Blood Donation and Transfusion Guidelines
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Questions and Answers

What condition must platelet components meet to be transfused?

  • Must exhibit normal visual assessment criteria without discolouration (correct)
  • Must be stored at temperatures below 20°C
  • Must be pooled from at least six different donors
  • Must have a volume exactly 300 mL

    • Which of the following discolorations indicates a unit is NOT acceptable for transfusion?

  • Oral contraceptives (green)
  • Lipemia (increased opacity)
  • Hemolysis above 0.8% at expiry (correct)
  • Icterus (yellow-brown)

    • Under what condition does the shelf life of platelet components become four hours?

  • If the container is not gas-permeable
  • If stored at room temperature without agitation
  • If aliquots are not prepared using a sterile connection device (correct)
  • If transfusion is initiated within 7 days of collection

    • What is the acceptable identification for bacterial contamination in RBCs?

    <p>Excessive and unusual air bubbles and dark purple color</p> Signup and view all the answers

    What is the typical platelet count in pooled platelet components?

    <p>Over 300 x 10^9 platelets</p> Signup and view all the answers

    What is the maximum frequency for whole blood donation for females?

    <p>Every 84 days</p> Signup and view all the answers

    Which organization is responsible for managing Canada's blood system in Quebec?

    <p>Héma-Québec</p> Signup and view all the answers

    What is the standard minimum weight requirement for blood donors?

    <p>At least 110 lbs</p> Signup and view all the answers

    What is the purpose of questioning donors about medical conditions and behaviors?

    <p>To prevent health risks to donors and recipients</p> Signup and view all the answers

    What is the deferral duration for individuals who have received tattoos or piercings?

    <p>Three months</p> Signup and view all the answers

    What is the condition that can permanently disqualify a donor from donating blood?

    <p>Having taken money or drugs for sex since 1977</p> Signup and view all the answers

    What must female donors have at minimum in terms of hemoglobin levels?

    <p>125 g/L</p> Signup and view all the answers

    Which of the following is a restriction that is scheduled to be removed pending approval?

    <p>MSM prohibition</p> Signup and view all the answers

    How often can a donor give platelets through apheresis?

    <p>Every week</p> Signup and view all the answers

    What was the outcome of the Krever Inquiry published in 1997?

    <p>It implicated both the Canadian government and the Canadian Red Cross Society.</p> Signup and view all the answers

    Which of the following blood products were linked to the Tainted Blood Scandal?

    <p>RBCs, platelets, and plasma components.</p> Signup and view all the answers

    How many recipients of blood products in Canada contracted HIV due to the Tainted Blood Scandal?

    <p>2,000 recipients.</p> Signup and view all the answers

    What percentage of recipients infected with hepatitis during the scandal exceeds 30,000?

    <p>Approximately 70%.</p> Signup and view all the answers

    Which guide would one refer to for eligibility criteria for donating blood?

    <p>Donor Eligibility Guide and Questionnaire.</p> Signup and view all the answers

    Which organization was implicated in the Krever Inquiry aside from the Canadian government?

    <p>Canadian Red Cross Society.</p> Signup and view all the answers

    What significant health risks were reported among blood recipients during the 1980s?

    <p>HIV and hepatitis infections.</p> Signup and view all the answers

    What is the minimum hemoglobin concentration required for males to be eligible for blood donation?

    <p>130 g/L</p> Signup and view all the answers

    What method is used to disinfect a donor's skin prior to blood donation?

    <p>2% chlorhexidine gluconate and 70% isopropyl alcohol</p> Signup and view all the answers

    What is the primary purpose of routing the first few milliliters of blood into a diversion pouch?

    <p>To reduce contamination of the collection pack</p> Signup and view all the answers

    Which infectious disease is specifically tested for from June to November?

    <p>West Nile Virus</p> Signup and view all the answers

    What additional testing is performed if a donor, mother, or maternal grandmother has resided in Central/South America?

    <p>Trypanosoma cruzi testing for Chagas disease</p> Signup and view all the answers

    Why is Cytomegalovirus (CMV) testing performed on a subset of blood donors?

    <p>To create a small inventory of CMV-negative units for specific patients</p> Signup and view all the answers

    What type of testing is performed on platelet products 36 hours after collection?

    <p>Bacterial detection testing</p> Signup and view all the answers

    What risk do IgA deficient recipients face during transfusions?

    <p>Severe allergic reactions to donor IgA antibodies</p> Signup and view all the answers

    What does the term 'negative-to-date' indicate for platelet products?

    <p>Bacterial testing has been performed within 6 hours of collection</p> Signup and view all the answers

    What combined testing approaches are used for screening infectious diseases in blood donations?

    <p>Serological testing and confirmatory testing</p> Signup and view all the answers

    What is the main purpose of adding sodium citrate to whole blood collections?

    <p>To bind calcium and prevent coagulation</p> Signup and view all the answers

    Which method is NOT used by Canadian Blood Services for whole blood collection?

    <p>Platelet-rich plasma method</p> Signup and view all the answers

    What is the standard format label for manufactured blood components referred to?

    <p>End label</p> Signup and view all the answers

    Which of the following statements about Parvovirus B19 is TRUE?

    <p>It is tested in plasma donations for safety.</p> Signup and view all the answers

    What component is produced from a whole blood donation using the Buffy Coat (B1) method?

    <p>A packed red blood cell unit, a plasma unit, and a buffy coat</p> Signup and view all the answers

    What potential issue does leukoreduction address in blood transfusions?

    <p>Avoid febrile transfusion reactions</p> Signup and view all the answers

    What does intravenous immune globulin (IVIG) refer to in blood product manufacturing?

    <p>A fractionated plasma protein product</p> Signup and view all the answers

    Which anticoagulant is used in whole blood collections to allow safe storage?

    <p>CPD (Citrate, Phosphate, Dextrose)</p> Signup and view all the answers

    What is primarily filtered out during the leukoreduction process?

    <p>White blood cells</p> Signup and view all the answers

    What condition is known as fifth disease, associated with Parvovirus B19?

    <p>A viral rash illness</p> Signup and view all the answers

    Study Notes

    Canadian Blood Services: Blood Donor Products

    • Canadian Blood Services (CBS) provides RBCs, platelets, and plasma components.
    • Refer to the following resources for information:
      • Circular of Information: https://www.blood.ca/en/hospital-services/products/component-types/circular-information
      • Clinical Guide to Transfusion (Chapters 2 & 6): https://professionaleducation.blood.ca/en/transfusion/clinical-guide-transfusion
      • Visual Assessment Guide: https://professionaleducation.blood.ca/sites/default/files/VAG_en.pdf
      • Donor Eligibility Guide and Donor Questionnaire: https://www.blood.ca/en/blood/am-i-eligible-donate-blood/abcs-eligibility, https://www.blood.ca/en/blood/donating-blood/donor-questionnaire

    Tainted Blood Scandal and Krever Inquiry

    • In the 1980s, over 2,000 Canada blood recipients contracted HIV. Another 30,000 were infected with hepatitis.
    • Review the Krever Inquiry Report: https://youtu.be/QPIbwnWmkmk
    • The Krever Inquiry (1997) implicated both the Canadian government and the Canadian Red Cross Society.
    • New Health Canada regulations and organizations (Héma-Québec and Canadian Blood Services) replaced the Canadian Red Cross Society to oversee Canada's blood system.

    Donation Frequency

    • CBS donors are volunteers.
    • CBS accepts whole blood and apheresis donations.
    • Whole Blood:
      • Frequency: up to every 56 days (for males) and 84 days (for females).
      • Collection: 10-15 minutes, approximately 480 mL of blood.
    • Apheresis:
      • Frequency: up to every 14 days.
      • Process: returning RBCs to the donor while obtaining large volumes of plasma or platelet-rich plasma.

    Donor Eligibility Criteria

    • Donors are screened for medical conditions and behaviors that might pose a risk to themselves or recipients.
    • Refer to the eligibility guide for precise details: https://www.blood.ca/en/blood/am-i-eligible-donate-blood/abcs-eligibility
    • General Health:
      • Feeling well on the day of donation. No transmissible viral diseases, bacterial infections, or certain autoimmune conditions.
    • Age: Minimum 17 years old (18 in Quebec).
    • Height and Weight: Minimum weight requirements specified for different age groups.
    • Hemoglobin levels: Defined minimums for females and males.
    • Deferrals: Three-month deferral for tattoos, piercings, and men who have sex with men; permanent deferral for various reasons (e.g., intravenous drug use).
    • Travel Restrictions: Geographic deferrals based on risk of malaria or Zika, or residence in areas with vCJD outbreaks.

    Mandatory Donation Testing

    • Skin disinfection with 2% chlorhexidine gluconate and 70% isopropyl alcohol.
    • Initial blood samples are diverted to test for various transmissible diseases, including HIV, HBV, HCV, HTLV-I and II, WNV, and Syphilis.
    • Infectious disease screening and confirmatory testing using a combination of serological tests to detect antigens or corresponding antibodies.

    Additional Testing

    • Testing for various diseases such as Trypanosoma cruzi (Chagas disease), Cytomegalovirus (CMV), and West Nile Virus (WNV).
    • Testing on a subset of donors to maintain an inventory.
    • Conditions affecting fetal intrauterine transfusion are considered.

    Product-Specific Testing

    • Platelet products are tested for bacteria 36 hours after collection.
    • Aerobic and anaerobic culture is performed.
    • Platelets can be issued as "negative-to-date" as early as 6 hours after inoculation.
    • Certain plasma donations are pooled and further processed. (e.g., albumin, coagulation factors, immunoglobulins, and Parvovirus B19)

    Product Labelling Guidelines

    • All blood components have standard labels.
    • Information is barcoded for hospital inventory management.
    • ISBT 128 standard is followed in Canada.

    Whole Blood Products

    • Whole blood donations are collected in anticoagulants (CPD).
    • Sodium citrate prevents coagulation.
    • Citric acid slows down glycolysis.
    • Monobasic sodium phosphate maintains pH.
    • Dextrose is a source of sugar for cell metabolism.
    • Two collection methods (Buffy Coat and Whole Blood Filtration) separate whole blood into components (e.g., red blood cells, plasma, platelets).
    • Leukoreduction removes white blood cells to prevent potential immune reactions.

    Buffy Coat (B1) Method

    • Separation of whole blood into red blood cells (RBC) unit, plasma unit, and buffy coat.
    • Buffy coat is combined from multiple donors for pooling, and leukoreduction takes place.

    Whole Blood Filtration (B2) Method

    • Direct production of plasma and RBC units without separating a buffy coat.
    • Pooled platelets cannot be produced.
    • Plasma can be further processed. (e.g., frozen plasma, cryosupernatant plasma, cryoprecipitate.)

    Red Blood Cells

    • RBC units are stored at 1-6°C.
    • Shelf life is 42 days; with irradiation, it reduces down to 14 days.
    • RBCs may be frozen with glycerol. This extends storage to 10 years at -65°C.
    • Thawing and washing must occur before transfusion.

    Platelets

    • Typical platelet volume: over 300 mL; with over 300 x 10⁹ platelets.
    • Pooled platelets are from buffy coats of four whole blood donors (using CPD).
    • Apheresis platelets are from single apheresis donors (using ACD-A).
    • Platelet storage: 20-24°C under continuous agitation.
    • 7 days shelf life; 4 hours after breaching.

    Plasma - AFFP, FP/AFP, CSP and SD

    • Coagulation factors (V and VIII) are not stable for long periods under refrigeration and are stored frozen at –18°C.
    • Thawed plasma may be refrigerated at 1-6°C for up to 24 hours.
    • Fresh frozen plasma collection is collected by apheresis in 8 hours; or whole blood within 24 hours.
    • Different classifications for plasma (e.g., frozen plasma FP, apheresis fresh frozen plasma AFFP, cryosupernatant plasma CSP, solvent detergent plasma SD).
    • Usage and indications are separated based on the different plasma classifications.

    Cryoprecipitate

    • Cryoprecipitate is extracted from frozen plasma.
    • It is stored at -18 °C.
    • Shelf life is one year.
    • Used for fibrinogen replacement in various conditions.
    • It contains 285 mg of fibrinogen per 10 mL bag.
    • Cryo must be processed in a specific way (room temperature).

    Other Transfusions

    • Directed donations are collected by relatives.
    • Autologous transfusions are for patients donating blood before surgery later for their use.
    • Stem cell and bone marrow donors may be involved.

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    Blood Donors and Products Lecture 11 PDF

    Description

    Test your knowledge of the essential guidelines and conditions regarding blood donation and transfusion practices. This quiz covers topics such as donor eligibility, platelet component shelf life, and contamination protocols. Perfect for healthcare professionals and students in blood banking and transfusion medicine.

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