The document discusses the donation of blood, including the selection of blood donors, collection of blood, transportation and storage of blood, and preservative solutions. Key points include: - Blood donors must meet certain medical criteria to ensure the safety of the donor and recipient. Blood is collected following standard procedures and stored with anticoagulant preservatives at cold temperatures. - The cold chain system is used to safely transport and store blood and blood products by maintaining the correct temperature range. Blood products have specified storage times depending on their component and temperature. - Preservative solutions such as CPD and CPDA-1 are used to prevent clotting and maintain the biochemical balance of blood during storage.

1. CHPTER -EIGHT
The Donation of Blood
CH

2. 2
Content
 Selection of blood donors
 Collection of Blood
 The cold chain
 Transporting blood
 Storage of blood
 Preservative solution

3. 3
Learning objectives
At the end of this chapter, the student should be
able to:
 Discuss the medical and physical requirements
that would exclude an allogenic donor
 Describe the proper procedure for collecting
blood from donors.
 Name the commonly used anticoagulants for
donated blood and their respective approved
maximum storage time.
 Explain the possible donor reactions.

4. 4
Learning…
 Describe the cold chain and its use.
 Explain the different storage and transportation
temperatures of blood and blood products.
 Discuss the different preservative solutions and
the purpose of their components.

5. 5
8.1 Selection of blood donors
Aim
 to prepare safe blood from a safe donor to give
a recipient
 by identifying conditions which could harm both the
donor and the recipient

6. 6
8.1.1 Selection Criteria
Age
 Between 17 – 65 years
Hemoglobin
 Females -not less than 12.5 g/dl (PCV 38 %)
 Males -not less than 13.5 g/dl (PCV 41%)
 In both sexes Hgb above 19g% (Hct above 57%) are not
acceptable.

7. 7
Selection Criteria…
Pulse, Blood pressure and Temperature
 Pulse - between 60 – 100 per minute.
 B.P
 Systolic between 90 and 180 mmHg.
 Diastolic between 50 and 100 mmHg.
 Temperature should not exceed 370C.

8. 8
Selection Criteria…
Weight
 A person
 between 45-50 kgs can donate 350 ml of blood.
 above 50 kg can donate 450ml of blood.
 Obese donors who are unable to climb onto the
couch are not acceptable.
 Donors with unexplained weight loss of a
significant degree are not acceptable to donate.

9. 9
Selection Criteria…
Pregnancy
 Are excluded from donating for 1 year after the
conclusion of their pregnancy.
Medication
 Deferral of donors depends on the nature of the
disease for which the drug was ordered.
 Consult a medical doctor about a donor’s long
term treatment.

10. 10
Selection Criteria…
Illness
Prospective donors with:
 disease of the heart, liver, lungs, or
 history of cancer, or
 bleeding problems should be excluded, subject upon
evaluation by a physician.

11. 11
Selection (illness)…
 Donors who have had leukemia must never be
accepted.
 Donors with a previous history of tuberculosis
are acceptable after completion of therapy and if
the disease is no longer active.

12. 12
Selection…
Infectious diseases
 A donor must be free from transfusion
transmissible infections
 Recipients of blood or blood products known to
be possible sources of hepatitis and donors
having had close contact with an individual with
viral hepatitis must be deferred for 1 year.

13. 13
Selection (infectious)…
 who have a history of malaria, or were Persons
at high risk for acquiring or transmitting AIDS
should not donate blood.
 Donors previously resident in an endemic area,
should be deferred for 3 years after becoming
symptomatic or after leaving the endemic area.

14. 14
Selection…
Previous donation
 An interval of at least
 four months for men and
 six months for women, is required before the next
donation.
 The recipient can also donate a blood after 12 months
of recovery

15. 15
Selection…
Surgery
 If the surgery is minor (such as tooth extraction)
a donor is excluded until healing is complete and
full activity has been resumed.

16. 16
Selection…
Vaccinations
 Persons recently immunized with
 toxoids and
 killed viral, bacterial and rickettsial vaccines are
acceptable, if they are symptom free and not febrile.
 After small pox vaccination, a donor is
acceptable when the scab has fallen off, or 2
weeks after an immune reaction.

17. 17
Selection…
 A donor who has received an attenuated live
virus vaccine such as mumps or yellow fever is
deferred for 2 weeks after the last immunization..
 If rabies vaccination has been given following a
bite by a rabid animal, the donor must be
deferred for 1 year after the bite.

18. 18
8.2.Collection of Blood
Before blood collection Basic information about the
donor like
 date of donation
 full name,
 Address
 Sex
 age and
 the ABO and Rh blood group
 donor’s medical history, must be obtained and signed
by the phlebotomist who performs the procedure.

19. 19
Collection…
 Patient identification also is an important step in
blood collection.
 Blood collection should be carried out with the
blood donor lying on a simple bed with a support
for his head.
 The donor must not be left alone while donating
blood.

20. 20
8.2.1 Blood collecting bottles and bags
 A standard unit of blood contains 450 cc blood
and 63cc of preservative solution.
 If lesser amounts of blood is to be collected the
amount of the preservative should be reduced
proportionally.
 350 ml blood bag with 49 ml of anti coagulant.

21. 21
8.2.2. Preservative solution
 The common anticoagulant preservative
solutions are:-
 CPD (citrate, phosphate & dextrose)- For 21 days/at
2-80C
 CPDA- 1 (CPD with adenine)----For 35 days at 2-80C
 ACD (Acid Citrate Dextrose)------For 28 days /at
2-80C

22. 22
Method for blood collection
1. Identify the donor ,tell him to comfortably sit or
lie on the bleeding bed.
Bleeding bed/couch

23. Method for blood…
2. Apply a pressure cuff to the upper arm a few
inches above the elbow, and raise the
pressure to between 80 and 100mmHg.
3. And select a large deeply situate vein for the
vein puncture, usually near the bend of the
elbow.
4. Clean very well the required part of the arm with
cotton wool and 70% methylated spirits.
23

24. 24
Method for blood…
5. Make the vein puncture with the needle
directed up wards in the line of the vein. If
necessary secure the needle in place with a
small strip of adhesive tape.
6. When the blood begins to flow, reduce the
pressure of the cuff to 40-60 mmHg, and ask
the donor to squeeze a small object.

25. Method for blood…
7. When the blood has almost reached the 450
ml mark, reduce the pressure to zero and
remove the object from the donor’s hand.
8. Clamp off the tubing and remove the cuff.
25

26. 26
Method for blood…
9. Take the needle out of the vein, applying
pressure with cotton wool.
10. Ask the donor to bend his arm up wards, with
the cotton wool over the puncture wound.
11. Empty the blood in the tubing of the taking set
in to – a clean dry test tube
- for grouping and screening the blood.

27. 27
Method for blood…
12. Mix the blood well with the anti coagulant by
inverting the bottle at least four times, but not
shake it as this could damage the cells.
13. Seal the tops of the collecting and pilot bottle
with adhesive tape on which is written the
group and the bottle number.
14. Label the sample with- the blood group, the
bottle number and the date of collection.

28. 28
Method for blood…
15. Place a small pad of cotton wool and an
adhesive plaster on the donor’s arm as a
dressing, making sure that the bleeding has
stopped
16. See that the donor is given a rest and a drink,
perhaps of tea or orange juice, but not alcohol
to make up his fluid lose.
17. Thank the donor and give him a certificate of

29. 29
8.2.3.Danger in taking blood
 The greatest danger in taking blood is an air
embolism
 can be caused by the air out let needle becoming
blocked, either before or during the taking of blood.
 If the air out let is blocked, the following can
happen.
 The flow of blood can slow down and even stop
 The blood may move in the opposite direction,
returning to the arm

30. 30
Danger…
 Slowing down of the flow of blood can also be
occurred due to:
 A fall of the pressure cuff
 A bend in the tubing of the taking set
 The needle in the arm requiring adjusting

31. 31
8.2.4.Donor reactions
Include:
 syncope (fainting),
 weakness,
 excessive perspiration,
 dizziness,
 pallor, and nausea.
 Occasionally convulsions, loss of consciousness
or involuntary bowl or urinary passage.

32. 32
Donor reactions…
Note:
 At the first sign of the reaction, the phlebotomist
should stop the phlebotomy
 Preliminary measures taken when donor
reactions occur……

33. 33
Donor reactions…
Syncope
- Place the donor on his or her back and raise the feet
above the level of the bend.
- Loosen tight clothing, and ensure that the donor has
an adequate air way.
- Apply cold compress to the donor’s forehead or back
of the neck.
- Refer if the condition is not improved

34. 34
Donor reactions…
 Nausea
 instruct the donor to breath slowly and deeply,
 Have emergency basin and damp towel available in
case the donor vomits.
 Convulsions
 the convulsions are rare, when they occur help should
be summoned immediately.

35. 35
Donor reactions…
 Weakness, excessive perspiration, Dizziness,
pallor
 Apply cold compress to the donor’s forehead

36. 36
Donor reactions…
 Hematoma
 remove the tourniquet and the needle from the
donor’s arm ,
 place gauze and apply pressure for 7-10 minutes with
the donor’s arm held above the level of the heart.

37. 37
Donor reactions…
 Air-embolism
 this is very dangerous and always take care.
 If it happens, immediately call for help. Because, it
cause rapid fall of systolic blood pressure, death can
occur.

38. 38
8.3.The cold chain
 Is a system for storing and transporting blood
and blood products in a safe a way to maintain
all their function
 The two essential parts of the cold chain are:
 People to organize and manage the storage and
transportation of blood and blood products.
 Equipment to store and transport the blood and the
products safely.

39. 39
8.4 Transporting blood
 During transportation the temperature of:
 Red cell products must be kept between 2-80C
 Platelet products must be kept between 22-240C
 Frozen plasma in a frozen state at < -180C

40. 40
Transport…
 When blood is to be transported using cold
boxes for long distances in hot weather
 there should be as much ice as there is do blood and
 if above 100C it should be discarded.

41. 41
Transport…
 Containers for transporting red cell products
should be pre- cooled to 40C and,
 For transporting platelet should be kept open at
room temperature for 30 minute before use.

42. 42
Transport…
 When blood is collected outside the blood bank-
at a mobile session, cold boxes should again be
used.
 If possible a maximum and minimum thermometer
should be put inside the box without touching the ice
box.

43. 43
Transport…
 On arrival at the blood bank the blood must be
put into the refrigerator as soon as possible.
 Periodic temperature checks of received
components under all encountered weather
conditions should be performed & documented
to ensure shipping methods are adequate to
meet these criteria.

44. 44
Transport…
 Returned blood and blood products should not
be re- issued for transfusion if:
 the bag has been penetrated or entered
 there is leakage
 visual change or
 it has not been maintained continuously within the
approved temperature range.

45. 45
8.4.1 Transport within the blood bank or
hospital
 The blood should be issued in a cold box (80C) if
 the temperature inside the blood bank is greater than
250C or
 the blood will not be transfused immediately
 stored away from the main blood bank, such as in
operating theater or hospital wards
 The blood must be allowed to “warm” before
transfusion and this will take time.

46. 46
8.5 Storage of blood
Changes occurring in stored blood
Viability
 It is the capacity of the transfused cells to
survive in the recipient’s circulation after 24
hours
 Progressive loss of viability is the most
important change occurring in the RBC during
storage.
 the lower viability limit for successful transfusion.
 70% survival of transfused red cells after 24 hrs.

47. 47
Storage….
 Viability depends on preservative solution.
 Viability in CPD (which contain less citric acid than
ACD) appears to be lost as little more slowly.
 After 21 days of storage in
 CPD 79% of the cells were viable
 ACD 74%,
 After 28 days
 CPD 77%
 ACD 71%

48. 48
Storage…..
 The progressive loss of viability during storage is
related to:
 Depletion of ATP
 Depletion of 2-3 DPG
 Decrease in PH of the solution

49. 49
Storage….
 Changes taking place during liquid storage of
blood at 40C:-
 Bilirubin and potassium levels increase in weeks
 ATP, 2 3 – DPG, PH decrease in weeks
 Factors V,VII,VIII, VWF decreased in days
 Function of white cells and platelet Decrease in
hours.
 Factors I,II,VI,IX,X,XI,XII levels are not affected

50. 50
8.5.1 Importance of storage
 The purpose of storing blood is to:-
 Maintain viability and function of each relevant
constituent.
 To prevent physiological changes harmful to the
constituent.
 To minimize bacterial multiplication.

51. 51
8.5.2 Temperature and storage time for
blood products
 Whole blood, 2-80C for 21-42 days
 Packed cells up to 42 days at 2-80C
 Red cells frozen in glycerol -650c up to 10 years
 Fresh frozen plasma -180 C or lower for 1 year

52. 52
Temp. and storage time….
 Platelets 20-240C (Room temp) with rotation for
5 days.
 Before blood is issued, every pint must be
examined visually for hemolysis and any
abnormal discoloration

53. 53
8.6 Preservative solution
 The survival of blood cells depends during
storage on the delicate biochemical balance of
nutrients specially glucose, PH, and ATP.
 The preservatives contain citrate, phosphate,
Dextrose and Adenine
 The common anti coagulants are ACD, CPD and
CPD-1

54. 54
Preservative solution…
 The purpose of the solution during storage are:
 Citrate binds calcium and prevents clotting of the
blood
 Citric acid is added to the anticoagulant in order to
obtain a hydrogen ion concentration

55. 55
Preservative…..
 Dextrose is used by the red cells during storage and
each dextrose (glucose) gives 2 molecules of ATP.
 Adenine helps the red cells to synthesis new ATP.
Note: Low temperature slows glycolysis, and
reduce bacteria proliferation.

56. 56
Preservative…..
Other anticoagulants
 SAGM- contain saline, Adenine, Glucose,
Mannitol (it is RBC’ additive solution)
 CPDA-1- contains CPD+125% Glucose +0.25
mmol adenine
 CPDA-2 – contains CPD+ 175% Glucose + 0.25
mmol more adenine

57. 57
Review questions
1. List some clinical conditions that exclude a
donor
2. What are the steps in performing a
venipuncture?
3. Where is the most common venipuncture site?
4. List some potential hazards that occur during
or after blood donation.

58. 58
Review…
5. What it the transportation temperatures of red
cell products, platelet products and fresh
frozen plasma?
6. What are the different components of blood
preservative solutions and their use?
7. How does the viability of red cells can be
affected during storage

59. References
1.Immunohematology for medical laboratory
science students,Yayehyirad T. and Misganaw
B., Upgraded lecture note.2008
2.Basic and applied concepts of
Immunohematology, 2nd ed. Kathy D.Blaney
and Paula R.Howard,2009
3. Blood banking and transfusion medicine: basic
principles and practice. Christopher D.Hilliyer et
al., 2nd ed.2007.
4.Safe blood donations, Module 1 WHO.2002
59

60. References…
5.Screening for HIV and other infectious agents,
Module 2, WHO. 2002
6.Blood group serology. Module 3 WHO.2002
7.Guidelines and principles for safe blood
transfusion practice, Introductory module. WHO
2002.
8.Immunohematology: Principles and Practice
Quinley. 2nd ed.1998.
9.AABB Technical Manual .15th Edition.2005
60