to
indicate “TO USE” or “NOT TO USE”. Thus collection staff /interviewer is
blinded to the choice.
• Not required. Abandoned by some collection centers due the high rate of
inadvertent mislabeling by donors.
Block 1 Blood Donation and Donor Eligibility
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Last Updated 2/8/2011