Transfusion Medicine for Pathologists

A Comprehensive Review for Board Preparation, Certification, and Clinical Practice

Brian Castillo,Amitava Dasgupta,Kimberly Klein,Hlaing Tint,Amer Wahed

• Éditeur: Elsevier
• Année: 2018
• ISBN:
  9780128143148
• Sujet: Sciences biologiques
• Sous-sujet: Biologie

Transfusion Medicine for Pathologists: A Comprehensive Review for Board Preparation, Certification, and Clinical Practice is a concise study guide designed to complement standard textbooks in the field of clinical pathology. Pathology residents and fellows of transfusion medicine will find this book useful as a preparation tool for their exams. In addition, the book is a valuable timesaver for busy residents looking for a focused and compact study guide on transfusion medicine that will also be ideal for practicing pathologists who cross-cover transfusion medicine in their clinical practice.

• Incorporates key words at the end of each chapter for quick review before an exam
• Includes concise and easy-to-digest chapters ranging from Donor Selection and Testing, to Blood Bank Testing, Transfusion Reactions, Apheresis, Hemotherapy, Special Transfusion Situations, and more
• Focuses on key topics to study for board examinations, saving time during busy residency programs

Chapter 1

Donor selection and testing

Abstract

This chapter covers criteria for accepting or rejecting a potential blood donor. A potential blood donor must have a good health and free from infectious disease. Even travel to countries outside the United States and Canada may make a donor ineligible for blood donation. Moreover, blood donors must not take certain medications in immediate past. Donors must be free from human immunodeficiency virus (HIV) and hepatitis infection. In order to ensure safety of blood products, after collection an aliquot of blood is also tested for the presence of certain infective agents including hepatitis and HIV. As a result, blood products used in the United States are very safe.

Keywords

bacterial infection

blood donor

hepatitis

HIV

medication

travel history

Introduction

The major purpose of donor selection is to provide safest possible blood products to the recipients as well as to protect the donor if there is any risk involved in donating blood or donor has a health condition which is not suitable for donating blood. The blood center aims to protect the recipient from infective organisms, exposure from potentially teratogenic agents, and theoretical risk of transmission of illnesses such as malignancy.

Over the last 20–25 years, considerable improvement in providing safe blood to recipients have taken place in the United States as well as many other countries [1]. As a result, posttransfusion infections are steadily declining worldwide. However, risk-free supply of blood products has not been achieved yet. A donor can donate:

• • One unit of whole blood
• • Two units of red blood cells (RBCs)
• • Platelets apheresis
• • Plasma apheresis
• • Granulocytes

The donated units are properly used for any suitable recipient. In addition, the donation may be autologous or directed. In autologous donation, a donor donates blood in advance for donor’s own use. These units are not subject to the same testing criteria as other donations and thus, if not used will be discarded. Directed donations are those donations made for a specific individual. Such blood products are subjected all testing and if not used may be made available for other patients.

Steps of Donor Selection

There are four major steps of donor selection:

1. 1. Donor screening by means of a medical history interview
2. 2. Reading of educational materials
3. 3. Undergoing a brief physical examination
4. 4. Laboratory testing

Medical History Interview

A full-length donor history questionnaire (DHQ) developed by the American Association of Blood Bank (AABB) and approved by the Food and Drug Administration (FDA) is used by many blood centers for screening donors. This questionnaire may be administered orally or can be self-administered. Follow-up questions will be asked by donor center staff as and when necessary. Highlights of various questions in DHQ are listed in Table 1.1. The FDA has also approved an abbreviated donor history questionnaire (aDHQ) for qualified frequent donors. This is because some questions in the uniform donor questionnaire (UDHQ) refers to events in the remote past and recent changes in medical, behavior, and travel information will be identified by the aDHQ. Highlights of various questions in aDHQ are listed in Table 1.2. Both questionnaires are readily available from the AABB website. Some centers have a computer-assisted self-interviewing process that utilizes audio, visual, and touch-screen components. The potential donor should be provided adequate privacy when self-answering the questions.

Table 1.1

Highlights of Uniform Donor Questionnaire (UDHQ)

Type of Question	Time Frame	Examples (answer to these questions should be “yes” or “no”)
General health	Current	Feeling healthy? Have a chance to read education materials related to blood donation?
Any recent infection	Current	Taking any antibiotic or being treated for infection?
Recent medication history	Past 2 days	Did you take aspirin or any product containing aspirin?
Long-term medication history	Past 2 days–forever	Taking ceratin medication may disqualify a person from blood donation. Please see Table 1.2
Activity in past weeks	Past 8 weeks	Did you donate blood, platelets or plasma? Did you receive any vaccination o...