UNIT III Introduction to blood banking technology
DONOR SELECTION
1.Pre-donation counselling by trained staff should be made available
maintaining privacy and confidentiality.
Pre-donation information should include:
➔ Modes of transmission leading to risk behaviour and self exclusion for
patient's safety.
➔ Alternative testing site
➔ Tests carried out on donated blood
➔ Confidentiality of test results
➔ Need for honest answers in view of window perioid.
2 . A questionnaire should be prepared in English and local languages
which is simple and easy to understand to be answered by the donor.
3 . For donors who are illiterate, assistance should be given by donor
registration staff.
4 . Medical officer with MBBS qualification should be responsible for
reviewing the donor's health conditions and performing physical
examination of the donor.
5 . Demographic details such as name and address of donor, date and
time of donor selection and donation should be registered.
6 . Consent should be obtained in writing from the donors after explaining
the procedure, potential adverse reactions as well as the tests carried
out on the donated blood.
CRITERIA FOR SELECTION OF DONORS
Following guidelines should be observed in order to determine that the
blood donation will not be detrimental to the donors/recipients.
Physical Examination
A medical officer should certify the donor fit for blood donation.
B-General Appearance
The prospective donor should appear to be in good health.
➔ Age
Donors should be between the age of 18 and 65 years.
➔ Haemoglobin or packed Cell Volume (Haematocrit):
The haemoglobin should be not less than 12.0 gm/dl or the packed cell
volume (haematocrit) should be not less than 36%. The screening should
be carried out by using any appropriate and validated methodology. A
more sensitive method of hemoglobin testing should be available as a
reference or control.
➔ Weight
Blood collection from donors weighing 45-55 Kg should be 350 ml blood
and from those weighing 55 Kg and above should be 450 ml.
➔ Blood Pressure
The systolic blood pressure should be between 100 and 160 mm of
mercury and the diastolic pressure should be between 60-90 mm of
mercury.
➔ Temperature
Temperature should not exceed 37.50C/ 99.5oF
➔ Pulse
Pulse should be between 60 to 100 beats per minute and regular.
➔ Donor Skin
The skin at the venepuncture site should be free of any skin lesion or
scar indicative of addiction to narcotics or infection as well as marks of
repeat venepuncture.
Examination of respiratory system, cardiovascular system and abdomen
should be carried out if necessary.
MEDICAL HISTORY
➔ Conditions that affect safety of donors:
Before each donation questions should be asked to determine that
the donor is in normal health and has not suffered or is not suffering
from any serious illness e.g. malignant disease, epilepsy, bronchial
asthma,diabetes, excessive menstrual bleeding, cardio-vascular
conditions, renaldisease, allergic diseases, abnormal bleeding tendency.
➔ Pregnancy:
Prospective donor should not be accepted during period of pregnancy
and till 12 months after full term delivery and also during lactation.
Donors who have abortions should be deferred till 6 months after 2nd
and 3rd trimester abortion. Menstruation in itself should not be a cause
for deferral.
➔ Any donor who appears to be under the influence of alcohol or any
drug abuse and who does not appear to be providing reliable answers
to questions on their medical history should not be accepted.
➔ Conditions that affect safety of recipients.
1 Any donor on antibiotic therapy or other medications should be
deferred after evaluating his/her suitability as donor.
2 Infectious disease
(1 )Donors having history of malaria should be accepted after 3 months..
(2) Donors having history of jaundice should be deferred up to 1 year.
(3) Donors having history of being HIV, HBsAg / HCV antibody positive
should be permanently deferred.
(4) Donors having intimate contact with HIV, HBsAg / HCV antibody
positive individual should be deferred for 1 year.
(5) Donors having history of measles/mumps/chickenpox should be
deferred for 8 weeks.
(6) Donors having history of influenza and URTI (Upper Respiratory Tract
Infections) should be deferred till 1 week after treatment. Donors
having history of diarrhoea in preceding week particularly if associated
with fever should be deferred.
(7) For emerging potential transfusion transmissible infections, the
guidelines published from central health authorities should be followed.
(8) Private interview of each donor is essential to assess the risk of HIV
infection due to high risk sexual behaviour and unsafe sexual practice.
(9) Donors who give history suggestive of HIV infection such as;
swollen glands
persistent cough
unexplained weight loss
night sweats/fever
skin rashes and skin infections and
prolonged diarrhoea Should be deferred permanently.
➔ 3. Vaccinations
1 Individuals who have taken vaccination against TAB/TT/CHOLERA/
HEPATITIS-A - should be accepted if free of symptoms. Those who
have received Hepatitis B vaccination should be accepted after 7 days
of vaccination.
2 Yellow fever/measles/polio - should be deferred for 2 weeks
3 Rabies vaccination - should be deferred for 1 year. Those bitten by any
animal should be deferred for one year.
4 Hepatitis B Immunoglobulin - should be deferred for 1 year
➔ 4 Aspirin Ingestion- Ingestion of Aspirin or any related medicine
within three days prior to donation should preclude use of donor as a
source of platelet preparation.
➔ 5 Surgical Procedures
1 Donors should be accepted one year after the recovery from major
operations and six months after recovery from minor operations
including acupuncture, tattooing and scarification.
2 Donors having history of receiving transfusion of blood or blood
products should be deferred for 12 months
