Training program from Virginia Blood Services based on their policy and practices as well as patient demographics for the Central Shenandoah Valley in VA. The emphasis of Data on Harrisonburg, VA and Winchester, VA

1. SPECIALS 210
Therapeutic Donor Diagnoses
Hereditary Hemochromatosis and Secondary Polycythemia: Testosterone Donors
Instructor:
Christopher Bayonet, NRAEMT
Collections Supervisor - RMBC

2. “Crossover” Therapeutics are those donors who meet ALLOGENEIC Criteria, including Hemoglobin
Levels. These donors have diagnoses such as Hereditary Hemochromatosis and/or Secondary
Polycythemia: Testosterone.
 Like all Therapeutic Donors –
 There is NO CHARGE for Phlebotomy
 A Complete & Legible Prescription from the Donor’s Physician that is approved by Dr.
Sheppard (our Medical Director) is required for Phlebotomy
 Their Physician determines their frequency of donation, as well as their minimum hemoglobin
value (no lower than 11.0 g/dL).
 They are registered in BBCS like any other Therapeutic
(Donation Type: WB Special: THER Group: THER)
 You might need to override them when registering; taking care to note if the error code is
either a 4310 or a 4320.
 We will need an 040 Donor History Report printed for each donor to ensure they are not
overdonating.
When preparing their chart for their chart both prior to their presentation and after their donation –
ensure that it contains the following: Current Prescription Approved by Dr. Sheppard Prescription,
Current APPROPIATE Signed Consent Form, Copy of the DHF and their 040.
General “Crossover” Therapeutics

3.  If when registering you receive Error Code “4320” - You cannot override this error code,
they are not eligible for “Crossover” Donation and must be drawn as a Therapeutic ONLY in a
Nutricel Bag. If you feel this is in error, consult with your Collections Supervisor about
possible “Therapeutic Re-Entry.”
 If the donor does not meet ALLOGENEIC Criteria (including Hemoglobin levels and volume)
then they are not eligible for “Crossover” Donation and will need to be drawn as a
Therapeutic ONLY in a Nutricel Bag as per SOP 14-301 until they meet ALLOGENEIC Criteria
again. Please remember to defer them appropriately from Allogeneic Donation.
 When performing a “910” in BBCS for “Crossover” Therapeutic Donors we want to change
the code from WB to the appropriate code (i.e. WBH or TV), remove all Special codes and
change the group to the appropriate CDC (i.e. CHAR, AMCB, RMBC, WIN, etc…)
 Like all THERAPEUTIC Donors, “Crossover” donors will require a valid prescription in order to
be registered, screen and donate. If the prescription is not valid, we cannot even schedule
them for donations at that time.
“Crossover” Therapeutic Notes

4. “The Celtic Curse”
Dx: Hereditary Hemochromatosis

5. Hereditary Hemochromatosis
Hemochromatosis is an iron disorder in
which the body simply loads too much
iron. This action is genetic and the
excess iron, if left untreated, can
damage joints, organs, and eventually
be fatal.
Predominately you will find this in
those of Irish/Northern European
ancestry. In the US the prevalence can
be as great as 1 in 200 people will have
it; it is sometimes referred to as “The
Celtic Curse”
0
20
40
60
80
100
120
16-17 25-3550-65
Total
HHEM
Male
HHEM
Female
HHEM

6.  Consent Form PS005H – Therapeutic Donors Who Have Hemochromatosis
must be completed and updated once every year.
 You will most likely need to override the “4310” Error Code in BBCS when
performing the “910” function and change the donation type to WBH
(Whole Blood – Hemochromatosis)
 Take care to not attempt to override the “4320” Error Code in BBCS when
performing the “910” function, as these donors are not eligible for
“Crossover” Donation at today’s donation.
 On your DHF in Comments please make sure that there is noted “HHEM” for
all your Hereditary Hemochromatosis donors.
Hereditary Hemochromatosis Notes

7. Hereditary Hemochromatosis:
A History and Explanation
Some donors with Hereditary
Hemochromatosis, if left untreated,
will complain of:
• Joint & Abdominal Pain
• Weakness
• Fatigue
• Diabetes
• Heart & Liver Failure
This is due to a genetic mutation
that was “desirable” in certain
regions (Northern Europe).

8. Secondary Polycythemia due to
Testosterone Therapy
Dx: Secondary Polycythemia - Testosterone

9. Secondary Polycythemia - Testosterone
Secondary Polycythemia is caused by
either natural or artificial increases in
the production of erythropoietin,
hence an increased production of
erythrocytes. In secondary
polycythemia, 6 to 8 million and
occasionally 9 million erythrocytes
may occur per millimeter of blood.
Secondary polycythemia resolves
when the underlying cause is
treated.
This is specifically for those donors
who engage in Testosterone
Therapy.
0
5
10
15
20
25
30
35
40
16 to
17
25 to
35
50 to
65
Total
TSTV
Male
TSTV
Female
TSTV

10.  Consent Form PS031 – Informed Consent for Therapeutic Phlebotomy
Donation for Testosterone Therapy must be completed and updated once
every year.
 You will most likely need to override the “4310” Error Code in BBCS when
performing the “910” function and change the donation type to TV
(Testosterone Variance)
 Take care to not attempt to override the “4320” Error Code in BBCS when
performing the “910” function, as these donors are not eligible for
“Crossover” Donation at today’s donation.
 On your DHF in Comments please make sure that there is noted “TSTV” for
all Secondary Polycythemia: Testosterone donors.
Secondary Polycythemia – Testosterone Notes