PLT COLLEGE, INC.

Department of Medical Laboratory Science

Blood Banking
Second Semester SY 2020-2021

Course Topic

I. Introduction to Blood Banking and Transfusion Medicine

a. Significance of Blood Banking and Transfusion Medicine
b. History of Transfusion Medicine
II. Blood donation
a. Types of Donation
b. Sources of blood
c. Donor screening
III. Blood recipients
a. Indications and contraindications in giving blood/ components
IV. Blood components
a. Component preparation
b. Contents of blood components
V. Preparations prior to transfusion
a. Pretransfusion Compatibility Testing
VI. General guidelines during transfusion
VII. Importance of Transfusion Medicine
VIII. Roles of Medical Technologists in Transfusion Medicine

References:

Modern Blood Banking and Transfusion Practices by: Harmening

Henry’s Clinical Diagnosis and Management by Laboratory Methods
You can use other Blood Banking text books as references
Introduction to Blood Banking and Transfusion Medicine

Blood Banking- encompasses activities, procedures and tests done to ensure blood for transfusion is properly collected,
preserved, stored and dispensed for use in blood transfusion.

Transfusion Medicine- a multidisciplinary branch of medicine concerned with the transfusion of blood or its components,
including proper selection and utilization of blood/ components as well as removal of blood/ components in the treatment
or prevention of disease.

Food and Drug Administration (FDA)- governing body for blood bank inspections. Since blood is regulated both as
BIOLOGIC and as a DRUG, Blood Banks are inspected EVERY YEAR.

Significance of Blood Banking and Transfusion Medicine

Blood Banking is very important to ensure the safety of the blood donor, the blood recipient and the patient undergoing
therapeutic bleeding.

History and Milestones in the field of Blood Banking and Transfusion Medicine
1492- Pope Innocent VII was transfused blood from 3 human donors
1892- A woman suffering from postpartum haemorrhage was successfully transfused by James Blundell of England
1901- Karl Landsteiner discovered the ABO groups
- Descatello and Sturli defined the fourth Group AB
1941- techniques on Blood Transfusion and Blood Preservation during World War II was developed by Dr. Charles Drew
1943- the use of ACD (Acid Citrate Dextrose) as blood preservative was introduced by Loutit and Mollison of England.
1985- Dr. Yves Lapirre developed Gel test in Lyon, France

BLOOD DONATION
- Blood must be taken from donors who meet the standard sets of requirements to ensure that the recipient of
blood or its components benefit from the transfusion.

TYPES OF DONATION
1. ALLOGENEIC DONATION- blood is taken from an individual of the same species as the recipient.
- Allogeneic means genetically different individuals but of the same species.

2. AUTOLOGOUS DONATION- blood to be given to the recipient comes from the recipient himself or the blood donor and
the recipient is the same person.
- Autologous means self

3. APHERESIS- blood is withdrawn from the donor and separated into its components, one or more of the components are
retained and the remaining blood constituents are recombined and returned to the donor.

ALLOGENEIC DONATION
Donor Screening:
a. To assess if at the time of donation, an approximately 450mL of blood is harmful to the donor.
b. To assess if at the time of donation, the blood drawn from the donor could potentially transmit a disease(s) to the
recipient.

Donor Requirements:
1. Identification card for photographic identification.
2. Donor Registration Form or the Donor Interview Sheet- contains vital information and medical history of the donor
(full name, age, date of birth, sex, address, contact no.)
 3. Consent- must be signed by the donor giving permission to draw blood and perform required laboratory testing and
to give information to another laboratory for confirmation if donated blood is found reactive.

General Requirements for Donation

Philippine Standards
a. Good appearance- generally in good health condition
b. Age: 16-65 years old
16-17 years old: written consent from parent or guardian of blood donor
>65 years old: discretion of the blood bank physician
c. Weight: ≥50 kgs or 110 lbs
d. Temperature: not greater than 37.5ºC or 99.5ºF
e. Blood Pressure: Systolic BP of 90-160mmHg
Diastolic BP of 60-100
f. Pulse Rate: 60-100 bpm
g. Hemoglobin: male: 13.5– 18 g/dL
Female: 12.5-16.0 g/dL

AABB Standards
a. General appearance- appears healthy
b. Age: minimum 17 years old with a written consent from guardian
Elderly persons may donate at the discretion of the blood bank physician
c. Weight: ≥50 kgs or 110 lbs
d. Temperature: not greater than 37.5ºC or 99.5ºF
e. Hemoglobin: ≥12.5 g/dL
f. Hematocrit: ≥ 38%
g. Blood Pressure: Systolic BP of ≤180mmHg
Diastolic BP of ≤100mmHg
h. Pulse Rate (PR): 50-100 bpm
- If donor is an athlete with high exercise tolerance, a lower PR may be accepted.

COMPUTATION FOR BLOOD DONORS WEIGHING LESS THAN 50 KGS.:

Sample Problem:
Donor is 43 kgs.
How much anticoagulant (CPD) must be removed from the bag?

Formula:
1. Allowable amount of blood to be drawn (mL)= donor’s weight in lbs x 450mL
110 lbs
2. Amount of anticoagulant needed (mL)= allowable amount to be collected x 14
100
3. Amount of anticoagulant to be removed from the blood bag= 63mL – anticoagulant needed

Solution:
1. Convert lbs to kgs using the factor 2.2
43kgs x 2.2= 94.6lbs

2. Allowable amount of blood to be drawn from the donor (mL)= 94.6 lbs x 450mL = 387mL
110 lbs

3. Amount of anticoagulant needed for the donor (mL) = 387 mL x 14 = 54.18 mL

100
 4. Amount of anticoagulant to be removed from the blood bag (mL) = 63 mL – 54.18 = 8.82 mL

DONOR DEFERRAL GUIDELINES

Note: Please note that deferral guidelines can be updated anytime by the Department of Health

PERMANENT
1. Positive HBsAg
2. Repeat reactive test for anti-HBc on more than one occasion.
3. Clinical or laboratory evidence of HCV, HTLV or HIV infection
4. Previous donation associated with Hepatitis, HIV or HTLV transmission (Human T- cell leukemia virus)
5. Behavioral risk factors for HIV infection according to current FDA guidance
6. History of Babesiosis or Chaga’s disease
7. Parenteral drug use
8. Injectable non-prescription drugs
9. Risk of Variant Creutzfeldt–Jakob disease (vCJD-  a type of brain disease within the transmissible spongiform
encephalopathy family. Symptoms include psychiatric problems, behavioral changes and painful sensations)
according to current FDA guidelines
10. Donors who have taken Tegison or Etretinate (both given to psoriasis patients)
11. Donors who have had leukemia or lymphoma
12. Donors who are recipients of human- derived growth hormone

ONE- YEAR DEFERRAL

1. Mucous membrane exposure to blood
2. Non-sterile skin or needle penetration
3. Sexual contact with an individual with a confirmed positive test for HBsAg or viral hepatitis
4. Sexual contact with an HIV infected individual or at higher risk for HIV infection
5. Incarceration in a correctional institution for longer than 72 consecutive hours
6. History of syphilis or gonorrhoea
7. Rabies vaccination following a bite of a rabid animal.
8. Recipient of Hepatitis B Immune Globulin (HBIg)
9. Recipient of blood or tissue transplantation

ONE- MONTH DEFERRAL

1. Recipients of live attenuated for German measles (rubella) or chicken pox vaccine
2. Donors who have ingested Accutane or proscar (for benign prostatic hyperplasia (BPH) and male pattern hair
loss, also called androgenetic alopecia)

TWO- WEEK DEFERRAL

Recipients of live attenuated or bacterial vaccines (measles or rubeola, mumps, polio- oral, typhoid or yellow fever,
small pox vaccine)

NO DEFERRALS
- Recipients of toxoids or killed or synthetic viral, bacterial or rickettsial vaccines especially if donor is symptom- free
(vaccines for anthrax, cholera, diphtheria, influenza, parathyphoid, pertussis, plague, polio, Rocky Mountain
Spotted fever, tetanus, typhoid and typhus)
- A previous history of tuberculosis that has been successfully treated and is no longer active need not disqualify a
donor
- Recipients of recombinant type growth hormone

OTHER DEFERRALS
1. Previous donation
a. Pheresis donation- defer for 48 hours
b. Whole blood donation (Philippine standards) – 3 months, regular donors 2 months
2. Pregnancy – 6 weeks postpartum
 3. Malaria- confirmed diagnosis- defer for 3 years after becoming asymptomatic (no remission)
4. History of travel to or residing in an endemic are as defined by the Centers for Disease Control (CDC)- defer
according to FDA
5. Male donors who have taken up Dutasteride or AVODART (for benign prostatic hyperplasia and hair loss) deferred
for at least 6 months since the drug is teratogenic (causing malformations of an embryo or a fetus).
6. Soriatane deferred for 3 years. Soriatane is used to treat severe psoriasis in adults. This medicine is not a cure
for psoriasis, and may relapse after you stop taking this medication.
7. Donors who have taken aspirin and aspirin- containing compounds are deferred for 3 days
8. During donor screening, both arms must be examined for signs of repeated parenteral entry, especially multiple
needle puncture scars. Such evidence is reason for indefinite exclusion, since this may indicate IV drug use.

BLOOD COLLECTION PROCEDURES

1. Positive identification of the blood donor
2. Use aseptic technique: iodine and 70% isopropyl alcohol
3. Scrub site at least 4cm or 1.5 inches in all directions (from the site of puncture outwards) for 30sec.
4. Apply tourniquet or blood pressure cuff @ 40-60mmHg
5. Gauge number of needle used for bleeding is 16g
6. 20- degree angle: position of the blood drawing unit (needle)
7. Instruct the donor to open and close hand every 10-12 seconds during the collection procedure.
8. Mix the blood bag periodically every 30-45 seconds or 1-2 times per minute.
9. Volume of blood withdrawn is 450 mL ± 10% (or from 405 to 495 mL) mixed with 63 mL anticoagulant.
10. Blood is withdrawn over a 7-10 minute period.
11. Blood withdrawn more than 8 minutes in NOT suitable for platelet concentrate, fresh frozen plasma,
cryoprecipitate preparation.
12. A unit containing 450-495 mL should weigh 425 – 520 grams plus the weight of the container with its anticoagulant
13. A low- volume unit drawn without adjusting the volume of the anticoagulant MUST BE DISCARDED.
14. STRIP the tubing as completely as possible.
15. Store whole blood immediately after collection @ 1-6ºC.
16. Store whole blood unit @ room temperature (20-24 ºC) if to be processed to platelet concentrate
17. It has to be processed within 6-8 hours after collection.
18. Label and coding of blood bags, test tubes and forms properly.
COLOR CODING OF BLOOD BAGS
FDA 1985 RA 1517 (AN ACT REGULATING THE COLLECTION, PROCESSING AND SALE OF HUMAN
BLOOD, AND THE ESTABLISHMENT AND OPERATION OF BLOOD BANKS AND BLOOD
PROCESSING LABORATORIES) Approved: June 16, 1956
Blood Type Color Label Blood Type Color Label
A Yellow A Blue
B Pink B Yellow
AB White AB Pink
O Blue O White

Additional Color Labels (FDA 1985, optional)

Color Label Indication

Tan Hold for further testing
Green For autologous transfusion use only
Gray Not for transfusion
Orange For emergency use only
 Purple Irradiated
Red Biohazard
Chartreuse (precisely halfway From therapeutic phlebotomy
between green and yellow)