DONOR SCREENING

Donor Screening
• Objectives
– State the governing agencies that regulate
immunohematology laboratories
– identify the minimum acceptable levels for the following
testing allogeneic donation
• Weight
• Temperature
• Pulse
• Hemoglobin
• Hematocrit
• Blood Pressure
 Donor Screening
• Objectives
– Describe and apply the standard set of criteria in
donor screening given various medical conditions
– Identify the different criteria for donor deferral
 Donor Screening
• Governing Law
– Republic Act No. 7719
– “National Blood Services Act of 1994”
• An Act Promoting Voluntary Blood Donation, Providing
for an Adequate Supply of Safe Blood, Regulating Blood
Banks, and Providing Penalties for Violation thereof
 Donor Screening
• Governing Program
– National Voluntary Blood Services Program (NVBSP)
– Objective:
• To provide adequate, safe, affordable and equitable
distribution of supply of blood and all blood products.
 Donor Screening
• Governing Agencies
– Department of Health (DOH)
– Philippine (National) Red Cross (PNRC)
– Philippine Blood Coordinating Council (PBBC)
– Hospital Blood Transfusion Committee (HBTC)

– American Association of Blood Banks (AABB)*

– Food and Drugs Administration (FDA)*
– College of American Pathologist (CAP)*
– Joint Commission on Accreditation of Healthcare
Organization (JCAHO)*
 Donor Screening
• Encompasses. . . .
– Medical history requirements for the donor
– (mini) Physical examination
– Serologic testing of the donor blood
 Donor Screening
• Purpose. . . .
– To ensure the blood supply is as safe as possible.
– To minimize the possibility of transmitting an
infectious agent from a unit of donated blood to
the recipient of that unit.
– To ensure the welfare of the donor himself.
 Donor Screening
Pre-Donation
• Process
– Education
– Filling-up self-administered donor and medical
declaration forms/Registration*
– Physical Examination
– ABO & Rh blood grouping (Slide)
– Interview
 Donor Screening
Pre-Donation
• Education
• Blood Collection Unit (BCU) shall provide necessary
leaflets, information sheets, brochures, and other
visual aids to assure the basic messages for donors
are consistently and effectively communicated.
 Donor Screening
Pre-Donation
• Education
– The following minimum information shall be given to the
donor:
• The importance of truthfulness in his medical and social
history
• The risks of the blood donation
• The steps that are going to be done and why
• Signs and symptoms associated with HIV and AIDS infection*
• Opportunity to decline from donation process if they believe
their blood is not safe or they are uncomfortable with the
procedure*
 Donor Screening
Pre-Donation
• Education
– The following minimum information shall be given to
the donor:
• The steps to be followed when test results are known.
• The uses of their blood donation
• Health care during and after donation, including
care of the venipuncture site.
• Post-donation follow-up
 Donor Screening
Pre-Donation

• Filling-up Donor Forms

– Includes:
• Name, complete address, home & office telephone
numbers
• Age, Sex, weight, occupation, and marital status
• Donor classification (new/repeat donor)
• Date of last donation
• Hemoglobin level, ABO group and Rh type
• Pulse rate*, BP*
 Donor Screening
Pre-Donation

• Physical Examination
– Assessed by an adequately trained physician
and/or qualified Blood Service Facility (BSF) staff.
 Donor Screening
Physical Examination

• Criteria/Parameters to be considered as
“Potential Blood Donor”
– Age - General Appearance
– Weight - Temperature
– Pulse Rate - Presence of skin lesions
– Blood Pressure
– Hemoglobin
 Donor Screening
Physical Examination
Parameter Criteria
Age Between 16-65 years old
(parental consent for ages under 18)
Weight For 500 ml blood unit, at least 50 kg
For 250 ml blood unit, at least 45 kg
Pulse Rate Regular rhythm, 50-100 beats/min.
Blood Pressure 90-160 mmHg systolic </= 180mmHg
60-100 mmHg diastolic </= 100 mmHg

Temperature 37.5 C or 99.5F

Hemoglobin At least 125 g/L (12.5g/dL)

Hematocrit 38%*
 Donor Screening
Physical Examination
• Criteria/Parameters to be considered as
“Potential Blood Donor”
- General Appearance
- Note: Observe for excessive anxiety, drug or
alcohol influence, or nervousness.

- Presence of skin lesions

- Note: Ex. multiple skin marks = indefinite deferral
- Ex. Poison Ivy or rashes = evaluation by physician
 Donor Screening
Physical Examination

• Criteria/Parameters to be considered as
“Potential Blood Donor”
– Weight
 Donor Screening
Physical Examination

• Note:
– Special Donors
• Donors older than 65 years old or younger than 16
years old
• Athletes with pulse rates slower than 50 beats per
minute
• Donors with hypertension or hypotension

• May donate depending on the additional assessment

of the physician!
 Donor Screening
Pre-donation
• Interview
– Donor must be assured that information
concerning his medical and social history shall be
treated as highly confidential and shall not be
discussed even with his relatives or friends.
Donor Screening
Pre-donation
Donor Screening
Pre-donation
 Donor Screening
Pre-donation

• List Deferrals
– Permanent Deferrals
– Temporary Deferrals
 Donor Screening
Pre-donation

• List Deferrals
– Permanent Deferrals
• Cancers
• Cardiac Diseases (Arrythmias, Chronic Heart Failure,
etc.)
• Severe lung diseases like complicated asthma with
bronchiectasis or atelectasis, etc.
• Viral Hepatitis or jaundice of unknown origin and other
severe liver diseases like cirrhosis
• Use of prohibited drugs (past or present)
 Donor Screening
Pre-donation

• List Deferrals
– Permanent Deferrals
• High risk sexual behavior or continuing exposure to
persons with hepatitis, HIV/AIDS and other sexually
transmitted diseases (STD) including inmates of mental
institution and prisons.
• High risk occupations (e.g. prostitution)
• Sexually transmitted disease (STD) (past or present)
 Donor Screening
Pre-donation

• List Deferrals
– Permanent Deferrals
• Prolonged bleeding
• Unexplained weight loss of more than 5 kg over 6
months
• Chronic alcoholism
• Autoimmune diseases like SLE, etc.
 Donor Screening
Pre-donation

• List Deferrals
 Donor Screening
Pre-donation

• List Deferrals
 Donor Screening
Pre-donation

• List Deferrals
 Donor Screening
Pre-donation

• List Deferrals
 Donor Screening
Pre-donation

• Interview
– Note:
• Epilepsy or other medical conditions not stated may be
allowed to donate provided the medical condition is
under control and the donor is asymptomatic.
 Donor Screening
Pre-donation

• Interview
– Note:
• Donors with occupations such as pilots, flight
stewardesses, drivers, and occupations needing
strenuous physical exertion, may donate provided they
refrain from work for at least 24 hours after donation.
 Donor Screening
Post-donation

• Post-Donation Donor Care

– Observe patient for 10-15 for any adverse
reactions
– Observe dressing on arm for at least 3 hours.
Bruising and discoloration is an expected
occurrence and will disappear after few days
– Do not smoke for the next 2 hours
– Avoid alcohol intake for the next 12 hours
– Eat regular meals and increase fluid intake
 Donor Screening
Post-donation

• Post-Donation Donor Care

– Avoid strenuous exercise for several hours
– Premenopausal women who donate 2-3 times a
year should be encouraged to take iron
supplements.
 Donor Screening
• Serologic Tests
– Malaria
– HbsAg
– Anti-HCV
– Anti-HIV
– Syphilis
 Blood Collection
• Aseptic Technique
– Iodine compounds such as PVP iodine or
polymeriodine complex or chlorhexidine gluconate
and isopropyl alcohol
– Use tourniquet or BP cuff (40-60 mmHg)
– Area is scrubbed at least 4 cm from site for
minimum of 30 seconds